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Radiation can be delivered and so it’s really a blast of radiation that’s given to the target. And the target usually ends up being the pituitary gland. So radiation is fairly indiscriminate of that. Like the surgeon, which can distinguish between what’s tumor and what’s not, radiation has no power to do that. But it’s one advantage is that it can kill at the cellular level and so you’ve got a patient say with Cushing’s disease and it’s tiny tumor producing large amounts of ACTH which is producing ultimately large amounts of cortisol in the body and that if left untreated can be fatal and certainly reduces lifespan. So radiation can enter the picture and kill those cells that are producing that hormone perhaps when surgery has failed to accomplish its goal. And then radiation can enter the picture and maybe in the absence of surgery altogether in somebody who may be just medically unfit to undergo surgery, but they’ve got a tumor that is threatening to compress the optic chiasm, radiation can work. Some of the advantages of radiation, are it can be applied in patients who are not perhaps medically fit for surgery. And other times it’s actually a good choice for some hormonally active tumors that still persists despite surgery.
