Sheryl Crow has a benign brain tumor called a meningioma, the 50-year-old musician revealed Tuesday.

CBS News reports Crow told an audience about her condition at a recent concert, and her representative Christine Wolff says there’s no reason for alarm and the singer is doing great and is healthy and happy.

On her Facebook page Tuesday, Crow wrote: “Hey everyone – please don’t worry about my ‘brain tumor’, it’s a non-cancerous growth. I know some folks can have problems with this kind of thing, but I want to assure everyone I’m OK.”

Meningiomas are the most common type of brain tumor found in Americans, accounting for 33 percent of all diagnosed brain tumors. But the tumor actually isn’t inside the brain but on it’s outer membrane that surrounds the brain and spinal cord, known as the meninges. Meningiomas are found more frequently in older women, according to the Mayo Clinic. About 90 percent of meningiomas are benign – in rare cases they can be malignant – but a meningioma depending on its location in the brain can cause problems.

Symptoms include changes in vision, headaches that worsen over time, hearing or memory loss, seizures and weakness in extremities. Other people may experience no symptoms at all.

Crow said in an interview with the Las Vegas Review-Journal that she was experiencing memory problems which prompted her trip to the doctor.

“I worried about my memory so much that I went and got an MRI. And I found out I have a brain tumor,” Crow told the paper.

Dr. Rick Madhok, a neurosurgeon at the Cushing Neuroscience Institute of the North Shore-LIJ Health System in Manhasset, N.Y., told HealthPop that people should not jump to conclusions that the tumor is causing the singer’s memory woes. He said since MRI and CT scans are so accessible these days, people experiencing any odd symptoms, such as memory loss, may get an MRI and then a doctor may find an unrelated meningioma on a different part of the brain.

“Memory problems can be caused by a number of different reasons, we are speculating at best to say this meningioma would cause [Crow's] memory problems,” he said.

As for causes, Madhok said the tumors typically appear at random. Some research suggests a genetic component that may make them more common among families, while other studies have found people who have had high-doses of radiation to the brain may have an elevated risk. Recent research tied frequent dental X-rays to a raised risk for meningiomas, HealthPop reported.

Madhok said that is one of three potential treatment options for meningiomas. Depending on the size and location of the tumor and whether the patient is experiencing symptoms, there’s also surgery that can remove the meningioma or something called stereotactic radiosurgery that is focused high-powered dose of radiation that targets a small area, and serves as an alternative to patients who don’t want surgery or aren’t good surgical candidates.

Crow previously was treated for breast cancer in 2006, but Madhok said that the two conditions were likely unrelated.

“I think we can say safely breast cancer is not a risk factor for meningiomas, and neither is the opposite true,” he said.

Crow told CNN that she doesn’t need surgery but will have periodic scans to monitor the growth.

Madhok says about 10,000 people are diagnosed with meningiomas each year, and estimates show about 2 to 4 percent of people have them when they are autopsied, suggesting many people may not even realize they have one.

That’s not a reason for concern or to get screened he said, but people experiencing symptoms should see a doctor to decide on a treatment plan. Some people might want it out immediately, while others are averse to surgery.

He says, “The important thing is to take the entire picture, the symptoms, the patient’s overall health, the meningioma itself – its size and location – and patient’s desires, to figure out with your health care provider what the best treatment is.”

 (La Jolla, CA, 11/21/2011)  In its continuing effort to offer the best in medical care to the San Diego community, San Diego Gamma Knife Center is pleased to announce the acquisition and installation of a state-of-the-art Gamma Knife^® Perfexion™. 

 “Perfexion has become the new gold standard for cranial radiosurgery, providing a level of accuracy and precision in the treatment of brain tumors, vascular malformations, and other brain disorders that is far superior to any other radiosurgery system,” explains Neurosurgery Medical Director Kenneth Ott, M.D., F.A.C.S. Perfexion also incorporates significant safety advances.  According to Radiation Oncology Medical Director David Hodgens, M.D., F.A.C.R., “The radiation dose to normal brain and to other parts of the body is far lower than any other radiosurgery system.”

 Gamma Knife is not a knife at all, and no incisions are made.  Its highly focused beams of gamma radiation offer the precision of surgery, without a scalpel and without the usual risks of surgery or an incision.

