What is the CyberKnife System?

The CyberKnife Robotic Radiosurgery System is a pain-free, non-invasive alternative to surgery that can effectively treat complex tumors located virtually anywhere in the body, including the head, chest, abdomen and other sensitive areas.

Using a cruise-missile guidance system that continually tracks and adjusts for patient or tumor movement throughout the procedure, CyberKnife targets tumors with pinpoint precision while sparing the surrounding healthy tissue. To date, the CyberKnife has given new hope to more than 100,000 patients worldwide.

Despite its name, CyberKnife treatment involves no cutting and is a completely non-invasive procedure. The frameless, open construction of the machine allows patients to lie comfortably. In fact, many even opt to listen to music during treatment.

The CyberKnife delivers beams of high-dose radiation through a computer-controlled robotic arm that moves slowly around the area of concern, continually adjusting for even the slightest patient movement. This precise delivery attacks the tumor while limiting exposure to the healthy tissue that surrounds it. During treatment, patients are free to relax and may breathe normally.

CyberKnife treatments typically last 30-90 minutes and are performed on an outpatient basis. The procedure is painless, requires no recovery time and minimizes the risk of harmful side effects. Most patients are able to return to their normal lives immediately after receiving treatment.

While other radiation therapy and radiosurgery systems require as many as 40 treatments, CyberKnife usually requires no more than five treatments. CyberKnife has unlimited reach, and can be used to treat even the most complex tumors located anywhere in the body.

What makes the  CyberKnife Different?

Despite the best attempts of clinicians, it is virtually impossible to prevent patients and their internal anatomy from moving during radiation treatments. With conventional treatment, patients are subjected to invasive and uncomfortable methods to minimize their movement as much as possible.

These immobilization techniques can include attaching a metal frame directly into a patient’s skull, compression of the abdomen to limit breathing and movement during treatments, stabilizing body casts, and injection of rectal balloons or hardening agents into the rectum to stabilize the prostate, to name just a few.

Accuray Incorporated, the makers of the CyberKnife System, realized early on that patients, and their internal anatomy, are still going to move, no matter what means was taken to prevent it. Additionally, they believed that with greater accuracy in radiation delivery, the CyberKnife System could provide more effective treatments by minimizing the radiation exposure to healthy surrounding tissue and limit some of the short and long-term side effects that are common with conventional treatments.

The company set out, from the start, to develop a radiation treatment system with patient movement and comfort in mind. Rather than retrofitting existing technology, Accuray took

a new approach by developing an innovative design that could effectively address patient and tumor movement during treatment and eliminate the need for antiquated techniques, additional procedures, and patient discomfort. Instead of restricting patient movement, the CyberKnife System’s leading-edge technology was designed to move with the tumor. This unique capability results in the delivery of more accurate and higher doses of radiation to the tumor, while avoiding the surrounding healthy tissue and reducing the side effects commonly associated with conventional radiation therapy treatments.

What can the CyberKnife System treat?

The CyberKnife Robotic Radiosurgery System is a non-invasive alternative to surgery for the treatment of both cancerous and non-cancerous tumors anywhere in the body, including the prostate, lung, brain, spine, liver, pancreas and kidney. The treatment which delivers high doses of radiation to tumors with extreme accuracy offers new hope to patients who have inoperable or surgically complex tumors, or who may be looking for a non-surgical option. 

a) Prostate Cancer

The challenge that doctors face in treating prostate tumors with radiation therapy is that the prostate moves unpredictably as air passes through the rectum and as the bladder empties and fills. Minimizing any large movements of the prostate can help reduce unnecessary irradiation of surrounding healthy tissue. The CyberKnife Robotic Radiosurgery System is able to overcome this challenge by continuously identifying the exact location of the prostate and making active corrections for any movement of the prostate throughout the course of the treatment. During treatment, a patient lays still and breathes normally while the CyberKnife zeroes in on a moving target – the prostate – and irradiates it without harming surrounding areas. As a result, the procedure is more comfortable for patients, radiation is delivered more accurately and treatments can be completed in four to five days.

