Cyberknife Radiotherapy Treatment

What is a CyberKnife?

The first thing prostate cancer patients should know about ground-breaking CyberKnife Radiotherapy Treatment, is that it doesn’t involve a knife or any surgical procedure. Patients rest on a manoeuvrable seat or table; each fifteen seconds their x-rays are taken, as a robotic arm manoeuvres around them, accurately delivering beams of radiotherapy from numerous angles.

Traditionally, radiotherapy treatments allow for a small margin of error; this is due to basic inaccuracies or unavoidable movements of the prostate or patient. The CyberKnife vastly reduces this margin of error, bringing it down from between five and fifteen millimetres to just two or less; with this high level of precision.

Cyberknife Radiotherapy
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Candidates for CyberKnife Radiotherapy Treatment¹

CyberKnife is suitable for all patients with a small or medium-sized prostate; those with localised T1 or T2 stage prostate cancer, have a Gleason score of seven or lower, or a PSA score below twenty are also appropriate candidates. Claustrophobic patients can usually be accommodated, due to the free, open design of the machinery used.

Due to its use of MRI scanning, unsuitable candidates also include patients with implants such as pacemakers or metal plating; patients who have had both hips replaced are also unsuitable candidates (this could be a possibility where patients have received just one hip replacement procedure). CyberKnife is also unsuitable for severe urinary symptoms.

The procedure

The five procedures which suitable prostate cancer patients will receive, typically take less than sixty minutes each. Some patients choose to spread these five treatments throughout a fortnight, while others prefer to complete treatment within a week. CyberKnife results have proven to be equally as effective as regular radiotherapy.

Anaesthetised patients are injected (into the perineum) with needles containing gold, grain-sized Fiducial markers; so as to position these precisely within the prostate gland and to avoid unnecessary tissue damage, these needles are ultrasound-guided. Patients could suffer from mild discomfort for up to ten days, while movements and minor swelling start to ease.

Patients will receive both an MRI and CT scan ahead of their Treatment; by cross referencing these scans with the gold markers inserted within the prostate, the exact location of any cancerous cells is located and mapped out and any small changes in position or movement are noticed immediately (treatments could be paused intermittently).

CyberKnife Radiotherapy Side-effects

Although patients can resume everyday activities immediately following treatment, side-effects could be experienced. Short-lived side-effects experienced throughout treatment could include mild fatigue, urinary issues or the requirement of a catheter; erectile dysfunction is a long-term side-effect for up to thirty percent of men, but rectal injury or urinary effects are rare.

¹Cancer Research UK, Stereotactic radiotherapy (SRT), 6th Nov 2020

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