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Neuro-oncology · London

Gamma Knife radiosurgery, private in London.

Sub-millimetre stereotactic radiosurgery on the Leksell Gamma Knife Icon - for brain metastases, meningioma, vestibular schwannoma, pituitary adenoma, trigeminal neuralgia and AVM. A single visit, mask-based, home the same day.

A radiographer guides a patient onto the bed of an advanced 3 Tesla MRI scanner in a London imaging suite

Indicative pricing

What private Gamma Knife costs in London.

Indicative ranges across our partner centres.

In short

A private Gamma Knife session in London: £8,500–£28,000, home the same day.

Procedure Indicative range
Diagnostic planning MRI and neuro-oncology opinion £950–£1,800
Gamma Knife, single small lesion (<2 cm) £8,500–£13,000
Gamma Knife, single lesion (2–3 cm) or complex plan £12,000–£18,000
Gamma Knife, multiple brain metastases (2–15) £14,000–£28,000
Gamma Knife for trigeminal neuralgia £18,000–£24,000
Gamma Knife for AVM (planning complexity) £20,000–£28,000

Prices vary by centre, by whether the plan is frame-based or mask-based, by lesion number and complexity, and by whether general anaesthesia is required (rare in adults, occasional in children).

What it is

Dedicated intracranial stereotactic radiosurgery.

Not radiotherapy in the usual sense - a single, highly focused dose from 192 beams that converge on one intracranial target with sub-millimetre precision.

  • The Leksell Gamma Knife Icon

    192 cobalt-60 gamma-ray sources arranged around the head. Each beam alone is weak; where they meet at the target, the dose is high enough to destroy abnormal tissue.

  • Sub-millimetre precision

    Sharper dose falloff than any other radiosurgery platform, so healthy brain 1 to 2 mm from the target receives very little dose. Ideal for lesions near optic nerves, brainstem or cochlea.

  • Frameless or frame-based

    Most treatments use a thermoplastic mask with infrared motion tracking. A rigid Leksell frame under local anaesthetic is still used for AVMs and some functional cases.

Indications

When Gamma Knife is the right step.

  • Brain metastases (1 to 15 lesions, under 3 cm)

    Radiosurgery instead of whole-brain radiotherapy for a limited number of intracranial metastases. Preserves cognition and gives 80 to 95% local control at 12 months per lesion.

  • Meningioma (benign or atypical)

    Base-of-skull, parasagittal or convexity meningiomas up to about 3 cm. Ideal after subtotal resection or where surgery would be morbid. Long-term control above 90%.

  • Vestibular schwannoma (acoustic neuroma)

    Small to medium acoustic neuromas. Tumour control above 95% at 5 years, with better hearing preservation than microsurgery in selected cases.

  • Pituitary adenoma after surgery

    Residual or recurrent secreting and non-secreting pituitary tumours, with sub-millimetre sparing of the optic apparatus.

  • Trigeminal neuralgia (refractory)

    A focused single dose to the trigeminal nerve root entry zone for medication-refractory facial pain. 70 to 90% report meaningful relief at 12 months.

  • Arteriovenous malformation (AVM)

    Small to medium AVMs (under 3 cm nidus), often after partial embolisation. 60 to 80% obliteration at 3 to 5 years, without craniotomy.

  • Selected functional indications

    Rarely, refractory obsessive-compulsive disorder or essential tremor at a small number of international centres, under strict MDT and ethical governance.

  • When Gamma Knife is not the answer

    Lesions over 3 cm, extracranial targets, diffuse leptomeningeal disease or brainstem lesions with mass effect are usually better served by fractionated SRT, CyberKnife or surgery.

Techniques and comparators

One platform, several workflows.

What each option on the table actually involves - and which fits which target.

  • Leksell Gamma Knife Icon (mask-based)

    The current standard: a thermoplastic mask and infrared motion tracking replace the stereotactic frame. Frameless, comfortable, and suitable for single-fraction or hypofractionated plans over 2 to 5 sessions.

  • Frame-based Gamma Knife

    A Leksell stereotactic frame is fixed to the skull under local anaesthetic for the highest positional accuracy. Still used for AVMs, functional indications and some trigeminal treatments.

  • Single fraction vs hypofractionation

    Small metastases, schwannomas and meningiomas usually get a single dose. Lesions near optic pathways or brainstem are split over 3 to 5 sessions to spare healthy tissue.

  • Repeat Gamma Knife for new lesions

    Because each session is highly focal, new brain metastases discovered on surveillance MRI can be treated again without exceeding whole-brain dose limits.

  • CyberKnife (comparator)

    A robotic linac with a mask and image guidance. Also frameless, treats intracranial and body sites, but sub-millimetre precision is not quite Gamma Knife territory for tiny targets.

  • Linac-based SRS (comparator)

    Modern dedicated linacs (Elekta Versa, Varian Edge) deliver SRS in shorter treatment times and handle larger targets well, but tiny-target dosimetry favours Gamma Knife.

