FAQ

The CyberKnife system is a non-invasive alternative to surgery for cancer treatment. It is the most advanced technology for delivering radiation to tumors because it is able to track the natural movements of tumors that occur with breathing and natural body movements, and thus avoid sending radiation to healthy tissue or organs surrounding the tumor.

This radiotherapy treatment allows for a pain-free process with a reduced risk of side effects. Patients complete the treatment in a series of one to five short appointments, so it will not take up their whole day nor constrict them to bed rest for recovery. The CyberKnife system is the only robotic radiotherapy that offers a non-invasive alternative to surgery.

While effective at killing dangerous cancer cells, traditional radiation therapy also damages the healthy cells and tissue surrounding the tumor. This occurs because traditional radiation therapy does not adapt to the natural movements of the tumor, and instead sends radiation in a wide field around the tumor to make sure the tumor is completely covered.

Radiation damage to healthy areas of the body can cause a number of undesirable side effects. The CyberKnife system was designed to reduce the risk of unnecessary side effects caused by radiation. It successfully lowers risks by only including the tumor in its radiation field and tracking the tumors movements with pinpoint precision and submillimeter accuracy. This non-invasive procedure allows patients to complete treatment within 1 to 5 days rather than the several weeks traditional radiotherapy tends to take.

Tumors have been shown to move slightly with the body during radiation treatment, despite a patient’s best efforts to stay motionless. The cyberknife system works around this by adapting to the movements of the tumor with unprecedented accuracy. The advanced robotic technology of the CyberKnife system delivers radiation directly to the tumor, changing position to match the patient’s movements in real time, thus avoiding the surrounding areas of the tumor.

Conventional radiotherapy systems are limited in motion, restricting them from delivering radiation in the most precise possible angles. The CyberKnife System allows for radiation to be delivered from a wider variety of angles, making for precise and accurate radiation delivery to the tumor.

The CyberKnife System adjusts in real time to the patient’s breathing, rendering conventional radiation techniques like the patient holding their breath or being strapped down unnecessary. The Cyberknife System also reduces healthy tissue damage by narrowing the field of radiation delivery to only the tumor, rather than overcompensating for any accidently missed parts of the tumor like conventional radiation treatments. The CyberKnife System’s ability to minimize healthy tissue damage is unparalleled.

Treatment options vary according to cancer location and type. Treatments can usually be divided into the following groups:

1. Radiosurgery: This radiation therapy is actually non-surgical despite its name, and delivers high doses of radiation to the tumor using robotics and advanced technology. This treatment option effectively destroys tumors in 1 to 5 treatments over 1 to 5 days. This outpatient procedure is completely non-invasive and requires no hospitalization.
2. Radiation Therapy: In this treatment, radiation is usually delivered 5 days a week over a course of 6-8 weeks. Unlike stereotactic radiosurgery, this treatment delivers radiation to a larger portion of the body than the tumor, thus effectively killing the tumor, but exposing the tissue surrounding the tumor to radiation as well. This treatment is generally an outpatient treatment, requiring no hospitalization.
3. Brachytherapy: This is a form of radiation therapy where small, radioactive sources are placed in and around a tumor. There are two types of brachytherapy:
   • Low dose rate brachytherapy delivers radiation in low, prescribed doses over a long period of time, and radioactive sources are usually permanently implanted.
   • High dose rate brachytherapy delivers high, prescribed doses of radiation from radioactive sources for a shorter period of time and are therefore implanted only temporarily.

     Brachytherapy has been used to treat a wide variety of cancers such as head, neck, lung, breast, and prostate cancers.

4. Cryoablation: With cryoablation, also referred to as cryotherapy, a probe is inserted through an incision in the skin and sent straight to the tumor to freeze it and kill its cells. Depending on the advancement of the tumor, the procedure might be performed on an inpatient or an outpatient basis
5. High intensity Focused Ultrasound (HIFU): HIFU uses an ultrasound beam to target and kill tissue containing cancer cells. The treatment has not been approved by the United States FDA but has been used in Europe as a prostate cancer treatment.

