How to perform brain surgery without making a single cut - Hyunsoo Joshua No

Translator: Paola Costa Reviewer: Servizo de Normalización Lingüística

Every year, tens of thousands of people world-wide have brain surgery

Cada ano, decenas de miles de persoas do mundo sométense a cirurxías cerebrais

without a single incision:

sen sufriren incisión ningunha:

there’s no scalpel, no operating table, and the patient loses no blood.

non hai bisturí nin mesa de operacións e o paciente non perde sangue.

Instead, this procedure takes place in a shielded room

Pola contra, este procedemento ten lugar nun cuarto blindado

with a large machine that emits invisible beams of light

cunha gran máquina que emite raios de luz invisibles

at a precise target inside the brain.

cara a un obxectivo concreto dentro do cerebro.

This treatment is called stereotactic radiosurgery,

Este tratamento chámase radiocirurxía estereotáctica

and those light beams are beams of radiation:

e eses raios de luz son raios de radiación

their task is to destroy tumors by gradually scrubbing away malignant cells.

cuxo obxectivo é destruír tumores eliminando aos poucos as células malignas.

For patients, the process begins with a CT-scan,

Para os pacientes, o proceso comeza cunha tomografía computadorizada,

a series of x-rays that produce a three-dimensional map of the head.

que emite unha serie de raios x que xeran un mapa tridimensional da cabeza.

This reveals the precise location, size, and shape of the tumor within.

Isto amosa con exactitude a situación, tamaño e forma do tumor.

The CT-scans also help to calculate something called "Hounsfield Units,"

A tomografía computadorizada úsase tamén para calcular as “unidades Hounsfield”,

which show the densities of different tissues.

que amosan as densidades dos diferentes tecidos

This offers information about how radiation

e ofrecen información sobre a propagación

will propagate through the brain, to better optimize its effects.

da radiación polo cerebro para optimizar os seus efectos.

Doctors might also use magnetic resonance imaging, or MRI’s,

Hai médicos que tamén empregan resonancias magnéticas

that produce finer images of soft tissue,

que realizan imaxes máis precisas dos tecidos brandos

to assist in better outlining a tumor’s shape and location.

para definiren mellor a situación e forma do tumor.

Mapping its precise position and size is crucial

Delimitar a posición e o tamaño exactos é esencial

because of the high doses of radiation needed to treat tumors.

polas altas doses de radiación necesarias para tratar os tumores.

Radiosurgery depends on the use of multiple beams.

A radiocirurxía depende do uso de moitos feixes de luz.

Individually, each delivers a low dose of radiation.

Por separado, cada un deles emite unha dose baixa de radiación, mais,

But, like several stage lights converging on the same point

igual que cando as luces dun escenario converxen nun mesmo punto

to create a bright and inescapable spotlight, when combined,

para crearen un claro e inevitable foco, cando se conxugan

the rays of radiation collectively produce enough power to destroy tumors.

varios raios de radiación producen enerxía abondo para destruír tumores.

In addition to enabling doctors to target tumors in the brain

Ademais de permitir que os médicos distingan os tumores cerebrais

while leaving the surrounding healthy tissue relatively unharmed,

e deixen o tecido san de arredor relativamente ileso,

the use of multiple beams also gives doctors flexibility.

o uso dos feixes de luz tamén lles ofrece flexibilidade.

They can optimize the best angles and routes through brain tissue

Poden optimizar os mellores ángulos e as rutas no tecido cerebral

to reach the target and adjust the intensity within each beam

para alcanzar o obxectivo e axustar a intensidade en cada feixe

as necessary.

segundo se precise.

This helps spare critical structures within the brain.

Isto axuda a preservar as estruturas fundamentais do cerebro.

But what exactly does this ingenious approach do to the tumors in question?

Mais que lles fai exactamente esta achega innovadora a estes tumores?

When several beams of radiation intersect to strike a mass of cancerous cells,

Cando os feixes de radiación se cruzan e atacan unha masa de células cancerosas,

their combined force essentially shears the cells’ DNA,

a súa forza unida destrúe, basicamente, as células de ADN

causing a breakdown in the cells’ structure.

e causa unha fractura na estrutura celular.

