Why Am I Hearing So Much About CyberKnife?

Brenda, thank you for your comment. We consulted with Dr. Wu who provides this response:

Proton therapy means that the radiation is being delivered in the form of protons, a different type of subatomic particle. Both CyberKnife and TrueBeam use x-ray (also known as photon) radiation, which is the most common and best-established way to deliver stereotactic radiotherapy. Protons can sometimes be used to deliver stereotactic radiotherapy, but protons currently are not compatible with the same kind of sophisticated image guidance used in TrueBeam.

Brenda, unfortunately, we cannot answer personal medical questions on our blog. Decisions about the best therapy and best technology are based on each individual case, and we suggest your husband consult with his physician on questions such as this.

Barbara, thank you for your comment. Stereotactic radiosurgery as described in this story has been used to treat pancreatic cancer. You can read a recent discussion of it here:

http://www.mskcc.org/blog/new-approach-shortens-treatment-time-pancreat…

If you would like to make an appointment with a Memorial Sloan-Kettering physician, please call our Physician Referral Service at 800-525-2225 or go to http://www.mskcc.org/cancer-care/appointment.

Sylvia, thank you for your comment. We consulted with Dr. Wu and he responded:

We incorporate intensity-modulated radiation therapy (IMRT) into our stereotactic treatments. IMRT is a way of “shaping” the radiation dose in complex ways, while “stereotactic” means that the radiation dose/shape is delivered very precisely. So the two techniques are not mutually exclusive and we combine the two. Neutron radiation is very rarely used for any cancer nowadays, and is not used for stereotactic radiation as far as I know.

Mary, yes the devices discussed in the story have been used to treat tumors in the brain, both primary tumors and brain metastases. You can learn more about this treatment here:

http://www.mskcc.org/magazine/october-2013/prolific-partnership-yields-…
ation-therapy-advances

(scroll down to the section titled “Brain Metastasis: Single-Day High-Dose Radiation”)

We plan to have an updated blog story about this in a few weeks with more detail. Thank you for your comment.

Joan, thank you for your question about radiation treatment of breast cancer. To learn more about how Memorial Sloan-Kettering treats breast cancer, you can go to http://www.mskcc.org/cancer-care. For questions about breast cancer treatment, you also can call the National Cancer Institute’s Cancer Information Service at 800-4CANCER (800-422-6237). To learn more about the CIS, including Live Chat help and how to send them an email message, go to http://www.cancer.gov/aboutnci/cis/page3.

Dear Brenda, we are sorry to hear that the cancer is back. Unfortunately, we cannot answer personal medical questions on the blog. If you would like to make an appointment for a consultation with one of our specialists who can provide a personalized assessment of your treatment options, please call our Physician Referral Service at 800-525-2225. Thank you for reaching out to us.

Michele, thank you for your comment. We are looking into finding an expert who can provide a response for your particular question.

Michele, we consulted with MSK physician Josh Yamada, who responded:

There are several large patient series (University of Pittsburgh, and the UK series, for example) with long term follow up suggesting the radiosurgery for this type of tumor has an extremely low incidence of serious complications.

Susan, we passed your question on to Dr. Wu and he responded:

Yes, SRS is frequently used to treat metastatic lesions in the lungs and other organs. Usually it is only recommended when there are a limited number of lesions (~3 or less), and the lesions are relatively small (~5cm or less), but it is always on a case-by-case basis.

Susan, who passed your question on to Dr. Wu, who responds:

Most patients do not have any noticeable impact from this treatment on the function of their lungs. Often, the only noticeable side effect from SRS to the lungs is fatigue. There is, however, a small risk of developing a lung complication that can affect your breathing, as well as other risks that would have to be discussed with the radiation oncologist.

Dear Mark, we are sorry to hear about your friend. We are unable to answer personal medical questions on the blog. If he would like to make an appointment with one of our physicians for a more-personalized assessment and recommendation, please have him call our Physician Referral Service at 800-525-2225. Thank you for reaching out to us.

David, thank you for your comment. We are looking into this and hope to be able to post a response soon.

David, we consulted with Dr. Wu who uses stereotactic body radiotherapy to treat cancer and this is his response. I hope this is helpful:

It depends on what you mean by stage 4 liver cancer. If you mean cancer originating elsewhere in the body that has metastasized to the liver, then SBRT can sometimes be used to treat those liver tumors, but only in specific situations that you should talk to your doctor about. Likewise, SBRT can also sometimes be used to treat cancers originating in the liver, but whether this is technically possible or medically beneficial needs to be discussed with a doctor who knows the particular situation.

Dear Denise, we are sorry to hear about your husband. We sent your inquiry to Dr. Kathyrn Beal, one of our radiation oncologists specializing in treating brain cancer, and she responded: “Cyberknife is a form of stereotactic radiosurgery and it is usually very well tolerated. Long-term there is a risk of radionecrosis (scarring of the normal brain tissue from the high doses of radiation). Radionecrosis typically occurs about 6 months to 1 to 2 years following stereotactic radiosurgery and occurs in roughly 10% of patients. You should inquire with his doctor about this.”

Thank you for reaching out to us.

David, we are looking into an answer to your question and hope to post a response in the next few days. Thank you for your comment.

David, we passed your question on to Dr. Kathryn Beal, who responded:

Cyberknife or Truebeam stereotactic radiosurgery or gamma knife can all be used to treat AVM’s. We don’t treat AVM’s at our center since they are benign lesions and we treat primarily cancers or tumors here.

Dear Jero, thank you for your question. This type of radiation therapy can be given to patients with lung cancer that has spread to the lymph nodes. If you’d like to read more about radiation therapy for lung cancer, you can learn more here: http://www.mskcc.org/cancer-care/adult/lung/radiation-therapy. To make an appointment with one of our doctors, you can call 800-525-2225 during regular business hours, or you can go here to get more information about making an appointment: http://www.mskcc.org/cancer-care/appointment.

Dear Chris, thank you for your question. We reached out to Abraham Wu, who said: “This is an unusual situation which could only be answered by a radiation oncologist familiar with the details of your case. SBRT can technically be delivered to that region of the body, but whether this would be safe or offer you any potential benefit would have to be assessed by your doctor.”

Herschel, thank you for reaching out. Yes, SBRT is available at MSK’s Sleepy Hollow location and will be available at the Harrison site when it opens this fall.

Dr. Lessin, we consulted with radiation oncologist Abraham Wu, who responds:

Sleepy Hollow does not have a TrueBeam, but the Harrison site will. In any case, TrueBeam is not required to give SBRT and in most situations our SBRT technique would be identical with or without a TrueBeam. 

Dear Sally, we are sorry to hear about your mom. We cannot answer personal medical questions like this on our blog. If she would like to meet with one of our specialists to discuss whether SBRT would be a treatment option for her, please call our Physician Referral Service at 800-525-2225. Thank you for reaching out to us.

Dear Cavan, thanks so much for your question. Stereotactic radiation therapy could be an option for someone with your type of cancer, but an expert would need to evaluate you in order to confirm that. For information about making an appointment with an MSK doctor, go to: http://www.mskcc.org/cancer-care/appointment. We wish you the best, and thanks again for reaching out.