Currently the CyberKnife Radiosurgery System is most frequently used by itself for patients with early stage prostate cancer confined to the prostate or in combination with another therapy, such as external beam radiation for patients with disease that extends beyond the prostate. Depending on the stage of the patient’s prostate cancer the doctor will recommend a treatment plan.

b) Lung Cancer

The CyberKnife System is not a surgical procedure. In fact, there is no cutting involved. Instead, the CyberKnife System delivers high doses of radiation directly to lung tumors. The CyberKnife System offers patients who cannot undergo lung cancer surgery due to their poor medical condition, or who refuse surgery, a minimally invasive alternative treatment for lung cancer. CyberKnife lung cancer treatments are typically performed on an outpatient basis in one to five days, requiring no overnight hospital stays.  Most patients experience minimal to no side effects with a quick recovery time.

c) Brain Cancer

The CyberKnife System is not a surgical procedure. In fact, there is no cutting involved. Instead, the CyberKnife System delivers high doses of radiation directly to brain tumors. The CyberKnife System offers patients a non-invasive alternative to brain cancer surgery, and can be used for brain tumors that are considered inoperable because of their location in the head, for those patients who cannot undergo brain cancer surgery due to their poor medical condition, or who refuse surgery. The CyberKnife System also can treat benign, or non-cancerous, tumors and other conditions, such as trigeminal neuralgia and arterial venous malformations (AVMs).

CyberKnife brain cancer treatments are typically performed on an outpatient basis over a period of one to five days, requiring no overnight hospital stays. Most patients experience minimal to no side effects with a quick recovery time.

d) Spine Cancer

There is no cutting involved. Instead, the CyberKnife System delivers high doses of radiation directly to spine tumors. The CyberKnife System offers patients who cannot undergo spine cancer surgery due to their poor medical condition, or who refuse surgery, a minimally invasive alternative treatment for spine cancer.  CyberKnife spine cancer treatments are typically performed on an outpatient basis over a period of one to five days, requiring no overnight hospital stays. Most patients experience minimal to no side effects with a quick recovery time.

e) Liver Cancer

In fact, there is no cutting involved. Instead, the CyberKnife System delivers high doses of radiation directly to liver tumors. The CyberKnife System offers patients who cannot undergo liver cancer surgery due to their poor medical condition, or who refuse surgery, a minimally invasive alternative treatment for liver cancer. CyberKnife liver cancer treatments are typically performed on an outpatient basis in one to five days, requiring no overnight hospital stays. Most patients experience minimal to no side effects with a quick recovery time.

f) Pancreas Cancer

Instead, the CyberKnife System delivers high doses of radiation directly to pancreatic tumors. The CyberKnife System offers patients who cannot undergo pancreatic cancer surgery due to their poor medical condition, or who refuse surgery, a minimally invasive alternative treatment for pancreatic cancer. CyberKnife pancreatic cancer treatments are typically performed on an outpatient basis in one to five days, requiring no overnight hospital stays. Most patients experience minimal to no side effects with a quick recovery time.

The Advantages of CyberKnife

Non-Surgical Treatment Option

CyberKnife is a painless, non-invasive approach to radiosurgery that results in fewer complications than open surgery, with comparable outcomes.

Greater Flexibility

Using a fully integrated robotic delivery system, the CyberKnife allows for superior reach and maneuverability to previously inaccessible and inoperable lesions, such as lesions involving the spine, optic apparatus and pancreas. Robotic flexibility allows for isocentric as well as non-isocentric treatment.

Unparalleled Precision

With sub-millimeter accuracy, concentrated radiation beams, fired from a possible 1,200 distinct targeting positions, are directly administered to the tumor site, minimizing exposure to surrounding healthy tissue. With the addition of the Iris, the CyberKnife now has improved the localization of the radiation dose on the targeted tumor.

Superior Accuracy

CyberKnifeCyberKnife's image-guided robotic technology continually tracks patient movement and confirms tumor location prior to beam delivery, making it possible to treat lesions that move with respiration, such as lung and pancreas tumors.

Frameless System

Unlike conventional radiosurgical technology, the CyberKnife system uses the skeletal structure of the body, rather than invasive metal frames and skull pins, as a reference point for identifying the tumor position throughout the treatment.

Higher Radiation Doses

Many patients who previously reached the lifetime dose limit of traditional radiation therapy to critical structures and/or tissues can receive additional treatment with CyberKnife because of its targeted treatment precision.

What risks are there in the Cyberknife treatment?

Because the Cyberknife system is non-invasive, there are lower risks of complications when compared to other treatment options, including a lower risk of infections, lower risk of hemorrhage/severe blood loss, decreased risk of hearing loss, and decreased risk of alteration in feeling to the extremities.

Is the CyberKnife Treatment Right for Me?

With the CyberKnife System, there is not a one-size-fits-all approach to patient care. The CyberKnife System’s innovative design and use of leading-edge technologies enables your physician to tailor treatments specific to your tumor(s) shape in order to ensure the best possible outcome. The unique features of the CyberKnife System that allow for individualized treatments include:

Real-Time Image Guidance –

The CyberKnife System uses imaging software to track and continually adjust treatment for any movement of the patient or tumor. Unlike other

radiation treatments that require patients to hold their breath during treatment delivery or rely on the use of rigid head frames that are screwed into the patient’s skull to minimize motion, the CyberKnife System will allow you to breathe normally and remain comfortable during your treatments.