Non-Invasive Surgery

 Fueled by research and peer-reviewed published results, there is a groundswell of support for Gamma Knife radiosurgery.  Over 600,000 patients have been treated with the Gamma Knife worldwide. 

 Patients are attracted by its non-invasive nature, same day outpatient procedure and documented clinical results.  Following Gamma Knife radiosurgery, most patients resume normal activities within a day of treatment.

 Gamma Knife Perfexion delivers a single, high dose of ionizing radiation emanating from 192 cobalt-60 sources.  Gamma Knife surgeons guide the gamma irradiation to a target previously defined by advanced imaging techniques.  At this point, where all the beams simultaneously intersect, Perfexion dispenses a precise radiation dose to treat a target as intended by the physician.  Perfexion represents the latest advance by Elekta, the Gamma Knife manufacturer, in providing cutting edge tools for brain surgery.

 The alternative to treatment with Gamma Knife radiosurgery is traditional surgery, which involves certain risks and complications.  In many cases, it is impossible to surgically treat tumors that are deep-seated or situated close to critical parts of the brain such as the spinal cord or the visual and auditory cortexes.  Following traditional surgery, the patient must remain in the hospital’s intensive care unit for several days and in the neurosurgical department for a further 2-3 weeks.  The convalescence period may be several more months.

 About San Diego Gamma Knife Center

Having treated over 3,500 patients, San Diego Gamma Knife Center is an established center of excellence on the campus of Scripps Memorial Hospital La Jolla.  Since opening in 1994, the Center has been a leading radiosurgery resource for neurosurgeons and radiation oncologists throughout Southern California, Nevada and Arizona.  

 San Diego Gamma Knife Center is the region’s exclusive facility offering Gamma Knife radiosurgery for brain tumors and other brain abnormalities. U.S. News & World Report has named San Diego Gamma Knife Center’s Medical Directors, Kenneth Ott, M.D., and David Hodgens, M.D., as top honorees in their respective fields of neurosurgery and radiation oncology.

 For more information, please visit our website at www.sdgkc.com, or call

800-924-2662.

 # # #

]]> http://www.sdgkc.com/cell-phones-cancer-risk-a-fact-sheet-from-national-cancer-institute-what-do-you-think/feed/ 0 http://www.sdgkc.com/leksell-gamma-knife-administrators-meeting/ http://www.sdgkc.com/leksell-gamma-knife-administrators-meeting/#comments Thu, 23 Jun 2011 18:32:56 +0000 admin http://www.sdgkc.com/?p=745 Paul Loflin, Administrator, Beth Advani, Financial Coordinator, and I recently attended the North America Leksell Gamma Knife Administrators Meeting, sponsored by Elekta, held at the exquisite La Playa Beach & Golf Resort in Naples, Florida. The 4-day meeting provided a forum for the exchange of business and marketing strategies among Gamma Knife centers across the nation. Presentations included topics such as “Anatomy of a Gamma Knife Program for New Administrators”, “Healthcare Reform: How to Understand Upcoming Policy Effrects”, “Radiosurgery Today and Tomorrow”, “Utilization Trends: Current and Future Directions”, “Free and Low Cost Tools for Increasing Your Web Presence”, “Best Business Practices for Coding and Reimbursement”, “Marketing Your Program in a Competetive Landscape”, Case Studies: Focus on the Patient Experience”, and “Gamma Knife Radiosurgery: Current Status and Future Directions”. We appreciated the opportunity to participate in this exciting and educational event.

Lorrie Morris, Business Development Manager

Contact: Lorrie Morris                                            For Immediate Release

Tel. 800-924-2662

Cell Phone: 760-445-1740

Email: lorriemorris@sdgkc.com

SAN DIEGO GAMMA KNIFE CENTER TREATS 500^th PATIENT

AFFLICTED WITH TRIGEMINAL NEURALGIA

San Diego Gamma Knife Center has just treated its 500^th patient diagnosed with Trigeminal Neuralgia (or, Tic Douloureaux).  This extremely painful disorder of the facial nerve is infrequent, but the effects are devastating. Trigeminal Neuralgia originates from one or more branches of the trigeminal nerve that supply sensation to the face; and, is considered one of the most painful conditions known.  Sufferers complain of extreme electrical shock-like pains in the face.  Pain may be triggered by the slightest touch, so eating can be difficult or even impossible.

