Spine cancer is an abnormal growth of cells in or around the spinal cord resulting in a tumor. If the abnormal cells originated from cells in the tissues of the spine, this is a Primary Spine Tumor. Primary tumors in the spine are relatively rare and are either benign (non-cancerous) or malignant (cancerous).
If the abnormal cells originated in another part of the body, as in cancer originating in the lung, breast, colon or skin and were carried to the spine by the blood or other bodily fluid, growing into a tumor, then it is considered a Metastatic Spine Tumor.
Both primary and metastatic spine tumors are very serious because they can compress the spinal cord and/or destroy the bone and surrounding tissue in the spine. These tumors cause patients to experience pain, gait and posture problems, and other neurological issues.
The CyberKnife System provides patients with a noninvasive treatment option for spine cancer. Unlike conventional radiation therapy, during which low doses of radiation are delivered over weeks and months, the CyberKnife System can treat a spine tumor in one to five days by delivering a high dose of radiation with extreme accuracy.
Spine tumors present a treatment challenge because they move as the patient breathes. Conventional radiation therapy cannot account for this movement, so surrounding healthy tissue may be damaged by the radiation. The CyberKnife System is able to achieve a high level of accuracy completely non-invasively – without the use of body frames or implanted fiducial markers. CyberKnife precisely targets the tumor’s exact location tracking and compensating for movement during treatment delivery. Using this method, the CyberKnife System is able to deliver a high dose of radiation to the tumor while avoiding damage to the surrounding sensitive spinal cord tissue and other critical structures.
CyberKnife treatments involve a team approach, in which several specialists participate:
Generally there are three steps involved in CyberKnife treatment:
During set-up and imaging, the patient may be fitted for a custom body cradle, which is designed to help keep the patient more comfortable and ensures the patient is in the same position for both imaging (CT or MRI) and treatment.
If the tumor is in the upper cervical region, the patient also may be custom-fitted with a mesh face mask. Both the cradle and face mask are painless and completely non-invasive.
While laying in the body cradle and/or wearing the face mask, the patient will undergo a computed tomography (CT) scan. This scan data will be used by the CyberKnife team to determine the exact size, shape and location of the tumor. A magnetic resonance image (MRI) or some other type of imaging study also may be needed to fully visualize the tumor and nearby anatomy. Once the imaging is done, the body cradle or face mask will be stored for use during treatment.
Treatment planning is then performed by a medical physicist in conjunction with the treatment team. The patient will not need to be present at this time. During treatment planning, all CT, MRI and other scan data will be downloaded into the CyberKnife System’s treatment planning software to develop a customized treatment plan. The medical team will determine the size of the area being targeted by radiation and the dosage, as well as identifying critical structures – such as the spine or vital organs – where radiation should be minimized. The CyberKnife System calculates the optimal radiation delivery plan to treat the tumor. The treatment plan will take full advantage of the CyberKnife System’s maneuverability, allowing for extremely accurate delivery of radiation.
After the plan is developed, the patient will return to the CyberKnife center for treatment. The doctors may choose to deliver the treatment in one session, or stage it over several days. Typically, treatments are completed in one to five days.
For most patients, the CyberKnife treatment is a completely pain-free experience. Patients dress comfortably in their own clothes and, depending on the treatment center, they may be allowed to bring music to listen to during the treatment. Patients also may want to bring something to read while they wait, and have a friend or family member with them to provide support before and after treatment.
There are generally only minimal side effects from CyberKnife treatments. Occasionally patients report mild, temporary nausea, particularly if the lower abdomen is undergoing treatment. Prior to treatment, the doctor will discuss with the patient all possible side effects they may experience. The doctor also may prescribe medication designed to control any side effects should they occur. Patients may return to their normal activities after treatment.
After completing the CyberKnife treatment, patients should schedule and attend all follow-up appointments. Patients must keep in mind that the tumor will not suddenly disappear. In fact it could take several months, or longer, to determine the effectiveness of the CyberKnife treatment. Response to treatment varies from patient to patient. Clinical experience has shown that most patients respond very well to CyberKnife treatments. By routinely evaluating the symptoms and undergoing post-operative MRIs, the doctor can chart the patient’s post-treatment progress.
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