Cyberknife Experience - Patient Profiles

Patient Profile: Mr. C.V.G

Mr. C.V.G is a senior gentleman aged 86 years with a sharp mind with shining eyes. He was diagnosed with cancer of the prostate in 1999. He underwent TURP plus Bilateral Orchidectomy and was on hormonal management. A second cancer was detected three years later. This time a much more aggressive tumour in the nasal area. Conventional radiotherapy was able to control the disease for a year. But the nasal tumour kept on coming back. Laser surgery could remove only part of the tumour so it kept on re-growing. Chemotherapy was not considered for him being above 80 at that time. By the end of 2008 patient was having a completely blocked nose with epistaxis and permanent discharge. He was unable to breath properly anymore. His eyes were not shining anymore. Another course of radiotherapy to this area with eyes in close vicinity did not come to the picture, and hence Cyberknife was the only treatment option. We completed the procedure April 2009. Few weeks later, Mr. CVG returned smiling and had an opened up nasal cavity and with no complaints. Even the radiation oncologists were surprised by the fact that this radiation has targeted the inside tumour almost exclusively. Though it was a second irradiation there was hardly any radio-reaction on the skin. He thinks of visiting his son in the US again …

Patient Profile: Mr. JT

A young man aged 17 years was diagnosed with Hypothalamic Hamartoma
This young man had a long history of Gelastic seizures. The cause for this was a large space-occupying lesion in the suprasellar region. He underwent surgery but the tumour could not be removed as it appeared very vascular and per-operatively there was a lot of bleeding.
The only option for him was stereotactic radiosurgery. The CyberKnife treatment was done for him over 5 sittings in one week. He did not experience any side effects either during
or after the treatment. In fact, he used to travel all the way from Kovalam daily for this treatment. It has been over 2 months following therapy, he is doing fine and his symptoms have reduced. Since this tumour responds slowly to radiation, a post treatment scan has been scheduled for one month from now.

Patients from Asia, Middle East & Africa benefit from the Apollo CyberKnife Treatment

• A new ray of hope. An innovation in the treatment of cancer
• Apollo Speciality Cancer Hospital is the first hospital in India to treat patients with the revolutionary CyberKnife.
• Since the recent clinical inauguration, over fifty patients have undergone treatment and the results are very promising

Chennai, June 17, 2009: With the launch of Asia Pacific’s most advanced and India’s first CyberKnife^®, Apollo Speciality Cancer Hospital has joined the global league of hospitals equipped to provide 360-degree cancer care. Since the recent clinical inauguration by Prof. Dr. John Adler, the father of the CyberKnife, the hospital has reviewed around 600 cases and over 50 patients have already benefited from the treatment.

Addressing the media, Dr. Janos Stumpf DMS, Director Research in Oncology, representing the Apollo Cyberknife Clinical Panel said, “Over fifty patients with Intracranial, Spine, Lung and Prostate Tumors have benefited from the Apollo CyberKnife treatment and the results are very promising. Many of the patients had tumours that would have been considered inoperable or even untreatable earlier. The CyberKnife treatment offered them a new ray of hope. In quite a few cases, the CyberKnife treatment was even preferred to avoid the risks associated with conventional surgery. Apollo Speciality Cancer Hospital has received patients from across the country, Bangladesh, Malaysia, Oman, Sri Lanka, Iraq, Iran and Pakistan.”

While introducing a few patients present at the media briefing, Dr. Sanjay Chandrasekar, Senior Consultant Radiation Oncology said, “The CyberKnife offers precise, painless and non-invasive radiosurgery treatment. Most patients who undergo the Apollo Cyberknife treatment are free to resume their daily routine almost immediately even after the procedure.”

Benefits to Patients

· A new treatment option: This extraordinary sophisticated treatment can be used as an alternative to open surgery. Occasionally CyberKnife^® treatment can even convert a technically inoperable tumor to operable.

· Pain free: Treatment does not cause pain and therefore does not require anesthesia.