Among the surgical options for trigeminal neuralgia, Gamma Knife® Radiosurgery is the only non-invasive procedure which produces results comparable to open surgery. Gamma Knife produces an extremely focused center of radiation, fractions of an inch in size, which pinpoints the source of the pain with virtually no side effects. The treatment does not require hospital admission as patients return home just hours after treatment.  An additional benefit of Gamma Knife radiosurgery is that it avoids virtually all of the complications of invasive procedures.

Of the 500 patients treated was the mother of San Diego Gamma Knife Center’s physicist, Dr. Steven Goetsch.  Mrs. Goetsch suffered from trigeminal neuralgia for 16 years with little result from other treatments.  After Gamma Knife treatment in 1999, she spent the last 7 years of her life pain-free and off medications.  She expressed her gratitude to her son for allowing her to spend these years serving others while relieved of pain.

Diana, the sister-in-law of the Center’s Medical Director, Dr. Kenneth Ott, was unable to eat for weeks because of tic pain. She came to the Center from Nebraska for Gamma Knife Radiosurgery. She was unable to eat dinner the night before the non-invasive procedure. Her pain ended the afternoon of the procedure, and she enjoyed an excellent dinner that night (prepared by Dr. Ott) and she remains pain-free to date.

According to Dr. Ott, “Gamma Knife is valuable because it’s noninvasive. There’s no incision, no pain, no lengthy recovery, no hair loss or scarring, no general anesthesia, and a rapid return to normal activities.”

The 500 patients treated for trigeminal neuralgia during the past 15 years add to the more than 3,500 patients treated at the San Diego Gamma Knife Center for various problems, including benign and malignant brain tumors.  The Center has the most extensive radiosurgery experience for treating brain tumors in Southern California and one of the leading centers in the world for the treatment of trigeminal neuralgia.

San Diego Gamma Knife Center was opened as a Neurosurgical Center of Excellence in 1994; and, operates as part of the Neuroscience Department of Scripps Memorial Hospital La Jolla, and Scripps Cancer Center, Stevens Division, who provide diagnosis, treatment and support for a full range of neurological disorders.  More information may be obtained by visiting the website at www.sdgkc.com or calling 800-924-2662.

# # #

If you’d like more information about this topic, or to schedule an interview with Kenneth Ott, M.D., please call Lorrie Morris at 760-445-1740 or send an email to: lorriemorris@sdgkc.com

Response from Kenneth Ott, MD, and David Hodgens, MD

January 4, 2011
Editor
New York Times
Dear Sirs:

Thank you for the excellent article pointing out the risks associated with radiosurgery performed on equipment that is not dedicated to that purpose, and that is often a hybrid created with one company’s hardware driven by another company’s software, and then purchased by administrators that want to compete on the cheap.

As the Medical Directors of the San Diego Gamma Knife Center, the potential for exactly the type of complication described in the article is what compelled us, in 1994, to demand a treatment unit dedicated solely to brain radiosurgery, and we have operated a modern Gamma Knife Center in the San Diego area ever since, performing more than 3,000 procedures.

Radiosurgery is strong medicine.  We have seen it do wondrous good, but it has the potential to do life and limb threatening harm.  It is scalpel in the hands of some, or a dangerous, sharp knife in the hands of others.  As this technique has evolved outside the brain over the past twenty-five years, we have continued to advocate the use of dedicated equipment, and thus use a CyberKnife unit for extra-cranial radiosurgery.  With equipment, staff, and physicians dedicated to doing only one thing, the risk of human error, lapse of oversight, or incompatible computer technologies is either eliminated or greatly reduced, and the treatment is inherently safer, and in our opinion, more effective for the patient.

Your article illuminates a real problem in our field, and should push our colleagues in radiosurgery (before they are pushed by regulatory bodies) to have second thoughts about performing radiosurgery using what amount to modified, hybridized linear accelerators, and to consider doing what is ultimately best for patients—the utilization of dedicated radiosurgical devices like the Gamma Knife and CyberKnife.

Yours Sincerely,

Kenneth H. Ott M.D.      David W. Hodgens, M.D.

