Why so Passionate about CyberKnife?? This is One of Many Reasons.

I had just left the clinic and started a position as a trainer for Accuray, Inc. This had been an easy transition for me, as my site was the training facility for Accuray before they had one.

We had treated mostly spinal radiosurgery, but had branched out into Lung, Liver, Pancreas and even a few head and neck cases, but because of politics at our facility we would rarely use the system for treating the brain.

One of my first assignments was at a relatively rural hospital training an eager and enthusiastic team with the first case being a trigeminal neuralgia patient. Quite possibly the smallest brain indication.

For those unfamiliar with trigeminal neuralgia treatments, the first thing to know is this is not a malignant condition. Essentially, an extremely high dose of radiosurgery is performed in a single fraction to purposefully damage the trigeminal nerve and block pain signals to the brain. The treatment is minimally invasive and can be a good option for patients who do not respond to other treatments, but it must be highly precise as the nerve is surrounded by critical structures and generally is treated to an area approximately the size of the lead in your pencil and about as wide as the eraser. It causes extreme pain for patients, and this was evident in the patient that showed up in this clinic.

A CT scan was performed and sent to the planning system, and at 0.5 mm slices a neurosurgeon was called in to contour on only three of them. A plan was created in a short amount of time, and the patient was scheduled to receive their treatment the following day.

The neurosurgeon took a few moments to describe to me this woman’s condition prior to her arrival, and he was not one to exaggerate. She was approximately eight five pounds as she had been in too much pain to eat and as a result had a feeding tube placed. They brought her down from the floor in the late afternoon as she had to be sedated during the treatment with an anesthesiologist monitoring her. Even with the sedation from outside of the vault I could hear her moaning as she lay in a semi-conscious state. It was a sound I will never be able to forget.

Due to the size of the collimator and the dose prescribed, the treatment seemed to go on forever, but eventually that evening the treatment was completed and she was taken back to her room.

There was a collective sigh afterwards as we were all monitoring every pulse of monitor units coming from the system.

The next morning, I showed up on site early to debrief on the previous day, while preparing for the day to come and the phone at the treatment console began to ring. The Therapist answered, turning, and saying the call was for me. I mouthed the words, ‘who is it?’ to her not having any idea who would be looking for me. She covered the mouthpiece and whispered back, ‘it is the neurosurgeon.’

Nervously I held up the receiver and he asked, “what did you do to my patient”? Asking why, he said while standing next to her in her room, “she sat up first thing this morning and asked for breakfast.”

It was at this moment I knew I had made the right choice when I left the clinic and started working for Accuray.

It is cases like this when accuracy is of its greatest importance that a CyberKnife is necessary.

If you are at ASTRO in Washington D.C., please stop by the Accuray booth to understand how accurate a CyberKnife really is.

*The statements on this site are my own and do not represent Accuray opinions or positions.

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