The Barbara Ann Karmanos Cancer Institute is the first cancer center in Michigan to acquire and treat patients with the new Leksell Gamma Knife® Icon™, the most precise stereotactic radiosurgery system available to patients. This advanced technology and the special space built to accommodate it is part of the recent renovations completed at Karmanos Cancer Institute's outpatient treatment facility in Farmington Hills, Mich. — the Lawrence and Idell Weisberg Cancer Treatment Center.
Karmanos neurosurgeons and radiation oncologists treated the first patient with the Leksell Gamma Knife® Icon™ in June and have, to date, treated 22 patients, each successfully. Karmanos specialists can treat up to three patients a day with this precision therapy.
“This specialized form of radiotherapy offers patients and physicians the most advanced technology for treating certain conditions, including metastatic brain tumors and benign conditions,” said Justin Klamerus, M.D., MMM, president of the Karmanos Cancer Hospital and Network, and associate professor of Oncology for the Wayne State University School of Medicine. “We are excited to be the first in Michigan to offer patients this innovative treatment in an environment that optimizes the patient’s experience.”
The device is a clinically-proven radiosurgical method to treat select intracranial locations, such as the brain, brain stem or the trigeminal nerve. Gamma Knife does not involve a blade. Instead, this highly sophisticated non-invasive technology uses radiation beams to precisely target the tumor, sparing healthy brain and body tissue. Preserving tissue helps maintain normal function that can impact the patient's quality of life.
During an Icon™ treatment, up to 192 radiation beams are precisely directed to one or several intracranial lesions, so that the targeted tissue receives a concentrated dose of radiation. The source of radiation is cobalt, and the shape and dose of the radiation is optimized to focus on the exact location without damaging healthy tissue or other parts of the body.
Once the patient is in position, magnetic resonance imaging scans identify the exact location of the tumor in three dimensions, enabling neurosurgeons and radiation oncologists to direct the radiation beams to the target with unmatched precision. The actual treatment time can last from 30 minutes to two hours, depending on the tumor and target volume. Patients can listen to music during the procedure and the physician communicates to the patient via intercom.
Patients are monitored closely and evaluated over time, returning for periodic follow-up imaging to review the results of treatment and to address any side effects.
Michael Dominello, D.O., medical director for Gamma Knife Radiosurgery at Karmanos Cancer Institute and assistant professor of Oncology at the Wayne State University School of Medicine, has seen first-hand the benefit this innovative technology has on patients.
“One of the unique features of offering this precise Icon™ at our Farmington Hills location is that patients can receive this treatment in our beautiful and comfortable outpatient center instead of in a hospital setting,” Dr. Dominello said. “From an expertise standpoint, the radiation oncologist, neurosurgeon and neuroradiologist are all onsite, participating together as a team in the planning and reviewing of the final treatment plan prior to the patient’s treatment delivery. This is an uncommon practice but one that significantly enhances plan quality.”
Most Gamma Knife facilities are located in the basements of large hospitals, as was the case with the Gamma Knife that Karmanos previously had at its main campus in Detroit.
“The Leksell Gamma Knife® Icon™ allows us to treat brain tumors with precision accuracy using a frame-based or frameless immobilization system. The entire process, including MRI and PET (positron emission tomography) imaging services, happens under one roof in an intimate setting,” Dr. Dominello said. “Patients don't need to be transported to different locations within a hospital setting. Our Gamma Knife suite was designed to offer patients the expertise, comfort and convenience, all in one location.”
Icon™ can be used to treat targets in the brain ranging from a few millimeters to several centimeters – including in areas of the brain that cannot be accessed with traditional surgery or are situated close to or inside critical areas, including brain stem, visual cortex and motor cortex. The non-invasive technique can be used as a standalone treatment for a variety of brain tumors and neurologic disorders, or as a “boost” following whole-brain radiation therapy or surgical resection to decrease the risk of recurrence.
Unlike conventional radiation therapy, which is delivered during the course of many treatment “fractions,” Gamma Knife treatment is typically delivered in a single fraction. This treatment not only helps spare healthy brain tissue, it eliminates some of the side effects associated with more traditional therapies.
Dr. Dominello said patients go home following completion of the procedure and can generally resume normal activities the next day.
Karmanos' Lawrence and Idell Weisberg Cancer Treatment Center in Farmington Hills opened in 2001 with the purpose of making the state-of-the-science cancer services of the Barbara Ann Karmanos Cancer Institute in Detroit – one of the National Cancer Institute-designated Comprehensive Cancer Centers in the country – more easily accessible to residents of Oakland County.
“Our dedicated and compassionate staff working in the 17,700-square-foot facility’s home-like setting made a comfortable healing place for patients,” Dr. Klamerus said. “That same cancer expertise and warm atmosphere continues today.
"As our patient counts and services grew through the years, we realized that we needed to accommodate the continual growth, both in our clinics and with Karmanos’ integrative services, to continue to provide the most advanced technology and array of clinic and complementary services our patients and their families deserve.”
Karmanos' Weisberg Center's clinic visits increased by more than 30 percent from fiscal years 2015 to 2018. Since the Leah A. Davidson Healing Arts program launched seven years ago, offering art and music therapy, gentle yoga, Tai Chi, Reiki therapy, Mindfulness Stress Reduction, and more, Karmanos has seen a 60 percent jump in demand for these services. In addition, those impacted by cancer have participated in an average of 3,000 visits to support groups annually. Many of the complementary services are offered at no cost and are open to all cancer patients, even those treated elsewhere.
Building the $16 million state-of-the-art Gamma Knife suite with adjoining PET and MRI area, and clinic rooms, is the first in a two-phase expansion project that started in mid-2018 and was recently completed.
The Phase II expansion is underway and is expected to be completed in 2022. This will include an additional $30 million investment to expand the facility to approximately 64,000 square feet. The expansion will enhance clinic and infusion areas, radiation, radiology and imaging services, pharmacy and laboratory, as well as complementary services, to accommodate the continual growth of patient services – both in clinic and with Karmanos’ supportive services at its Farmington Hills location. The total project is being financed with internal funds and philanthropy.
Dr. Klamerus added, “We realize patients have options when it comes to their health care needs. That’s why at Karmanos our comprehensive cancer center team is committed to offering the most advanced cancer care, research, education, and integrative and supportive services to our patients, as well as their loved ones.”