  • Fractionated stereotactic radiotherapy

    Larger benign tumours (over 3 cm) or those hugging the optic apparatus are treated over 25 to 30 sessions of highly conformal radiotherapy rather than radiosurgery.

  • Second-opinion review

    A neuro-oncology review of your MRI, MDT letter and prior treatment history. Sometimes the answer is surveillance, surgery or fractionated SRT, not radiosurgery.

Where it is done

The private Gamma Knife centres we work with.

A short list of London-based Leksell Gamma Knife Icon platforms with mature neuro-oncology MDTs. Regional partners for patients outside the M25.

  • Cromwell BUPA Gamma Knife Centre, London

    The first Gamma Knife site in the UK, in South Kensington. Long-established Icon programme covering the full range of intracranial indications.

  • HCA Gamma Knife Centre, London Bridge

    Part of the HCA private network, integrated with Harley Street neurosurgery and the London Bridge Hospital oncology unit.

  • Amethyst Radiotherapy, Queen Square

    Adjacent to the National Hospital for Neurology and Neurosurgery, with a shared academic MDT and rapid access to functional-neurosurgery expertise.

  • National Hospital for Neurology (Private Care)

    UCLH Private Care at Queen Square, offering Gamma Knife alongside deep-brain stimulation and complex skull-base neurosurgery.

  • The Royal Marsden Private Care, Neuro-Oncology

    Refers into partner Gamma Knife platforms with full Royal Marsden neuro-oncology, systemic therapy and clinical-trials wraparound.

  • Regional partner centres (Sheffield, Newcastle)

    For patients outside London, we can route into NHS Gamma Knife programmes with private-patient pathways in Sheffield and Newcastle.

Selection criteria

How we vet every centre and consultant.

  • Consultant clinical oncologists and neurosurgeons with dedicated Gamma Knife lists

  • Leksell Gamma Knife Icon platforms with mask-based frameless workflow

  • Neuro-oncology MDT with neurosurgery, radiology and medical oncology in the room

  • On-site access to fractionated SRT, MR Linac and proton pathways when radiosurgery is not the right call

Outcomes

What Gamma Knife actually achieves.

Ranges from published international series and UK registries. Your consultant will personalise the numbers to your MRI and history.

  • Brain metastases

    Local control 80 to 95% at 12 months per treated lesion. Distant brain failure is common (30 to 50% at 12 months) and treated with repeat radiosurgery, not whole-brain radiotherapy.

  • Vestibular schwannoma

    Tumour control above 95% at 5 years for lesions up to 2.5 cm. Serviceable hearing preserved in around 60 to 70% at 5 years in modern series.

  • Meningioma

    Ten-year progression-free survival above 90% for WHO grade I lesions. Atypical (grade II) meningiomas need higher doses and closer surveillance.

  • Trigeminal neuralgia

    Meaningful pain relief in 70 to 90% at 12 months, with median time to response of 4 to 6 weeks. Facial numbness in 10 to 20%, usually mild.

  • Arteriovenous malformation

    Obliteration of small-to-medium AVMs in 60 to 80% at 3 to 5 years. During the latency window the haemorrhage risk continues, which we discuss up front.

  • Pituitary adenoma

    Tumour control above 90% for non-functioning adenomas. Biochemical remission in secretory tumours takes 2 to 5 years and depends on histology.

Compared to

Gamma Knife vs CyberKnife vs Linac SRS.

All three are excellent stereotactic radiosurgery platforms. The right one depends on target size, location and whether extracranial disease is being treated in the same episode.

  • Gamma Knife

    Intracranial only. Sub-millimetre precision. Single-visit workflow. Best-in-class for tiny targets, trigeminal neuralgia and AVMs. Mask-based on the Icon platform.

  • CyberKnife

    Frameless, mask-based, image-guided robotic linac. Treats intracranial and body sites (lung, liver, prostate, spine). Slightly less precise for tiny brain targets, more flexible for larger volumes.

  • Linac SRS

    Modern dedicated linacs (Versa HD, Edge, TrueBeam STx) deliver shorter treatment times and handle targets above 3 cm well. Less precise than Gamma Knife for sub-centimetre lesions but adequate for most SRS work.

  • MR Linac / SRT

    For large benign tumours or lesions abutting the optic pathways, we prefer fractionated SRT over 25 to 30 sessions on a conventional or MR-guided linac, not single-fraction radiosurgery.

Side effects and recovery

What to expect afterwards - honestly.

Gamma Knife is one of the best-tolerated cancer treatments in medicine. The things worth planning are transient fatigue, headache, and the 6 to 18 month radiation-necrosis window.

  • You are awake throughout

    No general anaesthetic. Sedation is offered for anxious patients or for frame-based treatments, but most people watch a film or listen to music through the session.

