Before CyberKnife treatment, you will meet with the radiation oncologist and surgeon to determine if CyberKnife is the best option for you. You may be required to undergo testing such as PET scan, CT scan, bone scan, blood work, biopsy, hearing tests, or fiducial placement prior to beginning the planning stage.
Fiducial placement is a short outpatient procedure in which a radiologist places a fiducial or small gold seed marker in or near the tumor. Fiducials enable the CyberKnife system to track tumor motion in organs such as the lungs, liver, pancreas, and prostate.
In addition to all of your prior diagnostic scans, you will be required to undergo special planning scans (CT, MRI, or PET). Your radiation oncologist will order the appropriate scans for your treatment. During the CT scan a CyberKnife therapist may construct special treatment devices to assist in the treatment delivery.
The CT data (MRI and PET-CT if required) is downloaded to the CyberKnife treatment-planning computer, where the medical physicist, radiation oncologist, and surgeon use advanced software to obtain a customized treatment plan. This procedure can take up to five days to complete.
CyberKnife treatment planning is performed by a team that designs your unique treatment ahead of your first session. Although CyberKnife sounds like surgery, it’s not. It’s a highly precise, non-invasive and advanced robotics system that delivers high doses of radiation to tumors with pinpoint accuracy.
Several specialists, including medical physicists and a radiation oncologist, work together to create a personalized treatment plan just for you. Before your treatment begins, you will be imaged using a high-resolution CT scan, MRI scan, or PET scan, which will determine the size, shape, and location of any tumors.
Following scanning, we digitally transfer the image data to the CyberKnife system’s treatment-planning workstation. From there, the radiation oncologist and medical physicists determine the right radiation dosage SMF treatment angles, as well as what critical organs to avoid for your particular case.
They work together, often with a collaborating surgeon, to deliver a powerful radiation dose to the identified tumor location. Their treatment plan is designed to attack cancer cells while limiting radiation exposure to the surrounding healthy tissue.
If you’re concerned about what to expect from CyberKnife treatment, you can relax. CyberKnife is pain free, comfortable, and only requires one to five visits to complete a course of treatment.
Once our team of doctors develops your individual treatment plan, they’ll help you prepare for CyberKnife treatment by positioning you on the comfortable treatment table. You won’t be placed inside any restrictive and uncomfortable immobilization devices. Instead, you’ll be able to relax while the CyberKnife’s robotic arm moves slowly around you.
In addition to using data from your original planning scans, the CyberKnife system takes real-time images of your tumors and runs them through its tumor-tracking software, allowing it to accurately track even very minute movement.
The intricate robotic arm delivers radiation to the tumor from almost every imaginable angle. When your body moves, the robotic arm makes immediate adjustments. It keeps radiation beams precision to sub-millimeter accuracy, preventing damage to healthy tissue.
The CyberKnife accuracy allows for very high doses of radiation requiring one to five treatments per course, unlike the low doses of conventional radiation therapy of over 25 to 40 treatments per course.
Each CyberKnife treatment session will typically last between 30 to 60 minutes, depending on the type of tumor and area being treated.
Side effects and complications with CyberKnife are less prevalent than those found in other radio-surgery modalities or radiation treatments. The side effects are also usually specific to the anatomic area being treated, and may vary in different patients.
However, it is still possible that following treatment some patients may experience minimal general side effects, such as fatigue, nausea, or headaches but those often go away within the first week or two after treatment.
Uncommon complications may include skin reddening or vomiting. Most patients experience minimal to no short-term side effects and often recover quickly.
Late side effects can occur months or years later; some may require intervention. Discuss your specific case with your physicians to fully understand the potential risks associated with your treatment regimen, since side effects are dependent on the site and duration of treatment.
The radiation being delivered by CyberKnife is so focused on a specific target that it is highly unlikely that hair loss or skin burn will occur. Typically, the radiation dose administered is not sufficient to cause permanent damage to the skin or hair follicles.
In the event that an intracranial lesion being treated is close to the scalp, a patch of hair may be affected. The hair may grow back, but not in all cases. Patients receive instruction before and after treatment and have an opportunity to talk with members of the medical team so that they are aware of possible events specific to their case.
Even when it feels like you’re being absolutely still, your body is in constant motion. Internal organs, like the bowels, are lined with smooth muscles that are always moving. You also need to breathe, so your lungs inhale and exhale, creating further movement within your body. This motion, though completely natural, presents challenges for many conventional radiation treatments.
With standard radiation treatments, the motion of the tumor requires more normal tissue to be irradiated. The doctors may order compression or immobilization devices designed to keep the patient still. One radiation treatment option for brain tumors, for example, requires doctors use a halo head frame bolted into the patient’s skull to completely immobilize the patient.
The CyberKnife system has been designed to deliver effective treatment with maximum comfort for patients. Thanks to real-time imaging, tumor-tracking software, and state-of-the-art robotics, CyberKnife treatment lets you skip those compression devices and immobilization techniques.
Because of the CyberKnife’s incredible precision, your team can deliver high-dosage radiation without significant damage to healthy cells. You will be treated on an outpatient basis and return home.
After treatments, patients typically follow up with their radiation oncologist and/or surgeon and are asked to get periodic CT/MRI/PET scans so that their doctors can monitor their progress.