The CyberKnife system has been a source of hope for those who have inoperable or surgically complex tumors, as well as those who want an alternative treatment to surgery. This non-surgical, non-invasive system treats tumors anywhere in the body with pinpoint precision and sub-millimeter accuracy.

Other benefits include:

• No incision
• No pain
• No anesthesia
• No hospitalization
• Patients don’t have to hold their breath
• No recovery time
• Patient can return to daily activities immediately prior to treatment

Radiotherapy has been used as a safe, effective treatment for cancer for many years. In fact, nearly two out of every three cancer patients receive some type of radiotherapy during their treatment. Radiotherapy works by limiting the ability of cancer cells to grow and spread. Radiation disrupts the DNA of these fast-growing cancer cells and prevents them from replicating.

The radiation is generated by a machine called a linear accelerator, which shapes beams of energy with varying intensities. These beams can be aimed at a tumor from multiple angles to attack it in a 3-D manner. The TrueBeam System delivers the lowest dose possible to the surrounding healthy tissue, while still delivering the maximum dose to the tumor.

When you hear the word “radiation,” you may immediately think of radioactive substances. However, no radioactive substances are involved in the creation of the beam by a medical linear accelerator. When a linear accelerator is switched “on,” radiation is produced and aimed directly at cancer cells. Then when the system is switched off, radiation is no longer emitted from the system.

The TrueBeam system gives medical professionals the tools to treat many different types of cancers. Benefits include:

• Speed – Simple treatments that once took 10 to 30 minutes can now be completed in less than two minutes. Faster treatment delivery not only is more comfortable for patients, requiring less time on the treatment couch, it also reduces the chance of tumor motion during treatment, which helps protect nearby healthy tissue and critical organs.
• Precision – The accuracy of the TrueBeam system is measured in increments of less than a millimeter, which is made possible by the system’s sophisticated architecture. The TrueBeam system synchronizes imaging, patient positioning, motion management, beam shaping and dose delivery, performing accuracy checks every ten milliseconds throughout the entire treatment.
• Imaging – TrueBeam imaging technology quickly produces the 3-D images used to fine-tune tumor targeting, using 25 percent less X-ray dose than previous systems.
• Motion Tracking – For lung and other tumors subject to respiratory motion, TrueBeam offers Gated RapidArc® radiotherapy, which makes it possible to monitor the patient’s breathing and compensate for movement of the tumor while the dose is being delivered in a continuous rotation of the treatment machine.

TrueBeam treatment involves these basic steps:

• Treatment Planning – After a diagnosis, the medical physicist generates 3-D diagnostic images (usually CT or MRI) of the tumor and the area around it. Using these images, a radiation oncologist will work with the physicist to plan your individualized treatment, specifying the dose of radiation needed to treat the tumor.
• Treatment Preparation – Most cases require a treatment preparation session. Special molded devices that help the patient maintain the same position every day are sometimes developed at this point. The radiation oncologist may request to have the treatment area marked on the patient’s skin to assist in aligning the equipment with the target area.
• Treatment – The individualized TrueBeam treatments will be delivered according to a schedule specific to the treatment plan. The total dose of radiation is usually divided into smaller doses, called fractions, which are delivered daily over a specific time period. During a TrueBeam treatment, the linear accelerator can rotate around the patient to deliver the radiation. The radiation is shaped and reshaped as it is continuously delivered from virtually every angle in a 360-degree revolution around the patient. Sometimes a marker block device is used to monitor breathing patterns to compensate for breathing motion during the treatment. Most treatments usually take only a few minutes each day.

There are a number of medical professionals who may be involved in your treatment:

• Radiation oncologist – A doctor who has had special training in using radiation to treat diseases and prescribes the type and amount of treatment. The radiation oncologist may work closely with other doctors and the rest of the healthcare team.
• Medical physicist – Participates in the planning process and ensures that the machines deliver the right dose of radiation.
• Dosimetrist – Plans the treatment with the oncologist and the physicist.
• Radiation therapy nurse – Provides nursing care and may help the patient learn about treatment or how to manage any side effects.
• Radiation therapist – Sets the patient up for treatment and operates the equipment that delivers the radiation.