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Prostate tumors

Prostate tumor treatment with CyberKnife

Welcome to the CyberKnife patient education video.  During the next few minutes we hope to help you better understand how the CyberKnife Robotic Radiosurgery System is used to treat prostate cancer.

We believe that the more a patient – and their family and friends – know about the steps involved in the CyberKnife treatment, the more comfortable everyone will be with the procedure.

The CyberKnife System is one of the most advanced stereotactic radiosurgery systems in use today. It relies on robotics and sophisticated image guidance technologies to attack tumors with extreme precision. The flexibility of the robotic arm enables your doctor to deliver multiple beams of high-dose radiation directly to your tumor from almost any angle while minimizing damage to surrounding healthy tissue and critical structures.

The challenge that doctors face with treating tumors in the prostate is that the prostate moves unpredictably as air passes through the rectum and as the bladder empties and fills. Conventional radiation therapy does not account for this movement, but the CyberKnife Robotic Radiosurgery System does.

The CyberKnife System is able to overcome this challenge by continually identifying the exact location of your prostate throughout the course of the treatment. It allows you to lie and breathe normally during treatment and enables your doctor to zero in on a moving target – your prostate – and treat it without harming surrounding critical structures or healthy tissue.  As a result, your treatment is more comfortable, radiation is delivered more accurately and treatments can be completed in a shorter period of time.

Your treatment involves a team approach, in which several specialists participate. Once the team is in place, you will begin preparation for the CyberKnife Treatment. 

As part of your diagnosis, your doctors will have measured your PSA or prostate specific antigen levels via a blood test which will be used to help track your treatment results.  Prior to CyberKnife treatment, you will be scheduled for a short outpatient procedure in which three to five tiny gold seeds – called fiducial markers – are inserted into the prostate. For prostate treatments, the fiducials are placed through a needle, which is guided via an ultrasound. You may be asked to clean out your rectum with an enema the day of the fiducial placement.

The CyberKnife System uses the fiducials as reference points to identify the exact location of the prostate. After insertion of the fiducials, you must wait approximately one week before CyberKnife treatment planning can begin to ensure the fiducial movement has stabilized.

During setup, a special custom-fit body cradle will be made. The cradle is made of a soft material that molds to your body and is created to make your treatment more comfortable and to ensure your body position is the same for each treatment session.

While lying in the cradle, you will undergo a CT scan.  This CT data will be used by the CyberKnife team to determine the exact size, shape and location of your prostate. An MRI scan also may be necessary to fully visualize the prostate and nearby anatomy. Once the imaging is done, your body cradle will be stored for use during your CyberKnife treatment.

During treatment planning, your relevant CT, MRI and/or PET scan data will be downloaded into the CyberKnife System’s treatment planning software.  Your medical team will determine the size of the area being targeted by radiation, the radiation dose and will identify critical structures – such as your bladder and rectum – where radiation should be minimized.

After your treatment plan is developed, you will return to the CyberKnife Center for treatment.  Your doctors may choose to deliver the treatment in one session, or stage it over several days. Typically, treatments are completed within five days.

For most patients, the CyberKnife treatment is a completely pain free experience. You can dress comfortably in street clothes and your Center may allow you to bring music to listen to during the treatment.

When its time for your treatment, you will lie on the custom body cradle made during the set-up process. 

When you are ready for treatment to begin, the location of your prostate will be tracked and detected continually as you breathe normally. Your medical team will be watching you every step of the way as the CyberKnife “watches” your prostate, follows it as it moves and safely delivers radiation to the prostate.

The CyberKnife System's computer-controlled robot will slowly move around your body to various locations from which it will deliver radiation to your prostate. At each position, the robot will stop. Then, special software will determine precisely where the radiation should be delivered.
You can expect each treatment session to last 30 to 90 minutes depending on your specific tumor. Nothing will be required of you during the treatment, except to relax and lie as still as possible. 

After completing your CyberKnife radiosurgery treatment, it is important to schedule and attend any follow up appointments. You must keep in mind that your tumor will not suddenly disappear. 

Once treatment is complete, most patients quickly return to their daily routines with little interruption to their normal activities. If your treatment is being delivered in stages, you will need to return for additional treatments over the next several days as determined by your doctors.  

There are generally only minimal side effects from CyberKnife treatments. Occasionally patients report temporary symptoms, which may include reduced urinary stream, burning with urination, having to urinate more frequently, increase in frequency of stools, loose stools and more gas with bowel movements than usual.  Your doctor will discuss all possible side effects you may experience prior to your treatment. Additionally, your doctor may prescribe medication designed to control any side effects, should they occur.

Response to treatment varies from patient to patient.  Clinical experience thus far has shown most patients to respond very well to CyberKnife treatments. Your doctors will monitor the outcome in the months and years following your treatment, often using either CT scans, and/or PET-CT scans.

Thank you for choosing the CyberKnife System and we hope that this video has addressed any questions you may have. Please consult with your doctors if you have any questions specific to your treatment. 

Related resources

Source: Leslie Nussbaum, MD,  PhD, neurosurgeon, co-medical director, Nasseff CyberKnife
Reviewed By: Leslie Nussbaum, MD,  PhD, neurosurgeon, co-medical director, Nasseff CyberKnife
First Published: 02/10/2015
Last Reviewed: 02/06/2015