By Ken Sakamoto, Star-Bulletin
Mike Diffenderfer, one of the first two patients to undergo
a new treatment for brain tumors at St. Francis Hospital,
checked out of the hospital yesterday.

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Medical center
has new weapon
against brain tumors

St. Francis' Gamma Knife has already
brought relief to two cancer patients

By Helen Altonn
Star-Bulletin

Noted surfer and golfer Mike Diffenderfer returned to his Waimea Bay apartment planning to work on a balsa surfboard, or maybe even golf.

Vera Pettit of Mililani, a retired nurse, said a friend was picking her up and "I'm going to have fun."

The two checked out of St. Francis Medical Center yesterday after making history Tuesday as the first patients in the hospital's Gamma Knife Center of the Pacific.

Both said they felt great after radiosurgery for brain tumors.

The Gamma Knife actually isn't a knife. No cutting is done; no blood is shed; and no general anesthesia is used except for children.

It's a sphere-shaped device with a radiation unit. The patient lies on a couch with the head fixed immobile in a frame. The head then is placed within a helmet that looks like a kitchen colander with 201 pinholes.

Inside are 201 cobalt-60 radiation beams, said neurosurgeon Marcus F. Keep.

They converge in one lethal dose to attack a tumor or abnormal tissue identified by magnetic resonance imaging scanner, he explained. No normal tissue is affected, he said.

Keep said four screws, like sharp pencils, go into the skin and push it to the side.

Tips of the pins go into the outer part of the bone and hold the frame firm to the skull so it won't move around.

"At first people are quite concerned about the pins," he said. "But compared to opening the head up, once they realize the option, they're quite delighted."

Keep was one of five St. Francis doctors trained to use the Gamma Knife at Sweden's Karolinska Institute, where it was developed.

Others are Maurice Nicholson, medical director of the new Gamma Knife Center; Brent Murphy, medical physicist; and Lois Mastrofrancesca and Paul A. DeMare, radiation oncologists.

"This device . . . enables a neurosurgeon to put down his scalpel and pick up a computer mouse," said Paul Crowe, president of Neuro Technologies, International, in partnership with St. Francis for the Gamma Knife Center.

He said the development cost nearly $5 million.

Diffenderfer, 61, said he "didn't feel a thing" during the half-hour procedure.

He had undergone brain surgery twice and another type of procedure for recurring tumors -- once in Costa Rica and twice at Johns Hopkins Hospital.

The first tumor discovered in Costa Rica was nearly as big as a baseball, he said. "The pain was incredible."

The Surfing Hall of Fame member, who came here from La Jolla, Calif., in 1957 to "ride a big wave," said he named the (Banzai) Pipeline in about 1963, although he couldn't surf it because the boards were too big and heavy then.

He said he stopped surfing about four years ago when he began getting headaches and was left with four screws in his head after surgery. However, he still does custom board shaping.

Pettit, 70, said the Gamma Knife "is a miracle God sent....I went to bed last night and it was heavenly to go lie down with no spinning of the head and your ears ringing."

A former nurse at Shriners Hospital, Kuakini Hospital and Waimano Training School and Hospital, Pettit said she started having vertigo in May.

Her right eye and facial muscles also twitched; she had buzzing and ringing in her right ear, then lost her hearing.

Her condition worsened despite prescribed medication, and an MRI revealed a rare, benign acoustic tumor, she said.

She was referred to a Los Angeles doctor who called her and discussed a craniotomy, she said. "I said, 'No way, not for this old lady.'"

She would have had to be away about two months, she said, "and I have a dog at home. . . .I would have continued with yearly MRIs."

Pettit said she learned of Dr. Nicholson in a chance meeting with her orthopedic surgeon, "my guardian angel."

Keep said the ultraprecise Gamma Knife is good for very small tumors and those close to the optic nerve or critical brain structure.

He said the success rate depends on the type of case and disease, but it's about 90 percent for a simple metastatic tumor.

The Queen's Medical Center opened an X Knife Stereotactic RadioSurgery Center in May using similar technology to kill bigger tumors, Keep noted.