ETMC Starting CyberKnife Lung Cancer Treatment
Courtesy of Tyler Morning Telegraph

East Texas Medical Center's Cancer Institute will soon treat its first lung cancer patients with the CyberKnife system. The first procedures are scheduled for early January.

"We are trying to cure these lung cancers by treating specific areas where the tumors are located," said Dr. James Kolker, the institute's medical director. "By using the CyberKnife, we are able to avoid surgery and a lengthy recovery period."

He said patients will wear special tracking vests to allow the CyberKnife to track the lung tumor as the patient breathes and his body moves. "The machine actually moves back and forth while a patient is breathing and is able to follow the movement of the tumor, concentrating radiation to the tumor site."

Kolker said the patients were selected because their tumors could not be otherwise treated by surgery which is the preferred treatment or by the second choice of radiation plus chemotherapy.

"Only tumors of a certain size and location qualify for radiosurgery, and many lung cancer patients are not really candidates for this procedure. Each lung cancer patient is considered for the best method of treatment for their cancer," Kolker added.

Dr. John S. Clarke, board certified thoracic and general surgeon is trained to use the CyberKnife. He will be working with Kolker or Dr. Heidi McKellar, both board certified in radiation oncology.

"So far we have done 10 patients with the CyberKnife. There has been one acoustic neuroma (any tumor of cells of the nervous system), four meningiomas (most common benign tumors of the brain, two brain metastases (a cancer that has spread from original site), two pituitary adenomas (benign growths in the hormone secreting gland in brain) and one spine," he said.

"These patients have been delaying treatment until the CyberKnife arrived because their tumors were otherwise too dangerous to treat with traditional treatments. Many had tumors too close to the optic nerves or brainstem to otherwise safely treat. With the CyberKnife we were able to break the radiosurgery treatments into three to five fractions and safely protect their vision or brainstem," he said.

Kolker said, "The spine patient we treated was also a patient who never could have otherwise had treatment. He had a metastatic kidney cancer, which is a kind of tumor that often does not respond very well to conventional doses of radiation. As a matter of fact, he had already had what we consider 'maximum radiation dose' to the spine at a facility near Houston a number of months ago and the cancer had already regrown."

The patient also recently needed surgery to let the pressure off the spine.

"We were able to retreat the tumor surrounding the cord. We were able to avoid treating the spinal cord with much additional radiation. In addition, we could treat in higher doses per treatment which is often much more effective in treating this type of cancer."

Kolker said the treatment has been extremely well tolerated. "It's really nice not to have to put these patients into surgically attached head frames as we had to do with the previous unit and the patients certainly appreciate this."

He said abdominal tumors and other cancer areas will be scheduled later. "The program is progressing on schedule as we had hoped," he said.

He said, "The CyberKnife is not a cure for all cancers, but in some cases we can lessen symptoms and pain to help the patients.

CyberKnife, the first stereotactic radiosurgery unit in East Texas, can pinpoint radiation with submillimeter accuracy using image guidance technology and computer controlled robotics to destroy small, complex-shaped tumors near critical structures.

Unlike traditional radiosurgery systems that can only treat tumors in the head and neck, CyberKnife can treat both intracranial and extracranial tumors. Extracranial treatments represent more than 50 percent of CyberKnife procedures in the United States, including those of the spine, lung, prostate, liver and pancreas.

 

Marvin Ellis covers hospitals and medical organizations.