December 28, 2010

A Pinpoint Beam Strays Invisibly, Harming Instead of Healing

By WALT BOGDANICH and KRISTINA REBELO

The initial accident report offered few details, except to say that an unidentified hospital had administered radiation overdoses to three patients during identical medical procedures.

It was not until many months later that the full import of what had happened in the hospital last year began to surface in urgent nationwide warnings, which advised doctors to be extra vigilant when using a particular device that delivers high-intensity, pinpoint radiation to vulnerable parts of the body.

Marci Faber was one of the three patients. She had gone to Evanston Hospital in Illinois seeking treatment for pain emanating from a nerve deep inside her head. Today, she is in a nursing home, nearly comatose, unable to speak, eat or walk, leaving her husband to care for their three young daughters.

Two other patients were overdosed before the hospital realized that the device, a linear accelerator, had inexplicably allowed radiation to spill outside a heavy metal cone attachment that was supposed to channel the beam to a specific spot in the brain. One month later, the same accident happened at another hospital.

The treatment Ms. Faber received, stereotactic radiosurgery, or SRS, is one of the fastest-growing radiation therapies, a technological innovation designed to target tiny tumors and other anomalies affecting the brain or spinal cord, while minimizing damage to surrounding tissue.

Because the radiation is so concentrated and intense, accuracy is especially important. Yet, according to records and interviews, the SRS unit at Evanston lacked certain safety features, including those that might have prevented radiation from leaking outside the cone.

The mistakes in Evanston involve linear accelerators — commonly used for standard radiation therapy — that were redesigned by the manufacturer, Varian Medical Systems, so they could also perform SRS. As the devices became more versatile and complex, problems arose when vital electronic components could not communicate with one another.

In the last five years, SRS systems made by Varian and its frequent German partner, Brainlab, have figured in scores of errors and overdoses, The New York Times has found. Some mistakes were caused by operator error. In Missouri, for example, 76 patients were overradiated because a medical physicist did not realize that the smaller radiation beam used in radiosurgery had to be calibrated differently than the larger beam used for more traditional radiation therapy.

Medical physicists say there is nothing inherently wrong with linear accelerators that deliver general radiation therapy, as well as SRS. And, they say, the overdoses might have been caught had users followed a more rigorous system of checks and double-checks.

“Tens of thousands of patients have been treated with protocols properly followed and no mistakes were made,” said Dr. Frank J. Bova, a medical physicist in Gainesville, Fla., and a pioneer in developing and enhancing the accuracy of SRS. “It has changed many difficult procedures, ones with high surgical risk, into one-day outpatient procedures.”

But radiation safety experts say the retrofitted devices made up of different companies’ products present a special challenge.

Dr. Howard I. Amols, chief of clinical physics at Memorial Sloan-Kettering Cancer Center in New York, said some problems appeared to be “a combination of user error, coupled with neither the manufacturers nor the F.D.A. being able to anticipate a potential safety flaw in a ‘mix and match’ treatment delivery system.”

Dr. William David Bloomer, chairman of radiation medicine at Evanston Hospital, said the mistakes happened even though medical personnel there had followed the manufacturer’s instructions. “We rely on them to make sure the medical devices are safe,” he said.

Varian, the world’s leading manufacturer of linear accelerators, declined to be interviewed, but said in a statement that it has “deep concern” for accident victims and their families. “Our products include many built-in safety features, and we work continually to make them even safer,” Varian said.

Brainlab denied any role in the accidents.

The accidents highlight shortcomings in the regulation of medical radiation.

Despite their complexity, the multipurpose devices are less regulated than their more simply designed competitor, the Gamma Knife, a device engineered specifically for stereotactic radiosurgery.

Linear accelerators, which generate radiation without using radioactive material, are overseen by the Food and Drug Administration, while the Gamma Knife is regulated by the Nuclear Regulatory Commission because it uses a radioactive isotope. The nuclear commission has more authority to investigate and publicize radiation errors.

The F.D.A. approved the retrofitted linear accelerators with little review on the grounds that they were mere extensions of existing technology.

But since there is no requirement that all mistakes involving linear accelerators be reported to a central database, getting a handle on how often SRS errors occur is difficult. “Everybody says these are isolated incidents,” Dr. Bloomer said, “until you find out that maybe they are not so isolated.”

