CyberKnife Treatment

CyberKnife is an advanced technology for non-invasive, painless radiosurgery that offers sub-millimeter precision in the treatment of cancer anywhere in the body.

What is CyberKnife?

CyberKnife is an advanced linear accelerator designed for cancer treatment. It can be used to treat cancerous and noncancerous tumors and some other conditions where radiation therapy is appropriate. CyberKnife is composed of a linear accelerator weighing 140 kg, which produces 6 MV x-rays, positioned on an industrial robot with six joints and a robotic patient couch that can move in six directions. The treatment device turns the patient around using computer-controlled robot technology and applies radiation from hundreds of angles. The robot has a sensitivity of 0.2 mm. Using this system, cancerous areas in the brain and all over the body can be treated with high doses of radiation. Normal tissues are highly protected from the effects of radiation. 

How does CyberKnife work?

CyberKnife is applied by placing a plastic mask or body immobilizer on the patient, without the need for a surgical procedure. During treatment, the patient is placed on a robot-controlled table that can move six-dimensions. An image-capturing system tracks the tumor’s location and monitors the patient’s movements to change the positioning if necessary. This helps with the safe treatment of lung and liver tumors that move with respiration. During the treatment, the patients do not have to hold their breath or breathe regularly. The system compares the computerized tomography and magnetic resonance images taken before treatment with the instant images taken during treatment. The tumor coordinates that are obtained are instantly assessed with the help of the computer, and the radiation dose is adjusted. Therefore, the treatment is not affected by the small movements of the patient. The delivered radiation dose is limited to the tumor, and damage to the surrounding healthy tissue is kept to a minimum. The results of the procedure appear gradually over time, and the tumor shrinks.

Stereotactic ablative radiotherapy

CyberKnife can deliver stereotactic radiosurgery (SRS) and stereotactic ablative radiotherapy (SABR). SRS is an alternative to surgery that does not involve incisions. Instead, it uses focused beams of radiation to treat cancerous tissues with surgical precision. The aim is the destruction of the tumor in a single session through high doses of radiation. When this treatment is delivered in more than one session (usually 3–5 sessions), it is called stereotactic radiotherapy. Unlike the Gamma Knife device, which is designed to perform radiosurgery mainly on brain lesions, CyberKnife can deliver treatment anywhere in the body. This is usually called stereotactic body radiotherapy (SBRT) or SABR. SABR applies high doses to the target areas with extreme accuracy, causing minimal damage to surrounding healthy tissues.

Advantages of CyberKnife

• Sub-millimeter precision. The system performs the treatment with a sensitivity of less than a millimeter, ensuring minimal damage to healthy tissue. 
• Full body capability. CyberKnife allows for the treatment of tumors or lesions throughout the body. 
• Alternative to surgery. CyberKnife is particularly useful for multiple tumors requiring complex surgery and in treating tumors that cannot be surgically removed.
• Motion synchronization. CyberKnife monitors the patient’s respiration and tumor movements, making sensitive corrections and applying radiation accordingly.
• Short treatment cycle. Typically, the radiation treatment is applied over one to five sessions.
• Painless treatment. There is no pain associated with radiation treatment delivered by the CyberKnife radiosurgery system. It does not require anesthesia.
• Outpatient treatment. CyberKnife treatment greatly reduces the risk of complications and the recovery time associated with traditional surgery. After treatment, most patients can return home and resume their regular activities.

CyberKnife cancer treatment

CyberKnife can be used for the treatment of cancer anywhere in the body when radiation therapy is indicated. It is preferred for the treatment of malignant and benign tumors, metastases, arteriovenous malformations, and some functional diseases. However, patients should consult their physician to determine if this treatment is right for them. 

Among others, CyberKnife can be used to treat the following conditions:

• Primary and metastatic brain tumors
• Head and neck cancers
• Spinal and vertebral tumors
• Soft tissue tumors (lung, kidney, liver, and pancreatic cancers)
• Acoustic neuromas
• Meningiomas and skull base tumors
• Pituitary tumors
• Eye cancer
• Recurrent and residual tumors
• Arteriovenous malformations
• Functional disorders, such as trigeminal neuralgia
• Prostate cancer

This method can be used safely on patients who have received radiotherapy previously for a disease that has recurred in the same area.

CyberKnife for prostate cancer

CyberKnife treatment can be used as a first-line option for early-stage, low- or intermediate-risk prostate cancer. In patients with advanced prostate cancer, this method may help to slow the progression of the disease. Surgery and radiotherapy are common treatment options for prostate cancer. CyberKnife is as effective as surgery and more accurate than conventional radiation therapy. According to clinical data, SBRT prostate treatment offers excellent disease-free survival rates at five years post-treatment. Additionally, it is non-invasive, painless, and convenient for patients. CyberKnife treatment for prostate cancer is usually completed in 4–5 sessions over 1–2 weeks, while traditional radiotherapy takes 8–10 weeks.

CyberKnife side effects

Due to its specific features, CyberKnife usually causes fewer and milder side effects than standard radiotherapy. In most patients, it comes with few to no side effects. However, as with any radiation treatment, CyberKnife has some potential risks. These vary from patient to patient depending on the tumor type and location, treatment dose, and general health condition of the patient. Fatigue, skin irritation, nausea, and vomiting are temporarily observed in some cases. Some patients may encounter other problems depending on the treated area. Our physicians discuss potential side effects and their management in detail with patients before their procedure.

