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Cyberknife: Surgery Without Cutting For Hard-To-Reach Tumors

By Rhonda Mann - Beth Israel Deaconess Medical Center Staff

More than 50,000 people have turned to it to treat hard to reach cancers: Cyberknife RadioSurgery uses real-time, image-guided robotics to accurately target tumors and lesions that may otherwise be untreatable.

"This is a real breakthrough," says Dr. Anand Mahadevan, of the Keith C. Field Cyberknife Center at Beth Israel Deaconess Medical Center, the first center in New England to offer Cyberknife therapy. "In the past, we've been limited to how much radiation we can give to treat cancers because it scatters around the tumor and causes collateral damage to nearby structures. This therapy pinpoints the exact location, sparing surrounding tissue."

Cyberknife was first approved by the Food and Drug Administration in 1999 and is now used to treat tumors and lesions of the brain, optic areas, neck, spine, pancreas, lung, liver and prostate. The treatment delivers high doses of radiation with sub-millimeter accuracy, adjusting for any tumor or patient movement.

"Even lung cancers, which move as you breathe, are targeted with unprecedented accuracy," says Dr. Mahadevan. "Because of its precision in hitting moving targets, the chances of controlling small lung cancers are very high, over 80-90 percent."

Patients are awake during the hour-and-a-half to two hour painless procedure. Side effects are rare and include fatigue, Dr. Mahadevan says. Most patients undergo one to five treatments over a week's time, as opposed to five to six weeks of conventional radiation. The risks with Cyberknife are also much less than conventional radiation, but include scarring of treated areas, and other local effects like ulcers in the stomach when treating tumors in the abdomen.

Terry Barden, RN, one of the Cyberknife Coordinators at the BIDMC Cyberknife center, says they've seen almost 1,000 patients since they began offering Cyberknife treatment in 2005. Referrals are received from around the world and people travel a great distance for the therapy.

"Most patients find us because we are their last hope," she says.

Barden explains one of its main benefits is treating tumors that have recurred—so the patient does not need to subject themselves to more toxic radiation. Many who have had traditional radiation and then Cyberknife say the latter is a far better experience because of the minimal side effects and the decreased amount of treatments that they need to receive, according to Barden.

But while there are stories of cancers being cured with Cyberknife, for most patients it's a way to buy some time by shrinking tumors, and better their remaining quality of life. For some cancers, that extension can also be a life-saver.  Barden points to a liver cancer case, for example, where the therapy kept the disease from progressing long enough for a liver transplant. That patient is doing well today.

"We try to think of it this way – if this was a member of our family, of course we'd do everything we could to keep them with us as long as possible," says Barden. "We try to streamline the process as best we can to make it the least stressful for the patient and their family."

Then she adds, "we've had patients that have short-term goals and say 'I just want to see my daughter graduate.' With Cyberknife, we have helped them do that."

Above content provided by Beth Israel Deaconess Medical Center. For advice about your medical care, consult your doctor.

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