How to perform surgery from 1,000km away
In a rare tumour treatment procedure, a Port Elizabeth oncologist performed brain radiosurgery on a patient who was more than 1,000km away.
Dr Cathryn Walton, 42, performed the surgery from her Newton Park offices while the patient, who does not want to be named, was at the Milpark Hospital in Johannesburg.
In the gamma knife radiosurgery on October 30, Walton successfully treated the patient’s brain tumour.
Walton said the gamma knife radiosurgery allowed an oncologist to remotely plan and control the procedure through a laptop.
The gamma knife radiosurgery equipment was at the Milpark Hospital where the patient and the rest of the medical team were assembled.
“By planning and controlling the procedure remotely, we were able to minimise time and treatment costs,” she said.
Gamma knife is an advanced and highly precise radiosurgery that may be used in place of brain surgery.
It uses a single, high dose of gamma radiation delivered with the accuracy of less than one-tenth of a millimetre (the thickness of a sheet of paper).
It treats brain lesions with enough radiation to control them and can be used to treat targets even in the most critical, difficult-to-access areas of the brain.
“This treatment is groundbreaking because in certain cases it can eliminate the need for surgery – with the associated risk and lengthy recovery time, and the need for whole brain radiation – which affects the entire brain and can impair cognitive function later in life.
“This gives patients better outcomes and improved quality of life,” Walton said.
She became enthusiastic about this type of treatment and underwent gamma knife radiosurgery training in the US earlier in 2018.
She did a rigorous five-day course at the University of Pittsburgh, Pennsylvania, in September.
Then an opportunity arose to use the advanced treatment when a 59-year-old man was found to have lesions in his brain in October.
“The patient had previously undergone chemotherapy and understood the risks of whole brain radiation, so he was willing to undergo this new form of treatment – even though he was initially a little taken aback to learn that I would do the procedure from my rooms in Port Elizabeth,” Walton said.
The patient flew to Johannesburg and after an assessment and careful planning and quality assurance by teams in Johannesburg and Port Elizabeth, the procedure was carried out in less than an hour.
Nursing little more than a slight headache, the patient returned home the next day.
“It’s been very worthwhile learning to use the gamma knife system, and I’m very excited that we can now offer this treatment option to patients,” Walton said.
“The benefits for quality of life and overall survival of the patient are wonderful.
“This is the way medicine is moving, and I’m delighted to be part of this progress.”
Walton, a former Victoria Park High School pupil, is based at the Cancercare Oncology Centre in Newton Park.
Speaking about the gamma knife system, Walton said: “It cuts out the middleman.
“We [oncologists] do the processing from our offices, whereas in the past it would be six weeks in and out of hospital.
“In the long run, in comparison to surgery, the cost would be much less.
“The patient could literally fly out on Monday and come back on a Wednesday.
“This doesn’t replace brain surgery in any way, because it’s very tumour-specific.”
Asked how she felt about her first gamma knife radiosurgery, Walton admitted that she constantly called her patient to find out how he was.
“I was anxious the night before as well. I dreamt that I was failing an exam but the next day everything went well.
“Fortunately, he literally had [only] a little bit of a headache the next day.”
Walton is working on a plan for government patients that – if they meet the criteria – would help reduce the cost of surgery.
Her next gamma knife radiosurgery is due next week.