· Recovery Time: Vast majority of CyberKnife^® treatments are out patient procedures allowing patients to continue their activities.

· Comparative comfort: Many of the available high precision radiation techniques require application of some kind of frame around patient’s body, CyberKnife^® can spare that particular inconvenience for the patient. In many of the cases, it is a frameless procedure.

The CyberKnife^® system has significant benefits. Many of the complications associated with other conventional cancer therapies are minimized or eliminated by the CyberKnife^® system. In addition, it is possible to treat multiple tumors at different locations in the body during a single treatment session. Patient normally experiences dramatic pain relief after the CyberKnife^® treatment”.

All patients are reviewed by the Apollo CyberKnife^® Advisory Board prior to a decision on treatment

ACCURAY PRESS RELEASE ON THE FIRST CYBERKNIFE TREATMENT IN INDIA

First Patients Treated in India Using CyberKnife Radiosurgery
Newly Installed System at Apollo Hospital Treats Six and Preps Eight Patients in First Week
SUNNYVALE, Calif., April 3, 2009

To read more .... log on to http://www.accuray.com/; http://www.accuray.com/Content.aspx?id=2406&terms=india

Source: Accuray Inc

Cyberkife In India

Apollo Speciality Hospitals, Chennai has been the first Hospital in India to have started treatment with Cyberknife . We have so far treated 40 patients with Intracranial, Spine, Lung and Prostate tumors and the results are very promising.

For More Information regarding CyberKnife at Apollo please feel free to call Cyberknife Helpline, Ms.Lakshmi @ 044-24334455 or 9941056677 or SMS Apollo at 56677 . Email enquiries can also be to be sent to cyberknife@apollohospitals.com.

You may also visit us at http://www.cyberknifeindia.in/ and http://www.cyberknifeinindia.com/

Cyberknife Resource Team

Is the cyberknife really a knife?

Is the CyberKnife really a ‘knife’?
Though its name conjures up images of a scalpel – the CyberKnife in fact is the alternative to surgery! It is a Robotic Radiosurgery System. It is non-invasive procedure ideal for the treatment of both cancerous and non-cancerous tumors anywhere in the body. It uses image guided technology and computer controlled robotics to continuously track, detect and correct for tumor and patient movement throughout the treatment allowing for its extreme precision.
Here are more FAQs about the cyberknife:
1. Will a CyberKnife procedure be like a minor surgery?
In fact, much less strenuous! It involves no incisions, no blood, no anesthesia, and virtually no recovery time.

2. What does non-invasive procedure mean?
- It simply means that the procedure involves no invasion into the body – which means no cuts or incisions are made during the CyberKnife procedure.

3. How does a CyberKnife work?
- CyberKnife performs robotic radiosurgery during which precise radiation beams are focused on tumors while minimizing damage to surrounding healthy tissue.

4. Will patients have to get admitted to the hospital for this procedure?
- Certainly not. CyberKnife is a simple, outpatient procedure. Patients can undergo their treatment and immediately resume normal activities – as the side effects are minimal.

5. How long will the session last?
- Each treatment session may be between 30 - 90 minutes, depending on the type and location of the tumor. Sometimes the treatment is offered in stages in which case patients may have to return for additional sessions over a few days (not more than a week) – as advised by the doctor.

6. What are the pre-preparations for this treatment?
- Before starting treatment, the medical team will perform a high resolution CT scan to determine the size, shape and location of the tumor. Once this data is obtained it is transferred to the Cyberknife database and the treatment is planned in detail.

7. What can one expect during a CyberKnife treatment?
- Each case is unique depending on the health of the patient and the type as well as location of the tumor. Some patients need just one sitting while other may need to come for repeat sessions. A detailed orientation is given to patients – based on their specific case so that they know what to expect before they go in for treatment.

8. What types of conditions are considered for CyberKnife treatment?
- The CyberKnife is capable of treating tumors anywhere in the body, but its precision makes it ideal for sensitive zones like the brain, spine, lung, prostate, liver and pancreas.

