title: Stereotactic radiosurgery: the patient's experience.
abstract: Stereotactic radiosurgery (SRS), a highly technical treatment for life-threatening brain tumors and vascular malformations, is provided at one site (Dunedin Hospital) for all New Zealand. The full-day procedure begins with the surgical attachment by bone screws of a metal helmet, followed by computerized tomography with or without angiography, and concludes with focused irradiation of the lesion. Previous SRS research has focused on therapeutic indications and outcomes; we report here patients' experiences of this procedure using both qualitative and quantitative methods. Participants (n = 12) uniformly described SRS as unusual and highly significant, a pivotal event shaping the future. For most, the procedure symbolized relief of symptoms, hope, reduction of risk, and recovery. Descriptions of the disruption produced by the onset of symptoms, diagnostic procedures and SRS, followed by a period of uncertain prognosis, also signaled experiences of liminality. Although patients experienced anxiolysis and described status changes following SRS, their lives are not returned to normal; they continue to inhabit a liminal state between health and normality on one hand, illness and disability on the other. Our findings indicate aspects of the experience of SRS for patients and their families that could assist in technically informing and emotionally supporting patients through this unusual treatment.
authors.affiliation: Department of Psychological Medicine, University of Wales, UK. d.menkes@bangor.ac.uk
authors.forename: David B
authors.initials: DB
authors.lastname: Menkes
authors.forename: Mary P
authors.initials: MP
authors.lastname: Davison
authors.forename: Shaun A
authors.initials: SA
authors.lastname: Costello
authors.forename: Chrystal
authors.initials: C
authors.lastname: Jaye
mesh_terms: D000293:Adolescent; D000368:Aged; D001165:Arteriovenous Malformations / Q000523:psychology* / Q000532:radiotherapy*; D001932:Brain Neoplasms / Q000523:psychology* / Q000532:radiotherapy*; D002648:Child; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D009520:New Zealand; D010358:Patient Participation; D017060:Patient Satisfaction; D011379:Prognosis; D016634:Radiosurgery / Q000523:psychology*