Stereotactic Radiosurgery (SRS)

Stereotactic radiosurgery uses tightly shaped radiation beams to treat a defined brain target without a surgical incision.

Despite its name, it is radiation treatment rather than an operation. High-detail imaging and a rigid treatment plan guide beams to the target while reducing radiation to surrounding brain tissue. Systems may use a frame or a close-fitting mask to keep the head in the same position.

You first have imaging for treatment planning. The team may use a mask or frame, then confirms the target and nearby sensitive structures. On treatment day, you lie on a couch while the machine delivers radiation from many angles; it does not enter the body.

A session can take time because positioning and safety checks must be exact. The clinical team watches from outside the room and you can communicate through an intercom. Some plans are given in one visit, while others are divided across several visits.

Short-term effects can include tiredness, headache, scalp tenderness, nausea or swelling around the treated area. Medicines may be used when swelling is a concern. The effects you experience depend on the target location and the surrounding brain structures.

Seek urgent medical help for a seizure, new weakness, loss of balance, confusion, a severe or rapidly worsening headache, or new problems with speech or vision. Your oncology team should also know about symptoms that develop after treatment, even if they seem mild at first.

SRS aims to control a particular target while avoiding an incision. Its role differs between conditions such as brain metastases, meningioma, acoustic neuroma and other brain tumours. The expected benefit is based on the diagnosis, number and position of targets, previous treatments and your wider health.

Follow-up MRI scans help the team assess the treated area, but early scan changes can reflect treatment-related inflammation as well as changes in the condition. Your specialists consider imaging alongside symptoms and examination findings.

SRS requires close coordination between radiation oncologists, medical physicists, radiographers and other specialists. It may be delivered using a Gamma Knife, CyberKnife or another dedicated linear-accelerator system.

SRS may be discussed when a target is well defined and its position allows focused radiation to be delivered safely. It can be one part of care for certain benign tumours, cancer that has spread to the brain, or selected primary brain tumours.

A multidisciplinary team considers target location, size, symptoms, surgery options, prior radiation and the overall treatment goal. Not every brain condition can be treated with SRS.

Follow instructions about eating, drinking and regular medicines, especially if you take medicines for seizures, diabetes or blood thinning. Tell the team about claustrophobia, pain when lying down or any new neurological symptom before positioning begins.

Staff fit the planned mask or frame, obtain images if needed, and begin delivery once checks are complete. You need to keep still, but the team can pause if you feel uncomfortable. After removal of the positioning device, they give you personalised aftercare instructions.

Many people go home on the same day. Rest if you feel tired and follow the centre's advice about driving, work and medicines. A sore spot can occur where a frame was used. The team arranges follow-up appointments and imaging to monitor the treated area.

Radiation can cause swelling or delayed changes in treated and nearby brain tissue. Risks vary by location and may include effects on vision, hearing, balance, movement, speech or memory. The team will explain the individual risks and any measures used to reduce them before treatment.

Depending on the condition, alternatives can include observation with scans, brain tumour surgery, whole brain radiotherapy, systemic treatment or symptom-directed medicines. A specialist team can explain how each option fits the purpose of treatment and the pattern of disease.

Choose a centre with a stereotactic radiation service and a brain tumour multidisciplinary team. Ask who will coordinate follow-up, whether a neurosurgeon is involved, and how to contact the service outside routine appointment times.