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

Prevodilac: Aleksandar Bosnjak Lektor: Milenka Okuka

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

Svake godine, desetine hiljada ljudi širom sveta ima operacije na mozgu

without a single incision:

bez ijednog reza, ne koristi se skalpel,

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

niti operacioni sto, a pacijent ne gubi krv.

Instead, this procedure takes place in a shielded room

Umesto toga, ova procedura sprovodi se u zaštićenoj prostoriji

with a large machine that emits invisible beams of light

uz pomoć velike mašine koja emituje nevidljive snopove svetlosti

at a precise target inside the brain.

uperene u tačnu metu unutar mozga.

This treatment is called stereotactic radiosurgery,

Ovo lečenje se zove stereotaksična radiohirurgija,

and those light beams are beams of radiation:

a ti snopovi svetlosti su zraci radijacije.

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

Njihov zadatak je da unište tumore tako što postepeno čiste maligne ćelije.

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

Za pacijente, proces počinje CT skeniranjem,

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

nizom rendgentskih snimaka koji prave trodimenzionalu mapu glave.

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

Ovo otkriva preciznu lokaciju, veličinu i oblik tumora unutar glave.

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

Rendgetski snimci takođe pomažu u izračunavanju jedinica Haunsfilda,

which show the densities of different tissues.

koje pokazuju gustinu različitih tkiva.

This offers information about how radiation

Ovo pruža informacije o tome kako će se radijacija proširiti u mozgu

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

kako bi bolje optimizovala svoje efekte.

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

Doktori takođe koriste i magnetnu rezonancu ili MR,

that produce finer images of soft tissue,

koja proizvodi kvalitetnije slike mekih tkiva,

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

da im pomogne oko boljeg ocrtavanja oblika i lokacije tumora.

Mapping its precise position and size is crucial

Mapiranje njegove tačne pozicije i veličine je presudno

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

zbog visokih doza radijacije potrebnih za lečenje tumora.

Radiosurgery depends on the use of multiple beams.

Radiohirurgija zavisi od upotrebe više zrakova.

Individually, each delivers a low dose of radiation.

Individualno, svaki za sebe dovodi malu dozu radijacije.

But, like several stage lights converging on the same point

Ali, baš kao što se reflektori susreću u istoj tački

to create a bright and inescapable spotlight, when combined,

da stvore svetlo mesto na pozornici, kada se ujedine,

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

zraci radijacije zajedno proizvode dovoljno snage da unište tumore.

In addition to enabling doctors to target tumors in the brain

Pored toga što omogućava doktorima da ciljaju tumore u mozgu

while leaving the surrounding healthy tissue relatively unharmed,

dok je za to vreme okolno zdravo tkivo relativno neoštećeno,

the use of multiple beams also gives doctors flexibility.

korišćenje više zrakova daje doktorima fleksibilnost.

They can optimize the best angles and routes through brain tissue

Mogu da optimizuju najbolje uglove i putanje kroz tkivo mozga

to reach the target and adjust the intensity within each beam

kako bi došli do cilja i prilagodili jačinu svakog zraka

as necessary.

po potrebi.

This helps spare critical structures within the brain.

Ovo pomaže u spašavanju važnih struktura unutar mozga.

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

Nego, šta tačno ovaj genijalni pristup radi tumorima?

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

Kada se nekoliko zrakova radijacije ukrsti kako bi napali masu kancerogenih ćelija,

their combined force essentially shears the cells’ DNA,

njihova zajednička snaga u suštini seče DNK ćelije,

causing a breakdown in the cells’ structure.

uzrokujući rasparčavanje u strukturi ćelija.

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

Tokom vremena, ovaj proces postepeno prelazi u uništavanje celog tumora.

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

Indirektno, zraci takođe oštećuju oblast koja neposredno okružuje DNK,

creating unstable particles called free radicals.

stvarajući nestabilne čestice koje se zovu slobodni radikali.

This generates a hazardous microenvironment

Ovo proizvodi opasnu mikrookolinu

that’s inhospitable to the tumor,

koja je negostoljubiva prema tumoru,

as well as some healthy cells in the immediate vicinity.

kao i prema nekim zdravim ćelijama koje su u neposrednoj blizini.

The risk of harming non-cancerous tissue is reduced

Rizik od nanošenja štete nekancerogenim tkivima je smanjen

by keeping the radiation beam coverage

tako što se pokrivenost snopa radijacije

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

zadržava što je bliže moguće tačnom obliku tumora.

Once radiosurgery treatment has destroyed the tumor’s cells,

Jednom kada tretman radiohirurgije uništi ćelije raka,

the body’s natural cleaning mechanism kicks in.

mehanizam prirodnog čišćenja tela počinje sa radom.

The immune system rapidly sweeps up the husks of dead cells

Imuni sistem ubrzano skuplja ljuske mrtvih ćelija

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

kako bi ih izbacio van tela, dok se druge ćelije transformišu u ožiljke.

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

Uprkos inovacijama, radiohirurgija nije uvek glavni izbor

for all brain cancer treatments.

za lečenje svih karcinoma mozga.

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

Za početak, obično je rezervisana za manje tumore.

Radiation also has a cumulative effect,

Radijacija ima i kumulativni efekat, što znači da doze dobijene ranije

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

mogu da se preklope sa onim koje su dobijene kasnije.

So patients with recurrent tumors

Tako da pacijenti sa rekurentnim tumorima

may have limitations with future radiosurgery treatments.

mogu da imaju ograničenja za buduće lečenje radiohirurgijom.

But these disadvantages weigh up against some much larger benefits.

Nego, ovi nedostaci se odmeravaju sa nekim mnogo većim benefitima.

For several types of brain tumors,

Za nekoliko tipova tumora mozga, radiohirurška operacija

radiosurgery can be as successful as traditional brain surgery

može biti uspešna isto koliko i tradicionalna operacija

at destroying cancerous cells.

u uništavanju kancerogenih ćelija.

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

Kod tumora koji se zovu meningeomi, utvrđeno je da je recidiv jednak ili niži

when the patient undergoes radiosurgery.

kada se pacijent podvrgne radiohirurškoj operaciji.

And compared to traditional surgery—

U poređenju sa tradicionalnom operacijom,

often a painful experience with a long recovery period—

koja je često bolno iskustvo sa dugim periodom oporavka,

radiosurgery is generally pain-free,

radiohirurgija je uglavnom bezbolna,

and often requires little to no recovery time.

i često zahteva malo ili nimalo vremena za oporavak.

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

Tumori mozga nisu jedina meta za ovaj tip lečenja,

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

ovaj koncept se koristi za tumore pluća, jetre i gušterače.

Meanwhile, doctors are experimenting with using it to treat conditions

U međuvremenu, doktori eksperimentišu koristeći ga za lečenje oboljenja,

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

kao što je Parkinsonova bolest, epilepsija i opsesivno kompulsivni poremećaj.

The pain of a cancer diagnosis can be devastating,

Bol kada se ustanovi rak može biti razarajuć,

but advancements in these non-invasive procedures

ali poboljšanja u ovim neinvazivnim procedurama

are paving a pathway for a more gentle cure.

popločavaju put ka nežnijem lečenju.