Why choose Acibadem?

• Internationally recognized expertise in cancer treatment. Patients from 40+ countries come to Acibadem Oncology Centers for their cancer treatment. Advanced technology, leading medical professionals, and a multidisciplinary approach are our best tools against cancer.
• A variety of treatment options. Radiation oncology is rapidly developing to ensure greater safety and efficacy for cancer patients. At Acibadem, we have the latest devices and treatment options available to ensure that our doctors can select the most appropriate solution for each patient.
• Comprehensive service for international patients. Our International Patient Center provides 360-degree services for the convenience of our foreign patients, from scheduling treatment appointments to assisting with travel and accommodation arrangements.

What Types of Cancer are Treated by CyberKnife?

CyberKnife is a stereotactic radiosurgery machine used in cancer treatment. It can be used for primary cancers or metastatic cancers. A primary tumor means a tumor belonging to the organ or tissue itself. It arises from the organ or tissue’s cells. On the other hand, a secondary (metastatic) tumor is a tumor formed by the spread of cancer cells in a part of the body to other parts. CyberKnife treatment is used in both malign and benign cancer types. Also, if a treated cancer comes back (recurring cancer), radiation oncologists may apply Cyberknife treatment. This technology may be beneficial in destroying some tumor types in the brain, lungs, prostate, liver, pancreas, kidneys, breast, ovarian, spine, spinal cord; and head and neck. CyberKnife may provide better outcomes for localized tumors and patients with a limited number of metastases.

The brain is one of the main areas in which CyberKnife is used. Different types of brain tumors such as astrocytomas, gliomas, skull-base tumors, meningiomas, schwannomas, pituitary adenomas, and brain metastases could be treated with this technology. According to tumor size, location and type, physicians decide whether to apply CyberKnife treatment or not. Acıbadem brain tumor boards meet to evaluate patients and decide which treatment would benefit the patients more.

CyberKnife is a considerable treatment alternative for localized prostate cancer. For several years, radiotherapy was used to treat prostate cancers. With conventional radiation therapy, cancer was eradicated in more than 30 sessions and 2 months. It was a long and exhausting treatment for patients. However, today, CyberKnife treatment is just completed in less than 5 sessions and 2 weeks. Until today, more than 20,000 prostate cancer cases have been treated with CyberKnife.

What Can You Expect After CyberKnife Treatment?

After your certain diagnosis, optimal treatment for your cancer is evaluated in the Acıbadem tumor board. A tumor board, a multispecialty team consisting of surgeons, medical oncologists, radiation oncologists, radiologists, nuclear medicine physicians, and pathologists, come together in regular tumor board meetings to evaluate several different factors affecting a patient’s condition. Then, they decide on the best possible way for the treatment. Acıbadem tumor boards involve.

If CyberKnife is the best treatment for you, the radiation oncology team plans your treatment journey step by step. After a high-resolution CT scan, the image is transferred to the CyberKnife system. Radiation oncologists explore the size, shape, and location of the tumor. Successively, the radiation beam is shaped, the dose is identified, and the session number is determined.

In CyberKnife treatment, Acıbadem is aiming to deliver high-dose and precisely targeted radiation beams to the tumor. When the tumor is being eradicated, the healthy tissues are preserved. The whole treatment is no more than five sessions. Each session is completed between 30 and 60 minutes. CyberKnife treatment is painless and non-invasive. During a treatment session, the patient lies comfortably on the treatment table without anesthesia. CyberKnife has a robotic arm that delivers radiation beams. This robotic arm moves and bends around the patient to deliver radiation beams from different angles. CyberKnife is an outpatient procedure, after the treatment session patients can leave the hospital premises. All sessions take about 1 to 2 weeks and once the treatment is completed, physicians order a scan to check the tumor’s response to the treatment.

What are CyberKnife’s Disadvantages?

After the treatment, patients are generally able to go back to their routine life. By nature, radiotherapy has some side effects, but considering both cons and pros of radiotherapy, the disadvantages are significantly more limited than the advantages. Side effects may occur during radiotherapy or after radiotherapy. Acıbadem Radiation Oncology department has the latest technologies like CyberKnife, MRIdian, and ETHOS that deliver precisely targeted radiation beams to the tumor. It means that healthy organs and tissues are protected from radiation. Thus, the side effects of radiotherapy minimize to a great extent.

Most common side effects of CyberKnife treatment include fatigue, nausea, and skin irritation. These side effects last only a short time. CyberKnife’s potential side effects change according to the area being treated. For instance, if a patient has prostate cancer, and he is treated with CyberKnife, he may experience increased urination frequency, urinary urgency, weak urinary stream, and difficulty starting urination. These effects are not generally severe or permanent and they will fade once the treatment is finalized.

CyberKnife is one of the most preferred radiosurgery devices for the treatment of brain tumors. This is mainly because this treatment approach preserves important functions of the brain and minimizes side effects of the treatment compared to traditional radiation treatments. Side effects associated with CyberKnife treatment of the brain are headache, vomiting, seizures, and necrosis, which are generally mild and temporary.