Dr. John R. Adler invented a knife that’s not really a knife.
It’s the CyberKnife. For surgeons treating patients with tumors, it doesn’t slice like a scalpel — or anything else for that matter. In fact, it never touches or penetrates the skin.
Rather, it was a breakthrough in both radiation treatment and surgery. It’s a device that robotically moves around a patient using software to precisely pinpoint bursts of radiation to attack a tumor with minimal risk of damaging healthy, surrounding tissue.
Adler, a Harvard-trained neurosurgeon, invented the CyberKnife after seeing an earlier device that he knew he could improve upon by incorporating advancements in software, imaging and robotics.
Make An Impact Like John Adler
Not only has the CyberKnife treated more than a million patients, by his estimate, the concept behind it is being incorporated in other lifesaving devices. Trying to perfect the CyberKnife and find new uses consumes Adler’s working life.
At 71, he toils on. His latest company is Zap Surgical Systems, based in San Carlos, Calif., where he is founder and CEO.
“Basically all modern radiotherapy equipment kind of does what the CyberKnife does today,” he said. “How can I not feel good about that? But also, how can I not walk away from that ability, or sense of duty, of not giving up yet.”
In medical and innovator circles, Adler has certainly attracted recognition. They have ranged from the American Radium Society’s Janeway Medal to induction in the National Inventors Hall of Fame.
The American Association of Neurological Surgeons presented Adler with its Cushing Award for Technical Excellence and Innovation in Neurosurgery in 2018.
His “vision, persistence and entrepreneurial drive” resulted in transformative advances in radiosurgery, said Katie Orrico, the association’s CEO.
“These innovations have reshaped the neurosurgical landscape, giving patients with brain and spinal tumors and arteriovenous malformations noninvasive treatment options that were once unimaginable,” she said “His contributions continue to change lives every day, and our profession is stronger for his leadership and example.”
Approach Life With Sense Of Wonder
Adler considers himself to be a surgeon first, though much of his career has been dominated by his work as an entrepreneur. In both the realms of medicine and invention, he looks back on his accomplishments with a sense of wonder.
At almost every turning point, from being accepted to Harvard, taking the leap into becoming a physician, inventing a device that would improve the lives of millions, Adler expresses a sense of awe.
He said he really never thought about the “capacity of a human being, of one person to change the world through your ideas. And it never dawned on me that you could have ideas that other people would then want to use.”
Adler: Build On Great Ideas
The idea of the CyberKnife didn’t leap out to him in the dark. Rather, it was the result of lifelong learning and lessons.
He was born in Yonkers, N.Y., and raised in Somers, Conn. His parents worked together in bookkeeping and accounting. He was entrepreneurial from the beginning, starting with a succession of newspaper delivery routes starting at age 11 and culminating in working on a fishing boat at age 18.
Some of his lessons came from scouting. In working his way up to becoming an Eagle Scout, Adler learned to always leave his campsite better than he found it. And from an unhappy stint in parochial school, he was ingrained with the notion that it’s a sin to not use your God-given talents.
Except for maybe athletics, to which he admits to being mediocre, Adler succeeded at most of what he tried. His motivation to be the best was usually straightforward. When it came to outselling other Scouts during fundraisers, he wasn’t trying to show off. He just wanted to go to camp for free.
Adler assumed that he’d attend the University of Connecticut for college, but was told by his high school teachers he was smart and accomplished enough to have a shot at Harvard. He got in. Then, coming from a family of modest means, he graduated in three years to save money.
Aiming to become a biochemist, a classmate urged him to apply for medical school instead. He liked the idea of applying his science education to treating patients while still being able to do research.
As he would so many times in his life, he took the more challenging route: becoming a surgeon. “The harder work appealed to me,” he said. Besides, surgery was almost a throwback to his days casting nets. “There’s not that much difference between filleting a fish and operating on the human spine,” he said.
Become Obsessed
His breakthrough began with a stint in Stockholm, Sweden, to study radiosurgery. An inspirational surgeon, Lars Leksell, had invented a device he called the Gamma Knife. Like what would become the CyberKnife, it shot radiation into the skull of brain tumor patients with a high degree of precision. The downside was the device had a frame that had to be screwed into a patient’s skull — not a pleasant prospect.
Adler thought he could improve on Leksell’s creation. He envisioned a machine that fired beams as precisely as Leksell’s without a frame.
He became obsessed. “I became possessed with trying to make something new and better and different,” Adler said.
The actual concept didn’t take that long to create — a couple of weeks. A computer could analyze X-rays or a CT scan and a robotic arm would then move around the head to aim the radiation beam. There were added benefits. Without a Gamma Knife-style frame, the same principles could be applied to anywhere on the body, wherever a tumor appears.
Gradually, Adler worked through the challenges and the finer points of the device. Obsession gave way to perseverance. He filed a patent but couldn’t find backers for the project. Adler presented to medical device giants like General Electric (GE), Siemens and Phillips and each rejected the concept.
“The hard part of invention is that until you’ve proven it, it’s just an idea,” Adler said.
Embrace Your Vision Like Adler
By then, Adler had moved to Stanford University in the heart of California’s Silicon Valley and formed a company, Accuray. He convinced Stanford to fork over $1.3 million to buy one of his machines in the early 1990s. Fellow surgeons kicked in an additional $800,000 or so.
The first machine was rudimentary and clunky by his own admission. But “it worked,” he said. “Kind of lived up to maybe 50% of what was promised, but it was enough to get going.”
He got going, but the first few years were rough. Money was tight. He plowed all he had into the company he created to make the CyberKnife. Eventually a Japanese company invested and he started selling CyberKnife machines in Japan.
After another run of tough times, Adler took Accuracy’s helm.
“The company was really floundering,” he said, and his arrival was met by a management revolt. But over three years he said he was able to right the ship. By the time he left, the order book was in good shape, allowing Adler to return to research at Stanford where he developed procedures that made the machines even more useful.
Make The Elephant Dance
He left Accuray and went to a big health care company, Varian Medical (VAR), which has an extensive radiotherapy unit. But it lacked the nimbleness of a small company. He wasn’t happy. “After a couple of years trying to make the elephant dance, I realized this elephant wasn’t going to dance,” he said.
He left to create Zap. The company is looking to prove how radiation can be used more to treat tumors. For instance, he cites research that shows that radiation treatments could provide promise in treating depression and addiction.
Once again, he said he’s obsessed — “good team, good culture, solid investor base, growing business, growing market.” He’s eyeing a possible initial public offering in a couple years.
From the operating room to the boardroom, Adler has experienced it all. Does he miss being a working surgeon?
“Immensely,” he said. “Only a surgeon would understand what an amazing experience it is to be able to walk into an operating room and take a diseased human being and restore them to health or cure them. It’s an amazing thing. I like to say there’s few better things in life than coming out of the operating room and seeing a grateful family that’s just exuberant.”
He’s a found a substitute.
“I liken it to a big hug by one of my grandkids. It’s just an amazing feeling, pure joy,” he said.
Adler’s Keys:
- Neurosurgeon who invented the CyberKnife stereotactic radiosurgery (SRS) system, allowing precision therapeutic radiation.
- Overcame: Initial lack of commercial interest in the CyberKnife.
- Lesson: “I became possessed with trying to make something new and better and different.”
- AUTHOR: CHRIS WOODYARD
- https://www.investors.com/news/management/leaders-and-success/john-adler-created-surgical-knife-cut-above/