Seeking Respite From Pain

Before Marci Faber became a nursing home invalid at age 50, she had been leading a rich, full life. She loved musicals, country music and anything to do with her three daughters. When a mother was needed to oversee the sale of Girl Scout cookies, Ms. Faber was there.

“We go into a room and people really didn’t care so much about me — Marci was definitely the person that people gravitated to,” said Richard Faber, her husband. “She was gregarious, had a great smile. Her eyes light up the room.”

Last March, Ms. Faber sought treatment for trigeminal neuralgia, a non-life-threatening condition that produces facial pain. While Ms. Faber’s pain was intermittent, some cases become severe.

“It’s unimaginably bad and can drive some people to suicide,” said Dr. Daniel Yoshor, chief of neurosurgery at St. Luke’s Episcopal Hospital in Houston. “It’s an awful, awful thing and the cause of it is not very well understood.”

What is known is that the pain emanates from the tiny trigeminal nerve at the base of the brain. And stereotactic radiosurgery is one of the most effective methods of eliminating the source of the pain.

But treating trigeminal neuralgia “is probably the most technically demanding” form of radiosurgery, said Dr. Bova. “You are literally giving doses that are very, very high,” he said, “and the machine has to be able to deliver the dose to the trigeminal nerve and stay off the brain stem, which is immediately adjacent to it.”

Standard radiation therapy can involve dozens of treatments at lower doses, so one incorrect treatment might not cause much damage. But with SRS, there is often just a single potent dose requiring scalpel-like accuracy.

“It requires a little different mindset than when you are actually saying, I will give a little dose today, a little dose tomorrow and I will check it later,” Dr. Bova said. “This has to be checked the first time you do it because there is not a second day.”

For years, the Gamma Knife provided the necessary power and accuracy to accomplish its goal.

But many institutions could not afford it; the device costs upwards of $3 million and requires its own room, and treatments take longer. There is also the added difficulty of handling and replacing radioactive material.

“It doesn’t pay to have a Gamma Knife unless you have a large number of patients,” said Dr. Amols.

By using linear accelerators retrofitted with cone attachments, hospitals expanded their pool of patients without having to buy an extra unit.

Radiosurgery appeals to patients because it is an alternative to surgery and can be performed as an outpatient procedure, often in a single day. In recent years, the use of these small beam treatments has soared, as doctors have begun using them on parts of the body other than the brain and spine.

When Ms. Faber entered Evanston Hospital in March 2009, she had every reason to believe that her treatment would put an end to her pain. Indeed, when she left the hospital her trigeminal nerve was no longer an issue.

Little Problems Get Bigger

At first, Ms. Faber had no reason to be especially concerned. After her procedure, she experienced some vomiting, burning in her throat, and even a little weight loss. Swatches of hair began to fall out.

Still, the Fabers did not connect any of this to her radiation treatment.

But weeks later, as the hospital was on the verge of overradiating a fourth radiosurgery patient, its medical physicist caught the problem. He fixed it, and the patient received the correct dose.

But the hospital temporarily shut down its stereotactic radiosurgery program and began to investigate. What it found was deeply disturbing: three patients, including Ms. Faber, had been overradiated around the same time. All the victims were notified.

Evanston Hospital declined to discuss specific cases on privacy grounds, but a brief report sent to the F.D.A. in 2009 said one patient had been hospitalized three weeks after treatment with an irregular heartbeat, weakness, and changes in mental status; another was hospitalized for four days because of nausea, vomiting and dehydration; and the third, apparently Ms. Faber, was said to have experienced hair loss.

But about a year after her treatment, Mr. Faber said, his wife began losing her balance, falling occasionally and having memory problems. “I was sick to my stomach — scared,” he said.

Jordan Kagan, a family friend, said that when Ms. Faber attended his daughter’s bat mitzvah in April, she was mentally coherent but physically diminished.

Then, in what seemed like a blink of an eye, she disintegrated. “Four weeks later, she was like a vegetable,” Mr. Kagan said. “It was mind-boggling to see one person who was not elderly deteriorate that quickly.”

Now, she can only blink her eyes and lightly squeeze her husband’s hand. “It is very hard on the kids,” Mr. Faber said. “It has been hard on me but really nothing compared to what Marci is going through.”

Doctors who deal with her type of radiation injury say the prognosis for any meaningful recovery is poor.

