CyberKnife Radiotherapy

What is CyberKnife?

CyberKnife is a non-invasive radiation treatment that can be used on cancerous and non-cancerous tumours and other conditions where radiation therapy may be required. It delivers stereotactic radiosurgery (SRS), and stereotactic body radiation therapy (SBRT), treatments anywhere in the body with true robotic precision and integrated, AI-driven, real-time motion synchronization.

It can be used to treat a whole range of different types of cancers including but not limited to prostate cancer, lung cancer, brain, spine and head and neck cancer, breast cancer, pancreatic cancer and kidney cancer.

CyberKnife was developed during the early 90s and although it is still regarded as a ‘new’ or ‘novel,’ treatment, it has been used more often of the years and gained popularity due to the fact it can reduce the amount of treatment time needed. It has further use cases as it can also be used on patients who have inoperable tumours.

Benefits of CyberKnife

As it is non-invasive, there is rarely any pain related to the treatment. Other benefits of having CyberKnife include:

• Effectively treat irregular shaped tumours in challenging areas
• Can be treated on tumours that may have been previously diagnosed as inoperable  
• Can and will normally be done as an outpatient procedure
• No anaesthetic
• No scarring as no incisions are needed
• The whole process can be performed rapidly
• Accuracy achieved by constant monitoring of movements as the radiation beams are delivered. The CyberKnife’s integrated X-ray imagers provide continual image guidance and real-time tracking capabilities which help ensure the radiotherapy treatment is highly accurate and precise.
• Gentle application
• Minimises damage to surrounding healthy tissue
• Reduced side effects and low impact on daily life
• Reduces potential risks of infection unlike surgical procedures

What is the Process for CyberKnife Treatment?

Using an innovative and modern piece of technology, the CyberKnife system offers precise beam radiation therapy that can target tumours accurately, including irregular tumours in areas such as the brain or spine.

Depending on your case, the treatment can be performed in one to five sessions over the course of 5-7 days. Where other radiation therapies may involve going in for treatment several times over a number of weeks and months, this is one big benefit of the CyberKnife treatment. Your care team should discuss the best and most appropriate way to administer the treatment for you.

The actual treatment involves a number of stages:

First Assessment

Your oncologist will talk to you about your case and whether CyberKnife is an appropriate treatment option for you.

Imaging & Scans

If you agree with your doctor that you would like to move forward with CyberKnife treatment, the next stage will involve collecting images and MRI scans. If you have brain, spine or liver lesions, your MRI scan should be done less than 4 weeks before while for lung lesions, a CT scan alone will only be needed.

Planning the Treatment

Once all the necessary images have been provided to your consultant, they will upload the data onto a computer so that the team involved in your case can review these and decide on the best way to perform the treatment. This will involve working out how many beams the robot should deliver to the tumour in addition to the intensity and direction. 

About the CyberKnife System

The CyberKnife system comprises of a number of innovative technologies that work effectively to precisely target lesions. The machine that is used to perform the treatment features a small radiation device that is mounted on a robotic arm on the machine that can move in 6 different plains to accurately target the tumour. The robotic arm can easily move to target tumours in even hard to reach areas of the body without targeting beams on surrounding healthy tissue.

During the planning stage, your physicians will have worked out exactly the direction of travel the robotic arm needs to move in.

The second feature is a computer assisted image guidance targeting system that will be used to accurately target the right area throughout the system. This innovation can allow for small movements to happen which will prevent the cancer to “escape” the beams.

The third technological advancement of the system relates to the capability of the treatment beam to follow targets even with slight movements. Breathing can alter the position of tumours that are located in areas such as the lungs and liver however any movement from breathing is monitored using an infrared camera and internal tumour motion. The system then can actually move with the patient and follow the tumour to target the beams in the right place and ablate the tumour without any need for incision.

This is one big advantage of CyberKnife radiation therapy in comparison to traditional radiation therapies whereby fixation devices are not needed. In traditional radiation therapies, the beam can also cause the patient to be put into breath arrest too.

Discover more about CyberKnife treatment and how it works.

The Treatment Itself

You can usually go in for CyberKnife treatment as an outpatient. The treatment itself uses the CyberKnife system; a robot-like machine that will deliver the radiation to the targeted area.

If your tumour is located in the brain/head, a special mould will have been created beforehand that will keep your head in place and stop it from moving however this is different to a frame.  

Entering the treatment room, your physician will ask you to lay down on the treatment table and the CyberKnife system will be located above your body. If you are being treated for head/brain tumours, the moulded head rest will be used, while for other lesions a body guide will be placed.

