Dear CCAM Partners and Friends,

Today we met two of the physicians who will be involved in Buntheep's Gamma Knife procedure--the neurosurgeon Dr. Zeal and the radiation oncologist Dr. Deshmukh. Dr. James and Dr. Aldana will also be part of the team. However, the Gamma Knife schedule is booked up for the next two weeks. Please pray for an opening as soon as possible. Out of the limited options left to treat the tumor, the Gamma Knife seems to be the best.

With this procedure, radiation in the form of focused gamma rays is carefully aimed at the tumor, while caution is exercised not to damage nearby areas. However, because of the location of this tumor, there are serious risks to the temporal lobe of the brain (memory), the eyes, the ears, the pituitary gland, and important nerves like the one controlling swallowing. Please pray that God will give supernatural wisdom and skill to the doctors administering the radiation so that there will be no such damage.

Since there is no record of this type of tumor ever being radiated before, it is not even known how radiation will affect it, or how much radiation would be necessary to provide the desired effect. These doctors will be blazing a new trail. But we were glad to hear the radiation oncologist talk about being conservative. He said that it would be better to do the procedure again later if the dose was not strong enough, rather than to overdo the dose and cause irreparable damage to surrounding areas.

Adult patients of the Gamma Knife remain awake during the procedure. However, children are put to sleep throughout. An aluminum frame is screwed into the forehead and behind the head. This attaches to the vice that holds the head still during the procedure. Although Buntheep's recent skull X-ray does not indicate complete healing, the doctors said that the vice would be pulling the bones in the direction they are supposed to heal, so there should not be a problem.

After the frame is in place, MRI scans will be taken and coordinated through a computer to place markers on the face which serve as guides to aim the radiation. The exact amount of the radiation to be delivered to each location is carefully programmed in the computer ahead of time. Then the patient is moved into the chamber and the radiation is delivered. If there are multiple locations, the programming and delivery may need to be repeated several times. In depth studies of Buntheep's previous MRI scans have indicated that the tumor is growing back from three locations, instead of two!

Buntheep will be hospitalized at least overnight for observation. Side effects from the procedure might include bleeding when the screws are removed or subsequent infection. Buntheep will probably experience headaches and nausea for a while afterwards. However, because this radiation is so focused, her hair will probably not fall out. Please pray for protection from any serious side effects.

Of course, the same problem persists in this approach as it did in surgery--if even one cell is left alive, the tumor can, and probably will, grow back. So again, we are faced with a humanly impossible situation--how to get all of the tumor without damaging surrounding areas. But our God can do miracles, and has already done so many to bring Buntheep this far. Please continue to pray for the miraculous completion of her healing.

In His Hands,
Gioia and Buntheep

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