At the hospital, officials had been scrambling to figure out what went wrong. While the software that drives the linear accelerator is complex, the mechanics of how the overdoses occurred is strikingly simple.

Linear accelerators can be adapted to perform stereotactic radiosurgery in two ways: with small computer-controlled metal leaves that shape the beam, or with a cone attached to the machine’s opening through which radiation is delivered. That opening is made smaller or larger by moving four heavy metal “jaws” that shape the beam into a square. When a cone attachment is used, the square beam must fit entirely within the circumference of the cone. If the square is slightly larger than the cone, radiation will leak out through the four corners of the jaws and irradiate healthy tissue. In the Evanston accidents, records show, the beam was four times too large.

Operators could not see this incorrect setting directly because a metal tray on which the cone is mounted hides the jaws, though the settings should have been displayed on a computer screen, according to people who have worked with this device. The mount also blocks a light field that could have shown where the radiation was to hit the patient.

But while the mount blocks light, it does not block radiation, which in the case of Ms. Faber and other Evanston patients went into healthy brain cells.

Determining that the jaws had been set wrong was the easy part. Then the hospital had to figure out how and why.

A Failure to Communicate

Precisely why the jaws were open so wide is still in dispute. There is no indication that the State of Illinois or the F.D.A. has investigated the accident. No lawsuits have been filed. And Varian has declined to answer questions.

But public records and interviews with doctors and others familiar with Varian’s equipment point to a complicated matrix of computer systems and communication flaws that made such an accident more likely to happen.

That system is supposed to work this way: A treatment plan is developed on one computer, then transferred into another software system that, among other things, verifies that the treatment plan matches the doctor’s prescription. The data is then sent to a third computer that controls the linear accelerator.

Several months after the Evanston accidents, Brainlab reminded customers to verify the correct jaw setting, specifically citing the possibility that treatment information could be altered as it passed “through a chain of devices.”

Evanston Hospital had earlier encountered its own communication glitches after upgrading Varian software in December 2008. As a result, medical personnel had to load patient information onto a USB flash drive and walk it from one computer to another.

Then, three months ago, concerned that radiation might leak outside the cone, Varian warned customers that its software did not recognize cone attachments on the type of linear accelerator involved in the Evanston accidents.

To work around that problem hospitals needed to, as one medical physicist put it, essentially trick the machine into thinking it was using a different attachment, which it did recognize. To do that, users had to enter additional data into the SRS system.

Similar communication problems affected three other Varian brands of linear accelerators.

“If you weren’t careful, you could give the wrong treatment,” said Dr. Subhash C. Sharma, chief physicist at Parkview Comprehensive Cancer Center in Fort Wayne, Ind.

Last year, Varian promised to devise, among other things, a decidedly low-tech solution: a decal to stick on the machines, warning operators to be extra careful in setting the radiation field.

Dr. Bloomer, the radiation oncologist at Evanston Hospital, said the manufacturer had not answered the hospital’s questions about why the overdoses occurred there. “We haven’t gotten an adequate response,” he said.

Dr. Amols, the Sloan Kettering physicist, said he believed several factors could have contributed to the accidents.

“Arguably, the physicist or radiation therapist should have noticed that there was a mismatch,” Dr. Amols said, “and arguably there should be stricter laws regulating the ‘mixing and matching’ of complex medical equipment from different manufacturers. But at present there’s no legal requirement for different companies to make equipment integration transparent to the end user — i.e., the hospitals.”

After the accidents at Evanston, Brainlab and Varian this year released a software fix that will restrict the jaw size, so similar accidents will not occur, said David Brett, a Brainlab official. So far, 75 percent of the affected machines have incorporated the fix, the company said.

Dozens Are Overradiated

While Evanston and its suppliers were dealing with the fallout of the overdose cases there, a different problem involving the retrofitted linear accelerators had been unfolding at CoxHealth, a hospital in Springfield, Mo.

Earlier this year, CoxHealth announced that it had overradiated 76 patients, most of whom had brain cancer, during SRS treatments. The overdoses had continued for five years because the hospital did not realize that its radiation therapy equipment had been set up incorrectly.

The hospital’s medical physicist, who was apparently accustomed to calibrating larger radiation beams, did not realize that smaller beams needed to be handled differently, radiation experts say.