To ensure precise radiation, you will be encouraged to lie as still as possible while the treatment is performed.

Your physician team will watch the treatment be performed using video cameras where you can also talk to them through a microphone at any stage. The actual treatment should take roughly between 45 minutes and an hour to perform.

Follow Up

After the treatment, you may return to ‘normal’ daily activities. If more than one session of treatment is required, you will have to return to the clinic to undergo the remaining sessions.

Once the treatment has been delivered, you should have regular check-ups with your care team to review progress with your health condition. 

What Does the Treatment Feel Like?

CyberKnife is non-invasive so you are unlikely to feel anything while the beam radiation is delivered. During treatment, you may hear the machine moving around in order to target the areas of the tumour. Very often, clinics will let you bring your own music in to the room to listen to that can help you relax while the treatment is happening.

Preparing for CyberKnife Treatment

Due to the nature of the treatment, no special steps need to be taken prior to the surgery. Patients can have their breakfast as normal alongside any medication they usually take. To help you feel more comfortable and more relaxed, you may want to bring a close relative or friend along with you on the day(s) of treatment.

Potential Side Effects of CyberKnife

As it is non-invasive and gentle, most patients can go on to resume daily activities such as work and maintain quality of life after the treatment. However, while side effects from CyberKnife are minimal, all treatments do come with associated risks and side effects. Depending on the amount of radiation delivered may impact what side effects experienced.

Some side effects from CyberKnife treatment can include:

• Hair loss if the radiation has been administered close to the scalp
• Skin rashes or irritation from where the radiation has been delivered
• Fatigue
• Nausea
• Changes in bodily functions

Most side effects from CyberKnife will be temporary, however if you are concerned or they are ongoing, you should discuss these openly with your care team so they can offer advice and help you manage them.

Signs the Treatment is Working

The effectiveness of the therapy should be monitored through CT Scans and MRI scans after treatment. Your doctor will be able to see how the tumour has reduced/disappeared using these. The time it takes to see the effects can differ between patient so you may be asked to have more CT/MRI scans to evaluate the progress.

Daily Life After Treatment

As this type of treatment can be performed in a short space of time with less side effects, most patients can get back to resuming normal activities quickly. As with all treatments, side effects such as nausea and fatigue may disrupt your life temporarily and, depending on how quickly the tumour disappears or reduces can impact recovery. When your oncologist discusses your options with you, they should talk to you about what impact the treatment could have on your quality of life in order so you can make the best decision for you.

Costs of Treatment

Many private healthcare insurance providers will now cover the cost of SRS and SBRT however it is best to check what cover (if any) you have with your own provider.

Costs of treatment may vary depending on how many sessions are needed and the type of cancer being treated so it is best to talk through the potential costs with your doctor before moving forward with the treatment.

Some healthcare systems also offer reimbursement of treatment costs that can be claimed after travelling abroad for treatment. The NHS for example, can fund certain types of treatment in the EU, Norway, Iceland, Lichtenstein and Switzerland if eligibility criteria is met through the EU directive route. More information on eligibility criteria and how to apply can be found on the NHS website.

Getting treatment abroad while being reimbursed for costs may help you to access treatment more quickly however it is important to do your research and consider all the implications of this.

Alternatives to CyberKnife

Other Examples of Beam Radiation Treatment

CyberKnife is just one type of beam radiation therapy. Other types of beam radiation treatments include intensity-modulated radiation therapy, Gamma Knife radiosurgery, stereotactic body radiation therapy and proton therapy; all of which are alternatives to more conventional radiation therapies.

There are advantages and disadvantages to all types of treatment and each treatment has different use cases. In that respect, no one treatment will be suitable for every individual and case. Your oncologist should guide you through all your options and the benefits and drawbacks of each one so you can make an informed decision about the right treatment for you.

Explore Your Treatment Options

Oncolomed are partnered with a number of hospitals and clinics that offer this non-invasive treatment that can be delivered effectively and quickly.

However, CyberKnife is just one type of radiotherapy treatment for cancer and the best treatment for you will depend on a range of factors. Oncolomed can facilitate second opinions and treatment with leading oncologists and clinics worldwide that can help you explore your options and access the most suitable treatment. By guiding you through the process and facilitating treatments, you can concentrate on your own health and your family without the added worry of arranging your own treatment and everything in between.

Explore the range of cancer treatments we facilitate through our network or get in touch with our team for advice on yours or a loved one’s situation.

Further Resources & Websites

https://cyberknife.com/