9. They say CyberKnife does not require a headframe – what does that mean?
- Radiation treatment needs to be extremely precise – wrong tissues exposed to radiation could cause irreparable damage. Hence traditional radiation treatment like Lenear Accelerator use headframes or immobilization devices that are used to hold patients still. These could be extremely uncomfortable and painful. But CyberKnife eliminates all that! It has a built in sensor that only works at a particular body rhythm,. When the rhythm varies or when there is body movement (like coughing or sneezing) it automatically stops functioning.

11. Who determines if CyberKnife is the ideal treatment option for a particular case?
- The physician or a specialist can determine if CyberKnife is the ideal treatment option after evaluating the condition of the patient.

12. Can the elderly and children be treated with the CyberKnife?
- In most cases – yes. CyberKnife is less risky than traditional surgery as it involves no incisions at all. This makes it a suitable option for the elderly and the very young. The decision to perform the procedure will however be taken in consultation with the concerned physicians and anesthesiologist. The safety and comfort of the such patients are always kept in mind.

13. How is CyberKnife different from traditional Radiosurgery?
- While traditional radiosurgery methods (like the Linear Accelerator or Gamma Knife) worked on the same principle of focused radiation beams – none of the previous forms of treatment offered the precision and flexibility that CyberKnife does. Because of its robotic arm like structure the Cyberknife can reach tumors at angles that were previously inaccessible. Moreover CyberKnife uses a combination of a robotic arm, linear accelerator (high energy X-ray source), and image guidance technology – to give high precision results.

14. What are the advantages of CyberKnife?
- It has several inherent advantages. It is a pain free, non-invasive, outpatient procedure and the patients need virtually no recovery time. Moreover, there are no intrusive body or head frames and no breath-holding required during the procedure.

15.Is the CyberKnife safe?Being a non-invasive procedure, the CyberKnife is radically different from traditional surgery. It requires no anesthesia, no incision, no bleeding and no post-operative pain or unpleasant anesthesia after effects. Because of its precision, CyberKnife does not affect the surrounding healthy tissues thereby minimizing side effects – something that is not always possible with traditional radiation therapy.

16. After treatment, when will my tumor or lesion disappear?The effects of radiosurgery are not always immediately visible. Tumors also behave differently – depending on their location and the patient’s metabolism. Some tumors resolve more slowly than others and may or may not eventually disappear completely, while others simply stop growing and present no further biologic activity. After CyberKnife treatments patients will need to periodically undergo tests to assess their progress.

17. Will CyberKnife cause hair fall out or skin burn?The radiation delivered by the CyberKnife is so focused on a specific target that it is highly unlikely that hair loss or skin burn will occur. In the event that a treated lesion is very close to the scalp or skin though, the adjacent hair or skin may be affected. If so affected, this hair or skin will typically recover over time. All medical procedures, including CyberKnife treatment, have potential side effects and associated risks, and every patient will be individually evaluated and counseled in detail before a final plan of treatment is made.

18. Where in India can patients go for CyberKnife treatment?
Apollo Hospitals, Chennai, is the only hospital in India to have the CyberKnife. It is not just India’s first, but also Asia’s most advanced CyberKnife. Apollo Hospitals has trained technicians, doctors and counselors who can guide patients through the treatment process.

19. What are the facilities available for cancer care at Apollo Hospitals? Apollo Hospitals, across India have dedicated centers that offer comprehensive cancer care. The hospital's cancer centers have experienced surgical and radiation cancer specialists as well as diagnostic consultants. The center's teams of doctors examine each case jointly and decide on the best line of treatment for the patient. Since treatment of cancer involves tremendous physical and emotional strain, the hospital provides extra support to cancer patients by counseling them to stay positive and to eat right - thereby speeding up the recovery process. Specially trained medical counselors, speech therapists, dieticians and other professionals, appropriate to the individual case, provide support to the teams of doctors. The measurable success that the hospital has achieved in cancer care attracts thousands of national and international patients each year