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Frequently Asked Questions
- How is CyberKnife Different from other Stereotactic Radiosurgery Systems?
- What is Radiosurgery and how is it different from Radiotherapy?
- What Does CyberKnife Treat?
- What are the Benefits of CyberKnife?
- What are the Side Effects of CyberKnife Radiosurgery?
- Is CyberKnife Treatment Covered by Insurance?
Stereotactic radiosurgery has been used for more than 30 years to treat benign and malignant tumors. Radiosurgery does not remove the tumor or lesions, rather it uses high doses of radiation to destroy the tumor cells and stop the growth of active cells. For this treatment, multiple beams of radiation produced by a linear accelerator are directed at the abnormal lesion within the body.
Several stereotactic radiosurgery systems are available, with the most widely-used being the Gamma Knife and modified linear accelerators. CyberKnife's key advantage over other systems is its precision, enabling physicians to maximize the amount of radiation that reaches the tumor while minimizing exposure to healthy tissue and organs.
CyberKnife is the only radiosurgery system to combine a linear accelerator, a robotic arm and the image guidance system. With its unique precision capabilities, the CyberKnife can target lesions that are unreachable by other radiosurgery systems. It is also the only system that can continually monitor and adjust in real-time for patient movement during treatment. For procedures such as the Gamma Knife, patient movements are restricted through the use of a frame that must be bolted to the head with skull pins. The CyberKnife can locate and treat tumors without the use of this painful, invasive head frame. Also, unlike Gamma Knife, this precision can be equally extended to targets in the body (not just the brain, as with Gamma Knife) including targets that constantly move with breathing or with heart beats.
Stereotactic radiosurgery (SRS) combines the principles of stereotaxy, or 3-D target localization, with multiple cross-fired beams from a high-energy radiation source to precisely irradiate an abnormal (oftentimes cancerous) lesion within a patient's body. This technique allows maximally aggressive dosing of the target, while normal surrounding tissue receives lower, non-injurious doses of radiation. The ideal objective is the ablation or destruction of the targeted area without damaging any normal tissue outside of the defined target area.
Stereotactic radiosurgery differs from conventional radiotherapy in several ways. The efficacy of radiotherapy depends primarily on the greater sensitivity of tumor cells to radiation relative to normal brain tissue. With all forms of standard radiotherapy, the spatial accuracy with which the treatment is focused on the tumor is a secondary concern; normal tissues are protected by administering the radiation dose over multiple sessions (fractions) daily for a period of a few to several weeks. In contrast, radiosurgery, by its very definition, requires much greater targeting accuracy. With SRS, normal tissues are protected by both selectively targeting only the abnormal lesion, and using cross-firing techniques to minimize the exposure of the adjacent anatomy. Since highly destructive doses of radiation are used, any normal structures (such as nerves or sensitive areas of the brain) within the targeted volume are subject to damage as well. Typically, SRS is administered in one to five daily fractions over consecutive days. Nearly all SRS is given on an outpatient basis without the need for anesthesia.
Treatment is usually well tolerated, and only very rarely interferes with a patient's quality of life.Stereotactic radiosurgery has been used for more than 30 years to treat benign and malignant tumors, vascular malformations, and other disorders of the brain with minimal invasiveness. To date, more than 200,000 patients have been treated worldwide with radiosurgery. The success of SRS is based, to a large extent, on the use of a multidisciplinary approach, which requires close interaction between surgeons, radiation oncologists, medical oncologists, physicists, diagnostic radiologists, technicians, and nurses. This specialized team is responsible for the selection of appropriate patients for SRS, treatment delivery, and long-term follow-up.
- Cancers involving the brain
- Lung cancers
- Pancreatic cancers
- Metastatic liver cancers
- Cancers involving the spine
- Benign brain tumors, such as acoustic neuromas, meingiomas, pituitary adenomas, craniopharyngiomas hemangioblastomas, schwannomas Malformations of blood vessels within the brain, such as arteriovenous malformations (AVMs)
- Trigeminal neuralgia
- Metastatic orbital tumors, orbital lymphomas and orbital inflammations (tumors or inflammations around the eye)
The CyberKnife system offers an entirely new approach to stereotactic radiosurgery, one that does not require fixing a frame to the body and offers superior precision to minimize the effect on healthy tissue. More than 10,000 people worldwide have been treated with CyberKnife, a noninvasive alternative for patients who are not ideally suited for or unable to undergo traditional surgery. The benefits include:
- Non-invasive treatment
- No anesthesia
- No pain
- No incision
- No blood
- Immediate return to normal activity
- No metal head frame or skull pins for improved patient comfort
- No hospitalization
- Minimizes radiation exposure to healthy tissue and organs
- Continually compensates for any movement during treatment to ensure accuracy
- Lesions that previously received the maximum allowed dose of radiation can be treated
The CyberKnife is not really surgery and therefore, does not present the same risks - there's no anesthesia, no risk of infection and hemorrhaging is minimized. There are also fewer complications with CyberKnife compared with other radiosurgery systems, such as the Gamma Knife with its invasive head frame. After treatment with CyberKnife, some patients experience side effects related specifically to the area of treatment, such as headaches after brain treatment or nausea after abdominal area treatment. Tiredness may occur for some people, regardless of the area treated. Although not common, there may be skin reddening in the treatment area. Rare complications, again related to the area of treatment, may include decreased or loss of function in the treated organ. Medications may be used to treat symptoms such as brain swelling after brain treatment.
The CyberKnife procedure, like other stereotactic radiosurgery, is generally covered by most insurance plans as well as Medicare. Because CyberKnife is new to our region, some insurance companies may not be familiar with our services. We ask all of our patients to share with us their insurance information so we can assist with obtaining pre-authorization to meet coverage requirements.