Over time, this process cascades into destroying the whole tumor.

Co tempo, este proceso acaba por destruír o tumor enteiro.

Indirectly, the rays also damage the area immediately surrounding the DNA,

Os raios tamén danan, de xeito indirecto, a área que rodea o ADN

creating unstable particles called free radicals.

e crean partículas inestables coñecidas como radicais libres.

This generates a hazardous microenvironment

Isto crea un microecosistema perigoso e hostil para o tumor

that’s inhospitable to the tumor,

as well as some healthy cells in the immediate vicinity.

e para algunhas células sas derredor.

The risk of harming non-cancerous tissue is reduced

O risco de danar tecido non canceroso redúcese

by keeping the radiation beam coverage

se se delimita a radiación todo o posible

as close to the exact shape of the tumor as possible.

á forma exacta do tumor.

Once radiosurgery treatment has destroyed the tumor’s cells,

Unha vez que o tratamento de radiocirurxía destrúe as células do tumor,

é o momento do mecanismo natural de limpeza do organismo.

the body’s natural cleaning mechanism kicks in.

The immune system rapidly sweeps up the husks of dead cells

O sistema inmunitario varre rapidamente os restos de células mortas

to flush them out of the body, while other cells transform into scar tissue.

para expulsalos do corpo, e outras células transfórmanse en tecido cicatrizal.

Despite its innovations, radiosurgery isn’t always the primary choice

Malia os avances, a radiocirurxía non sempre é a primeira opción

for all brain cancer treatments.

para os tratamentos de cáncer cerebral.

For starters, it’s typically reserved for smaller tumors.

Para empezar, adóitase reservar para tumores máis pequenos.

Radiation also has a cumulative effect,

Alén disto, a radiación ten un efecto acumulativo,

meaning that earlier doses can overlap with those delivered later on.

o que supón que ás veces se poidan solapar as doses previas coas posteriores.

So patients with recurrent tumors

Por iso, os pacientes con tumores recorrentes

may have limitations with future radiosurgery treatments.

poden ter limitacións para recibiren tratamentos de radiocirurxía futuros.

But these disadvantages weigh up against some much larger benefits.

Porén, os beneficios son maiores que os prexuízos.

For several types of brain tumors,

En varios tipos de tumores cerebrais,

radiosurgery can be as successful as traditional brain surgery

a radiocirurxía pode ter o mesmo éxito que a cirurxía cerebral tradicional

at destroying cancerous cells.

na destrución de células cancerosas.

In tumors called meningiomas, recurrence is found to be equal, or lower,

Nos tumores coñecidos como meninxiomas, a recorrencia é igual ou menor

when the patient undergoes radiosurgery.

cando o paciente se somete a radiocirurxía.

And compared to traditional surgery—

En comparación coa cirurxía tradicional,

often a painful experience with a long recovery period—

que adoita ser dolorosa e ter un largo período de recuperación,

radiosurgery is generally pain-free,

a radiocirurxía é, en xeral, indolora

and often requires little to no recovery time.

e require pouca ou incluso ningunha recuperación.

Brain tumors aren’t the only target for this type of treatment:

Os tumores cerebrais non son o único obxectivo deste tratamento;

its concepts have been put to use on tumors of the lungs, liver, and pancreas.

a idea xa se puxo en práctica en tumores nos pulmóns, no fígado e no páncreas.

Meanwhile, doctors are experimenting with using it to treat conditions

No entanto, os médicos ensaian o seu uso para tratar doenzas

such as Parkinson’s disease, epilepsy, and obsessive compulsive disorder.

coma o párkinson, a epilepsia e o trastorno obsesivo-compulsivo.

The pain of a cancer diagnosis can be devastating,

A dor dun diagnóstico de cáncer pode ser devastadora,

but advancements in these non-invasive procedures

mais os avances nestes procedementos non invasivos

are paving a pathway for a more gentle cure.

están abrindo camiño cara a unha cura máis benévola.