You will need to see the specialists at ARC before having any treatment so that they have an opportunity to adequately assess you and to discuss in detail the treatment you will receive.
If you have not been registered with the Alberta Radiosurgery Centre yet, please bring your Alberta Health Card (if you are a resident of Alberta), as well as demographic information. If you are already a registered patient with ARC, please bring a list of your current medications and their dosages.
Please see section on indications for treatment. All referrals should be made by a physician.
Not usually as this type of treatment is not indicated for these conditions. The mechanism of growth of gliomas is more diffuse and infiltrative therefore a sharp cut-off in radiation dose, as is the aim of SRS, would not treat the entire tumour. Conventional 3-D conformal radiotherapy is optimal management for gliomas.
No, but you may speak to your physician and he/she can provide internet-based rapid referral to the ARC program.
Waiting lists are determined by the medical indication for treatment. In general benign tumours are slowly growing and will be treated less rapidly than malignant tumours. Also in some specific cases, treatment is not required when a tumour is initially diagnosed and the ARC physicians will advise your referring physician to repeat imaging over time instead of treating it immediately, and only if a tumour shows growth to recommend treatment. Other cases may require special tests (e.g. audiometry) to determine which is the optimal method of treatment (fractionated or single fraction).
For these situations, the patient should contact the Medical Director of the program.
Treatment is either applied in a single session with a high dose of radiation, known as stereotactic radiosurgery (SRS), or in a series of treatments over a period of time, known as fractionated stereotactic radiotherapy (FSRT). Fractionated stereotactic radiotherapy involves a similar total dose of radiation as stereotactic radiosurgery, but the radiation is delivered in smaller amounts. According to the experimental biology of tissue response to radiation, fractionated stereotactic radiotherapy allows the healthy tissue to recover from the impact of the radiation before the next treatment session. Your doctors will recommend the technique most appropriate for you, depending on the size and location of your tumor. For fractionated treatments, a face mask is worn instead of the metal head frame. Each face mask is formed to perfectly fit onto each patient's head and unique facial shape.
Novalis' high energy radiation beams aim to destroy tumor cells by damaging the cells and causing them to die. Visible results, as seen on a follow-up MRI or CT scan, might include shrinkage of the tumor or the halt of further tumor growth. Because cell destruction and the absorption of the cells within your system is a long-lasting process, it can take up to six months before the effect of the treatment is visible on a follow-up imaging. In the case of vascular malformations this may take up to three years.
The intent of the procedure is to maximize the dose to the target volume while minimizing any dose to normal structures or tissues; thereby minimizing any risk to the rest of the brain. Your team of doctors will go over all possible side effects with you prior to the procedure.
Your physician will indicate to you whether or not this is appropriate. The issue of whether stereotactic radiosurgery should or should not be combined with whole brain irradiation remains highly debated, and is the subject of an ongoing clinical trial. The ARC physicians will speak to you about this clinical trial, if you are a candidate.
The procedure itself is not painful, although some patients state that they find the head frame that must be worn for radiosurgery of brain tumors to be slightly uncomfortable. The local anesthetic when initially injected into the scalp is also uncomfortable but goes numb within a few seconds. Side effects that you might experience immediately following treatment include headache, nausea and dizziness. Your doctor will discuss specific side effects with you as every location in the brain may have slightly different effects, which may occur depending on your overall treatment plan.
You do not need to bring special clothing or equipment to the centre for treatment with Novalis. You might want to dress comfortably and bring a book or something else to keep you busy during the waiting periods (when your specialists are doing the radiation planning). You should also bring a friend or a relative with you and he/she may stay with you during the day. However, during the actual treatment procedure, your companion will have to leave the treatment room. Please make sure to arrange for transportation home as driving is not recommended.