  • Hair loss is unusual

    Gamma Knife concentrates dose on the target and spares the scalp. Focal hair thinning at the treatment site is possible for very superficial targets, usually temporary.

  • Mild fatigue and headache

    Transient fatigue for 1 to 2 weeks and mild headache for a few days are the commonest side effects. Simple analgesia and rest are usually enough.

  • Radiation necrosis in 5 to 15%

    Delayed treatment-related swelling appears at 6 to 18 months, usually managed with dexamethasone or bevacizumab. Surgery is rarely needed and monitored on MRI.

  • Hearing loss for schwannoma

    For vestibular schwannoma, hearing preservation is around 60 to 70% at 5 years, better with cochlear-sparing dose planning. Baseline audiogram is booked before treatment.

  • Facial numbness after trigeminal

    Mild bothersome numbness in 10 to 20% of trigeminal treatments. Rarely severe, but discussed carefully before you consent.

  • Nausea, seizure precaution

    Anti-emetics for the day. Existing anticonvulsants continue; a short course of prophylactic steroids is often prescribed for larger targets or those near motor cortex.

  • MRI surveillance is essential

    A follow-up MRI at 3 months, then every 6 months. New lesions can be re-treated. Radiation necrosis versus tumour progression is sometimes only resolved with advanced imaging or biopsy.

  • Red flags after discharge

    New severe headache, seizure, weakness, sudden vision or speech change - call the centre or go to A&E the same day.

Reading your radiosurgery plan

Your Gamma Knife report in four parts. Read the last one first.

Whichever centre treats you, the report the neuro-oncology team sends keeps to the same shape.

A UK neuro-oncologist reviewing a Gamma Knife plan

A quiet reminder

Radiosurgery language is precise and can read coldly - we translate it for you.

If you would like us to talk you through the plan before your review, just ask.

  1. 01 Header

    Target volume, prescription dose and platform

    Where the target was (with MRI co-registration), the volume in cubic centimetres, the prescription isodose (usually 50%) and the machine (Leksell Gamma Knife Icon).

  2. 02 Technique

    Frameless mask or Leksell frame

    Whether a thermoplastic mask with infrared tracking or a stereotactic head frame under local anaesthetic was used, and the number of isocentres and shots planned.

  3. 03 Findings

    Dose to critical structures

    Maximum doses to the optic apparatus, brainstem, cochlea and hippocampus, all within international constraints. Any deviation is explained.

  4. 04 Impression

    Follow-up plan and imaging schedule

    Read this first: when the next MRI is booked, whether steroids or anticonvulsants continue, and what changes on imaging should trigger a call back.

Recognised by major UK insurers

BupaAXA HealthVitalityAvivaWPACignaHealixBupaAXA HealthVitalityAvivaWPACignaHealixBupaAXA HealthVitalityAvivaWPACignaHealix

Cover for Gamma Knife varies by insurer and by indication - usually funded when medically indicated.

Frequently asked

Everything we get asked about Gamma Knife.

Quick answers on hair, day-case workflow, repeat treatments, insurance, size limits and radiation necrosis.

  • Will I lose my hair after Gamma Knife?

    Almost never. Because 192 gamma beams converge on the target and each beam alone is very weak, the scalp receives a low dose. Focal thinning at the entry point is possible for very superficial lesions and is usually temporary. Whole-scalp hair loss like whole-brain radiotherapy does not happen.

  • Is Gamma Knife an outpatient procedure?

    Yes. Almost all patients are treated as a day case on the Leksell Gamma Knife Icon: mask fitting and planning in the morning, treatment over 30 minutes to 3 hours, and home the same afternoon. Most people drive again the next day and return to work within a week.

  • Can Gamma Knife be repeated?

    Yes. Because each session is highly focal and delivers most of its dose to a small volume, new brain metastases or a persisting AVM can be treated again on a separate visit. We aim to keep cumulative doses to normal brain within safe international limits, guided by your MRI and prior plans.

  • Will my private medical insurance cover Gamma Knife?

    Usually yes when medically indicated for brain metastases, meningioma, vestibular schwannoma, pituitary adenoma, trigeminal neuralgia or AVM. Bupa, AXA, Vitality, Aviva, WPA and Cigna all authorise Gamma Knife in the right clinical setting.

  • Is there a size limit for the tumour?

    Single-fraction Gamma Knife works best for lesions up to about 3 cm in diameter or 15 cubic centimetres. Larger targets are treated with hypofractionated radiosurgery over 3 to 5 sessions, with fractionated stereotactic radiotherapy over 25 to 30 sessions, or with surgery first followed by radiosurgery to the cavity.

  • What is the risk of radiation necrosis?

    Symptomatic radiation necrosis occurs in around 5 to 15% of treated targets, typically 6 to 18 months later. Most cases settle with a short course of dexamethasone; a smaller number need bevacizumab. Surgery for necrosis is uncommon. We watch for it on your surveillance MRIs and treat it early.

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