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

Prevoditelj: Petra Lauš Recezent: Ivan Luka Sabolović

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

Svake godine, deseci tisuća ljudi diljem svijeta idu na operaciju mozga

without a single incision:

bez ijednog reza:

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

nema skalpela, operacijskog stola i pacijent ne gubi krv.

Instead, this procedure takes place in a shielded room

Umjesto toga, ova se procedura vrši u zaštićenoj prostoriji

with a large machine that emits invisible beams of light

gdje se nalazi veliki uređaj koji emitira nevidljive zrake svjetlosti

at a precise target inside the brain.

prema precizno određenom području mozga.

This treatment is called stereotactic radiosurgery,

Ovaj se zahvat zove stereotaktička radiokirurgija

and those light beams are beams of radiation:

i zrake svjetlosti su zrake radijacije:

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

njihova zadaća je uništiti tumore postepenim struganjem zloćudnih stanica.

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

Za pacijente, postupak počinje od CT pregleda,

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

koji čine X-zrake koje stvaraju trodimenzionalnu sliku glave.

Slika precizno otkriva lokaciju, veličinu i oblik tumora.

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

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

CT pregled također pomaže u izračunu Hounsfieldovih jedinica

which show the densities of different tissues.

koje pokazuju gustoću raznih tkiva.

This offers information about how radiation

One nam pružaju informacije o tome kako će se radijacija

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

širiti mozgom kako bismo optimizirali njen učinak.

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

Liječnici mogu koristiti i magnetsku rezonanciju ili MR

that produce finer images of soft tissue,

koja stvara detaljniju sliku mekog tkiva

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

kako bi pomogla bolje odrediti oblik i lokaciju tumora.

Mapping its precise position and size is crucial

Određivanje točne pozicije i veličine je ključno

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

zbog velikih razina radijacije koje su potrebne za uništavanje tumora.

Radiosurgery depends on the use of multiple beams.

Radiokirurgija ovisi o upotrebi nekoliko zraka.

Individually, each delivers a low dose of radiation.

Svaka zasebno daje nisku razinu radijacije.

But, like several stage lights converging on the same point

Ali kao što se svjetla pozornice sreću u istoj točki

to create a bright and inescapable spotlight, when combined,

kako bi nastalo svijetlo i neizbježno reflektorsko svjetlo,

zrake radijacije zajedno stvaraju dovoljno snage za uništenje tumora.

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

In addition to enabling doctors to target tumors in the brain

Uz to što pomažu liječnicima pogoditi tumore u mozgu

while leaving the surrounding healthy tissue relatively unharmed,

i ostaviti okolno zdravo tkivo netaknutim,

the use of multiple beams also gives doctors flexibility.

upotreba nekoliko zraka liječnicima također daje fleksibilnost.

They can optimize the best angles and routes through brain tissue

Mogu odrediti najbolje kuteve i puteve kroz moždano tkivo

to reach the target and adjust the intensity within each beam

kako bi došli do tumora, a mogu i prilagoditi intenzitet zrake

as necessary.

po potrebi.

This helps spare critical structures within the brain.

To pomaže poštedjeti ključne strukture u mozgu.

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

No što točno ovaj genijalni pristup radi tumorima?

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

Kada se zrake radijacije križaju kako bi pogodile stanice karcinoma,

their combined force essentially shears the cells’ DNA,

njihova zajednička snaga uništava stanični DNK

causing a breakdown in the cells’ structure.

i uzrokuje raspad stanične strukture.

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

S vremenom, proces prerasta u uništavanje cijelog tumora.

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

Zrake neizravno oštećuju i područje oko DNK-a

creating unstable particles called free radicals.

te se stvaraju nestabilne čestice, odnosno slobodni radikali.

This generates a hazardous microenvironment

To stvara štetno mikrookruženje

that’s inhospitable to the tumor,

koje je negostoljubivo prema tumoru,

as well as some healthy cells in the immediate vicinity.

ali i nekim zdravim stanicama u neposrednoj blizini.

The risk of harming non-cancerous tissue is reduced

Rizik od oštećenja zdravog tkiva smanjuje se

by keeping the radiation beam coverage

time da se zrake radijacije usmjeravaju

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

na područje mozga koje je što sličnije obliku tumora.

Once radiosurgery treatment has destroyed the tumor’s cells,

Kada radiokirurški postupak uništi stanice tumora,

pokreće se prirodni mehanizam čišćenja tijela.

the body’s natural cleaning mechanism kicks in.

The immune system rapidly sweeps up the husks of dead cells

Imunološki sustav brzo čisti ostatke mrtvih stanica

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

kako bi ih izbacio iz tijela, a ostale stanice pretvaraju se u ožiljke.

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

Unatoč inovativnosti, radiokirurgija nije uvijek primarni izbor

for all brain cancer treatments.

za liječenje svih tumora na mozgu-

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

Prvo, u većini slučajeva koristi se za manje tumore.

Radiation also has a cumulative effect,

Radijacija ima kumulativni učinak,

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

što znači da se ranije doze mogu preklopiti s kasnijima.

Pacijenti kojima se tumor vraća

So patients with recurrent tumors

may have limitations with future radiosurgery treatments.

možda ubuduće neće moći primiti radiokirurško liječenje.

But these disadvantages weigh up against some much larger benefits.

No veće su prednosti od nedostataka.

For several types of brain tumors,

Za nekoliko vrsta tumora na mozgu,

radiosurgery can be as successful as traditional brain surgery

radiokirurgija može biti uspješna kao i tradicionalna operacija mozga

at destroying cancerous cells.

u uništavanju stanica karcinoma.

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

Što se tiče tumora meningeoma, pojavnost je jednaka ili niža

when the patient undergoes radiosurgery.

kada pacijent primi radiokirurško liječenje.

And compared to traditional surgery—

U usporedbi s tradicionalnom operacijom,

often a painful experience with a long recovery period—

koja često znači bol i dug oporavak,

radiosurgery is generally pain-free,

radiokirurški zahvat je većinom bezbolan

and often requires little to no recovery time.

i često ne zahtijeva oporavak.

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

Ova vrsta liječenja ne primjenjuje se samo na tumore na mozgu:

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

njeni koncepti primjenjuju se na tumore na plućima, jetri i gušterači.

Meanwhile, doctors are experimenting with using it to treat conditions

Liječnici eksperimentiraju s primjenom radiokirurgije u liječenju

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

Parkinsonove bolesti, epilepsije i opsesivno-kompulzivnog poremećaja.

The pain of a cancer diagnosis can be devastating,

Dijagnoza karcinoma može biti izuzetno teška,

but advancements in these non-invasive procedures

ali proboji u neinvazivnim postupcima

are paving a pathway for a more gentle cure.

krče put prema nježnijem lijeku.