A hospital spokesman said the physicist used the wrong calibration tool to set up the machine, causing the overdoses.

“They were supposed to have switched over to a smaller detector,” said Dr. Brad Bradshaw, a lawyer, who represents many of the overdosed patients. “The larger detector gave them a false reading.”

Terri Anderson, 54, was overradiated at Cox last year while undergoing SRS treatment for a benign tumor. After her treatments, she began experiencing facial spasms. “I started having 12 to 14 of those a day,” Ms. Anderson said. She says she also developed balance and memory problems.

Dr. Bradshaw, who represents Ms. Anderson, said parts of her brain had received overdoses ranging from 25 percent to 100 percent.

A similar calibration problem involving a Brainlab and Varian unit was discovered in April 2007 at a hospital in Toulouse, France, where overdoses — smaller than those in Missouri — had occurred for a year, affecting 145 patients. These SRS treatments used tiny metal leaves to shape the beam.

“There were strong similarities between what happened in Missouri and what happened in Toulouse,” said Dr. Ola Holmberg, who heads the radiation protection unit for patients at the International Atomic Energy Agency.

But without a requirement that accidents and near-misses be reported, other hospitals cannot learn from these mistakes, Dr. Holmberg said.

“There is no effective way now of sharing the information or learning in a systematic way,” Dr. Holmberg said. “If something happens, such as Evanston, I would have wanted to know about it at the time.”

That point was echoed by Dr. Benjamin Movsas, chairman of the department of radiation oncology at Henry Ford Health System in Detroit. “I was not able to find any information about Evanston,” Dr. Movsas said. “It’s frustrating. We didn’t know there was a problem.”

Earlier this year, the American Society for Radiation Oncology called for the establishment of the nation’s first central database for the reporting of errors involving linear accelerators. So far that hasn’t happened.

“The system does need to change,” Dr. Movsas said. “Reporting needs to be transparent and mandatory.” He added: “We need regulations — that has to happen. It’s better for me and it’s better for my patients.”

Reflections – 2

The title of this blog piece happens to be the title of a book by Robert (Bob) Aldersley from Canada.

Periodically, non-reference books and articles make their way to our Center.

They remind us of why we love healthcare and to never forget the human element.

Bob’s book chronicles his journey from diagnosis of a primary brain tumor to date.

We enjoyed this book and give it our highest recommendation.

Our endorsement comes from not the patient perspective but one man’s love of family, friends and life.

Heck, Bob even personalized our copy.

Our facilities function as a shared resource for the San Diego neurosurgical and radiation oncology community, and we receive patients from all over the United States and the world. Gamma Knife radiosurgery is one of the most cutting edge methods of treating brain disorders that avoids many of the dangers and discomforts of conventional surgery treatments.

Patients at the San Diego Gamma Knife Center benefit from effective radiosurgery treatments that involve no incisions, no need for general anesthesia and that do not result in any kind of hair loss or scarring. Over 20 years of studies have shown Gamma Knife radiosurgery to deliver superior outcomes with a high degree of safety and efficiency.

The team of experts working at the San Diego Gamma Knife Center comprises a broad range of medical professionals, including radiation oncologists, medical physicists, neurosurgeons and nurses, all of whom work together to provide our patients with careful, individualized care while they undergo treatment. Each case is reviewed closely, and a specialized treatment plan is developed for each individual patient by a multidisciplinary conference of experts.

Currently, Gamma Knife surgery is the only FDA approved method for the treatment of brain metastases, and is considered the “Gold Standard” of radiosurgery procedures. The cutting edge medical technology used at the San Diego Gamma Knife Center was designed by neurosurgeons and dedicated specifically to the treatment of brain disorders.

The success we have had since the San Diego Gamma Knife Center was established has been pleasantly unprecedented. Over 400,000 patients have been treated with Gamma Knife surgery since the procedure first came into use, and there has been zero mortality and minimal morbidity reported. Our goal is and has always been to maximize our patients’ comfort while providing an effective alternative to chemotherapy and conventional surgery.

Our tools are backed up by more than two decades of clinical research and their application in the treatment of brain disorders continues to grow. Here on our blog you’ll be able to read about some of the latest developments in the field as well as the ways in which the Gamma Knife procedure is continuing to help make neurosurgery safer and better.