Unlimited Flexibility & Freedom –

The CyberKnife System’s robotic maneuverability allows your physician to deliver a highly individualized treatment. With a linear accelerator mounted on a flexible robotic arm, the CyberKnife clinician can select from thousands of different angles from which

to deliver radiation treatments. A typical CyberKnife treatment is comprised of 150 to 200 beams, each coming from a unique angle. This is a significant improvement over traditional static or fixed radiation delivery

systems, which typically only can treat a tumor with seven to nine discrete beams and require patients to be manually adjusted to deliver radiation from additional angles.

Unrivaled Accuracy –

The CyberKnife System can treat moving tumors with pinpoint accuracy that is unmatched by other radiosurgery systems. This is especially important when treating tumors that move with any bodily function, which may range from predictable movements caused by breathing to unpredictable movements due to other bodily functions, such as a gas bubble moving through the rectum. The

CyberKnife System can essentially “paint” your tumor with a high-dose of radiation by targeting the tumor from almost every conceivable angle. Unrivaled by any other

technology, the CyberKnife beams are guided by the actual movement of the tumor.

The X-rays in the CyberKnife treatment room are constantly taking pictures of the tumor, comparing its actual location to the treatment plan, and instantly reporting it back through a sophisticated software program to the robot. The robot responds to the new location and instantly adjusts the beam to accurately target the tumor. This unique tracking capability results in an extremely accurate delivery of radiation, sparing your surrounding healthy tissue and critical organs from damage.

Convenient –

Depending on the type of tumor, you will likely need only one to five CyberKnife treatments. With other radiation systems, you could require dozens of treatments spread out over several weeks. CyberKnife patients routinely report that they have minimal side effects from their treatment, and in most cases, they can immediately return to their normal daily activities.

Patient Safety –

From design to delivery, patient safety is paramount with any CyberKnife treatment. Unlike other gantry based linear accelerators, the CyberKnife operates on a fully integrated closed loop system. Each function works in unison to ensure the safest possible patient experience.

Who Can Get CyberKnife treatments?

It is up to your medical team to determine whether the CyberKnife treatment is right for you. Your doctors will make the decision about whether to treat with the CyberKnife System based on their clinical experience. Other factors that will influence their opinion are the tumor type, location and size of the tumor, and extent of disease. It is important to keep in mind that sometimes there are many different approaches and opinions can differ. The CyberKnife System is versatile and can treat cancers from early stages to advanced disease and, in some cases, the treatment can be partnered with surgery, chemotherapy, and conventional radiation therapy.

Your CyberKnife Treatment - Step-by-Step

After or during your diagnoses, your physician will determine if you may benefit from the

CyberKnife treatment. If you are a candidate, you can expect that your CyberKnife treatment(s) will involve a team approach

in which several medical professionals will collaborate to develop a treatment plan designed just for you.

The CyberKnife treatment process generally requires six simple steps from start to finish:

1. Evaluation – After being diagnosed, you can contact a CyberKnife center directly or have your treating doctor provide you with a referral. Though it may vary based on your specific treatment, you will likely work with a team of clinicians, including a radiation oncologist, surgeon, medical physicist, radiation technician and nurse coordinator.

2. Fiducial Placement – Depending on the type and location of your tumor, your team may recommend placement of fiducials which are small gold markers inserted near the tumor to help identify the exact location of your tumor during treatment. Not all treatments require fiducial markers. The determination will be made based on the density, size and location of the tumor.

3. Imaging – Prior to treatment, an MRI and a CT or CT/PET scan is taken to determine the size, shape and location of your tumor(s).

4. Treatment Planning – Using images from a CT scan, the data is digitally transferred to the CyberKnife System’s treatment planning workstation, where a qualified physician identifies the tumor(s) to

be targeted and the surrounding vital structures to be avoided. This plan is designed to match the desired radiation dose to the tumor location and limit radiation exposure to the surrounding healthy tissue.

5. Treatment – Once the treatment plan is developed, you can begin your CyberKnife treatments. At the CyberKnife center, you will be comfortably positioned on the treatment table. Then the CyberKnife System’s computer-controlled robot will carefully move around you to deliver radiation at various locations as prescribed by your treatment plan. At the same

time, the CyberKnife System is taking continual X-ray images that will provide real-time information about the location of your tumor and enable the system to dynamically track and correct for any

movement of your tumor. Depending on the type and location of your tumor, you can expect to undergo between one and five treatment sessions.

6. Recovery – Most CyberKnife patients do not experience side effects. Depending on the type of treatment you receive, your side effects will vary. Patients that do experience side effects are typically mild and considered acute and do not require intervention. Patients should speak to their doctor and discuss what side effects may occur and learn about potential risks.

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