A Patient’s Guide To CyberKnife – The Cutting Edge Technology in Precision Surgery

The delivery of radiotherapy has changed significantly over the last few decades. The healthcare industry has moved from conventional radiotherapy to highly advanced radiotherapy techniques such as three dimensional conformal radiotherapy (3D-CRT) and intensity modulated radiotherapy (IMRT). These changes in the delivery of radiotherapy have come about as result of trying to improve the targeted delivery of radiation to tumor carrying tissues.

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CyberKnife Radiosurgery is a type of IMRT that is non-invasive and non-surgical - and delivers very high doses of radiation in a very precise fashion.  What makes CyberKnife rather unique is that it’s the world’s first and only radiotherapy system designed to treat cancer anywhere in the body. It employs sub-millimeter accuracy and image guidance technology which results in no pain and no incision for patients. This translates to treatment which is noninvasive, with little or no post surgery recovery time.

Is CyberKnife better than conventional treatments?

CyberKnife treats tumors that were previously considered inoperable or untreatable through traditional radiation therapy. CyberKinfe’s precision accuracy minimizes damage to health tissue near the treatment area, leaving patients with virtually no side effects. Daily average treatment time is 30 to 90 minutes, ranging anywhere from one to five days (unlike traditional treatments that can take weeks).

How does CyberKnife work?

The first thing it does is it uses x-ray images to confirm the position of the tumor. Once it locates the tumor, it brings the radiation beam into perfect alignment with the tumor. Next, it aims each beam independently to precisely deliver high doses of radiation on the tumor.

When the tumor adjusts, due to natural breathing or movements like sneezing, the device detects the change. Almost immediately, it realigns for the change by bringing the radiation beam into alignment again with the tumor. This results with the tumor receiving large amounts of radiation, leaving out the surrounding healthy tissues.

Types of cancers treatable with CyberKnife

The following cancers and tumors are treatable with CyberKnife:

• Liver cancer

• Pancreatic cancer

• Head and neck cancer

• Spine cancer

  • Meningiomas

  • Neurofibromas

  • Schwannomas

  • Vascular malformations

• Lung cancer

• Prostate cancer

• Brain cancer (benign and malignant)

Benefits of CyberKnife Therapy

• Enhanced precision in tumor treatment

• Reaches most tumors from virtually unlimited directions

• Minimizes radiation exposure to healthy tissue surrounding a tumor site

• No need for anesthesia or hospitalization

• More tumor sites eligible for treatment, including inoperable or complex tumors

• Minimal side effects

CyberKnife Procedure

Step 1 - Initial Consultation

The initial consultation involves the radiation oncologist, a surgeon and other physicians, if required. They will determine if CyberKnife is right for you. Please bring a list of all of your medications to these appointments.

Step 2 - Treatment Preparation

Soft Tissue Fiducial Placement

Fiducials are tiny gold marker seeds that are implanted into soft tissues in or near the tumor to accurately guide the CyberKnife radiation beams. These markers are typically required for tumors in the abdomen, pelvis, prostate and some lung cancers. They are not required for tumors in the brain or spine.

If your treatment requires the placement of fiducial markers, Vaidam can help connect you with the right hospitals that will arrange for the procedure.

CT Scan

A CT scan is needed prior to beginning CyberKnife treatment. Even if you recently had a CT scan as part of your diagnosis, a new one will be needed in order for the radiation oncologist and physicist to develop your customized treatment plan.

MR Imaging

Sometimes special imaging procedures, such as magnetic resonance imaging (MRI), are needed in addition to the CT scan. Your radiation oncologist will write specific directions that apply to you. The radiation oncologist also determines whether this procedure requires contrast material, a special dye put in your body that helps the radiologist locate the treatment area on your radiology films.

Step 3 – Day of Procedure

Getting Ready

• Take your normal daily medications as usual with the exception of diuretics (“water pills”). Diuretics should not be taken until after treatment is finished that day.

• Wear comfortable clothing and no jewelry. A blanket is provided for warmth if needed.

When you Arrive

• A nurse will have you lie on the treatment table and position you into your mask or body mold system.

• X-ray images will be taken.

• This process is repeated many times as the X-ray system zeroes in on the target and the robotic arm realigns the linear accelerator from multiple different positions – often more than 100 times. At each angle, the CyberKnife delivers a precise radiation beam.

• If a lung or upper abdominal tumor is treated, the breathing cycle is also continuously tracked and correlated with the tumor’s position, causing the robotic arm to assume a real time “breathing” pattern that tracks the tumor.

During the Procedure

• You will need to lie still and breathe normally.

• Generally, no sedation is required because the treatment is painless, although medication will be available if necessary.

• You can watch a movie on the flat screen TV on the ceiling, or listen to music during the treatment.

• CyberKnife treatments are delivered in one to five sessions, within seven to 10 days, depending upon your situation. Treatment sessions last from 30-120 minutes.

After the Procedure

• You will receive written discharge instructions from the nurse at the end of the course of treatment.

• Typically, you may return home and resume normal activities immediately following treatment.

• Speak to a Vaidam Medical Representative who will guide you through the step-by-step process in more detail.

Step 4 – Follow Up

• It is generally advisable to get evaluated 1-2 months after the procedure.

• Specialist may ask for further CT scan or MRI scan to evaluate response to the treatment.

• Due to some tumors responding late (4-6 months), further follow-up evaluations may be recommended.

Where can I get the CyberKnife Procedure ?

Due to the advanced nature of the surgical procedure, only a handful of medical facilities provide this specialized service. Contact a Vaidam Health Representative today to find the best healthcare facility or radiologist that suits your healthcare needs.