Dear Ms. Larysa Ivshyna,
A new radiosurgery center, where brain tumors will be removed without trephination, is opening June 16 at 12.00 in Kyiv. The idea of a nationwide fund-raising campaign, Gamma Knife for Ukraine, emerged when Fakty published an article about a little Ukrainian girl who had a lethally dangerous brain vascular neoplasm removed in the Czech Republic by means of a device purchased for publicly-raised money. More than 10,000 Ukrainians need this kind of surgery.
Our colleagues from various publications, television channels, and radio stations came to support the campaign Fakty launched five years ago. Thousands of people have been sending all kinds of amounts – from but a couple to tens of thousands of hryvnias. When almost five million hryvnias came to the special account of the Kyiv-based Institute of Neurosurgery (never before had ordinary people of this country raised such a large amount of money!), the government of Ukraine allotted the remaining funds to purchase the equipment and build a radiological center.
While funds were being raised, the world saw a more sophisticated tumor removal device – a linear accelerator called Trilogy. So it was decided to buy Trilogy instead of the obsolescent gamma knife. Now the center is going to open at Kyiv’s Institute of Neurosurgery, and Ukrainians will be able to receive radio surgical aid free of charge.
We thank you for participating, together with us, in the nationwide fund-raising campaign.
June 16, 2010, was a red-letter day for doctors, especially those who deal with cancer-related pathologies. A new radiosurgery center was opened at the Institute of Neurosurgery (affiliated with the Academy of Medical Sciences of Ukraine), where heavy pathologies of the brain, as well as those of the spinal cord, will be treated without trephination. As the center was being launched, visitors (mostly Ukraine’s medical luminaries) were shown the most sophisticated (more advanced than the gamma knife) device to remove malignant tumors – the Trilogy linear accelerator, a cutting-edge development in the world radiation medicine.
The idea of raising funds to purchase a life-saving device (gamma knife at the time) belonged to Oleksandr Shvets, editor-in-chief of the newspaper Fakty, and other journalists of this publication. Five years ago they launched a fund-raising campaign which was supported by journalists of other publications, TV channels, the public, doctors, the Academy of Medical Sciences, and the authorities. Five million hryvnias is an unprecedented amount, especially when considering that they were raised by citizens and grassroots activists within as little as 18 months.
“Thousands of people sent us various amounts – five, ten, and tens of thousands of hryvnias,” Shvets says. “And these five or ten hryvnias, which were deposited onto a special account, may have been those people’s last money.”
The remaining 73 million came from the government. What is more, the installation itself was finished during the credit crunch (it would take hours to tell you about the obstacles and red tape…).
The Fakty editor found a common language with Prof. Zozulia, director of the Institute of Neurosurgery, who was the first, together with his colleagues, to speak about the need to have state-of-the-art equipment. Doctors are in turn grateful to Ukraine’s Academy of Medical Sciences and its President Oleksandr Vozianov for understanding and generous financial support.
“We had to spend a considerable part of the money allotted to the academy on this,” Vozianov said at the opening ceremony. “We have spent a staggering amount of money – perhaps a third of the total amount allotted to the academy which, incidentally, runs 36 institutes.”
The center is expected to treat about 1,500 patients free of charge, quickly (20 to 25 minutes), without trephination, painlessly, and “on the spot” (earlier, one had to go abroad, for example, to the Czech Republic). This is the approximate annual number of patients who need to undergo surgery. Indeed, Trilogy is a portentous event in Ukraine. It is of paramount importance considering that, according to the Ministry of Public Health, neurosurgery is the second biggest cause for Ukrainians to go abroad for medical treatment, the first place being brain transplants.
“Trilogy generates an intensely-modulated and very finely focused energy that is applied to the affected area only. In the case of tumors, it is very important that this energy should be isolated from other structures of the brain or the spinal cord, which should in no way suffer. The targeting precision is 0.5 mm. The process itself lasts 20-25 minutes at most, but it is more difficult to evaluate the target. Our task is to locate the target as precisely as possible and to decide on how to distribute the radiant energy. For this purpose, there is a device that immobilizes the head and the body,” Prof. Zozulia says.
What occurs under the action of Trilogy? Doctors say that it is not just the destruction of a tumor but “disintegration of the DNA in every pathology-affected cell.” Moreover, this cutting-edge device is applicable not only to cancer-type diseases but also to other heavy pathologies, such as brain dysfunctions that may cause stroke, epilepsy, Parkinson’s disease, etc.
“Radiosurgery differs from radiotherapy. Radiotherapy, especially in the case of serious lesions, presupposes fractionation, when it is necessary to determine the areas to be irradiated at intervals. This requires 40 to 45 sessions. Trilogy also allows therapeutic irradiation, but it provides for single-time radiosurgery.” Prof. Zozulia says.
The experts, who are already working though not yet treating patients, were trained at Moscow’s Institute of Neurosurgery, which also has a Trilogy, as do Sweden and Germany. Those being treated at the Institute of Neurology will be the radiosurgery center’s first patients. And a few words about the building which constructed rather quickly as a turnkey project. The construction had to be done under special conditions: the center was to fit the existing building and, what is more, to be built on a 45-degree slope. Doctors expressed special thanks to architects: the structure really fits in with the surrounding landscape. It was also necessary to relocate the old utility communications and to do drainage work. The crucial part is the reinforced-concrete cube which in fact houses the Trilogy. Nuclear physicists have calculated that the ferroconcrete walls should be 1.6 m to 3.6 m thick, while Ukrmed, which has experience in supplying and mounting specialized medical equipment, was in charge of installing the Trilogy itself and other state-of-the-art devices.
The radiosurgery center does not function so far, i.e., no surgery has been performed, because the management has not yet obtained a license to utilize this kind of equipment. To obtain it, this medical complex is to be approved by a Kyiv City Administration commission. Doctors hope that bureaucrats will not drag their feet with licensing documents and the long-awaited device will start working in early July.
