Pictured above: Cyberknife treatment team monitor first patient’s treatment using the Cyberknife M6.
A new robotic treatment was recently used for the first time at James A. Haley Veterans’ Hospital in Tampa. It’s a treatment that will increase the number of options Veterans have in their fight against cancer.
Staff members in the radiation therapy unit used the Cyberknife M6 machine for the first time Feb. 28 to treat a Veteran with a cancerous brain tumor. Tampa is only the second hospital in the VA system to use the Cyberknife, with the Michael E. DeBakey VA Medical Center in Houston the other.
The Cyberknife uses an arm similar to those used by manufacturing robots in auto plants to precisely deliver high dosage radiation to tumors to destroy cancer cells. Despite its name, it is a completely non-invasive procedure and causes no pain or sensation in the patient during treatment.
The Cyberknife joins another machine used in the RTU to gives Veterans more treatment options.
“We’ve started a stereotactic program and the program includes two machines,” said Dr. James Pearlman, hospital’s chief of radiation oncology.
Stereotactic denotes a therapy that delivers precisely targeted radiation in high-dose treatments.
“One is a Varian Truebeam STx that has excellent capabilities to treat multiple lesions. The Cyberknife is a machine that was designed more for stereotactic purposes. It has some advantages over the other machine and the Truebeam has some advantages over it. Combined, it gives a lot of options for us to offer Veterans different ways of being treated,” Pearlman added.
The Cyberknife’s computer generates an image showing where each of the 67 radiation “shots” will be aimed during the 19-minute treatment.
One advantage the Cyberknife has over other treatments is the ability to track and treat a tumor in real time. The machine uses x-rays to continuously image the patient and track any tumor movement, for instance a lung tumor moving while the patient is breathing.
“The Truebeam always shoots its dose at one point in space. To treat something, you have to physically place that thing in the center,” said Radiation Therapy Physicist Sidney Tazeh, who has been working with the Cyberknife system since 2007. “The Cyberknife is shooting anyplace in a flat volume so you don’t have to move the patient, you just move the robot, so that’s the biggest difference.”
While the Truebeam is better when a patient has multiple lesions, the Cyberknife can more precisely target a tumor, cutting down on the amount of healthy tissue that is subjected to the high doses of radiation. While the radiation is the same used in standard imaging x-rays, the dosage can be anywhere from 1,000 to 40,000 times greater in radiation therapy, meaning the less healthy tissue treated, the fewer side effects for the patient.
In order to determine the best treatment, the Cyberknife’s computer will take input from the physician and physicist – to include the radiation dosage needed to kill the tumor – and will come up with a plan that attacks the cancer from multiple angles over the course of several treatments. In the case of the first patient, the machine repositioned itself 67 times over the course of the 19-minute treatment.
The Cyberknife M6
Pearlman said he is most excited about offering more options for treatment to Tampa area Veterans now that the both Cyberknife and the Truebeam machines are up and running. While there are treatment facilities that use one or the other machines, nobody in this area offers both.
“We have both machines so we can offer either treatment depending on what machine best suits your needs, and that’s what we’re happy about, that we can offer both,” Pearlman said.
Radiation therapist Andrew Hawkins is one of three therapists trained to operate the Cyberknife. During a typical treatment, all three are busy monitoring the machine and the patient to ensure a safe and successful therapy session. He said he’s also excited about the Cyberknife operation starting.
“We don’t have to send our patients off to be treated somewhere else,” Hawkins said. “Our doctors here and our physics staff are very thorough and they do a lot of double-checking. I know what kind of treatment they’re going to get. We have all their records and Dr. Pearlman is constantly trying to improve the process, improve the experience for the Veterans and make sure they’re getting the best care possible. He’s looking for the best care, and if we can do it here, that’s even better.”