CyberKnife: nonsurgical radiation treatment for tumors anywhere in the body

Many men with prostate cancer never notice symptoms at all. For Tony, the red flags were slightly elevated PSA (prostate-specific antigen) levels detected over a few years during his routine annual physicals. Tony underwent a biopsy at MedStar Georgetown University Hospital, and it confirmed intermediate-grade cancer. Upon receiving the news, Tony decided he “didn’t want to sit around the house that day.” So, he went to the gym. “It took me two days to say that I had CANCER,” he says.

Afterward, Tony plunged into research with his characteristic energy. His cancer had not spread and was treatable. It was a question of choosing the right treatment option. He reached out to other prostate patients and reviewed countless articles.

In his consults with physicians all over the country, Tony kept coming back to the CyberKnife® Prostate program at MedStar Georgetown, the first on the East Coast to offer CyberKnife technology to patients with prostate cancer.

With CyberKnife, there is no going under the knife at all. “CyberKnife is an external radiation device that targets cancer cells with high doses of radiation, with a surgical precision that protects surrounding healthy tissue,” says Michael Carrasquilla, MD, director of the Prostate Cancer Program at MedStar Georgetown University Hospital. “CyberKnife has a real-time tracking system that provides updated prostate positioning and corrects the targeting of the radiation beam during treatment, so you have sub-millimeter accuracy.”

Tony was a good candidate for CyberKnife, the most accurate high-dose radiation, to control his cancer for the rest of his life. The biggest advantages for Tony were convenience, increased chance of cure, and the lower likelihood of significant side effects. “CyberKnife is painless, and there is virtually no recovery time. Most patients need just five treatments, versus the 40 required with conventional radiation,” Dr. Carrasquilla explains.

CyberKnife requires a team approach. The MedStar Georgetown team works closely with the MedStar Georgetown Urology, Radiology, Medical Oncology, and Radiation Oncology teams. The team has treated more than 2,000 patients, who continue to be followed throughout their lives. This level of expertise ensures that patients get the best, personalized treatment possible.

Approximately two weeks prior to treatment, John Lynch, MD, a urologist and former chair of the Urology department at MedStar Georgetown performed a critical step in the CyberKnife process. He implanted four tiny gold pellets, or markers, into Tony’s prostate. CyberKnife uses these markers to track the tumor.

On the first day of treatment, Tony was apprehensive. “The unknown, you know? But it was so nothing,” he says. During the second treatment, Tony listened to his favorite Wynton Marsalis CD. “By the fourth or fifth treatment, I was about to take a nap!”

Adding to Tony’s comfort was his experience with the whole MedStar Georgetown team, who provided support and answered any questions Tony had throughout his treatment.

After treatment, Tony’s first PSA results were better than expected: Seven years later, his PSA remains low, and he maintains his active lifestyle. “I recommend anyone diagnosed with prostate cancer to seriously consider CyberKnife at MedStar Georgetown,” Tony says. “I mean, why wouldn’t you?”

Don was 73 when diagnosed with intermediate prostate cancer. At the time, he was considering brachytherapy, a type of radiation that involves placing radioactive seeds in the prostate. But after meeting with the team at MedStar Georgetown, the expert physicians determined he wasn’t a good candidate for brachytherapy due to his moderate urinary symptoms, since brachytherapy can compress and obstruct your urethra. That side effect is not an issue with CyberKnife, a non-invasive, highly accurate form of stereotactic body radiation therapy (SBRT) that targets the prostate with high radiation doses.

“MedStar Georgetown was the first hospital on the East Coast to offer CyberKnife. Name notwithstanding, the treatment is not a surgical procedure, and there is no incision,” explains Keith Unger, MD, physician executive director of MedStar Health’s Radiation Oncology Service Line and chief of Radiation Oncology at MedStar Georgetown University Hospital.

This shorter treatment time appealed to Don, who was working at the time. A 35-year veteran of the diplomatic corps, Don had served in nine different countries.

Don recalls his first treatment. “When I entered the room, the MedStar Georgetown team was so kind. They asked what kind of music I liked. I said ‘classical,’ and then I went to sleep. This happened for all five treatments. Sometimes I was disappointed they woke me because I was enjoying my nap!”

Since his fifth and final treatment, Don has had no cancer recurrence, he feels great, and his PSAs have been consistently low. “There’s a group of us right in this neighborhood; we were all in Vietnam around the same time. Four of us had prostate cancer, and we all did CyberKnife. I was the first. I recommended it because it’s such an easy process and highly successful.”

To date, MedStar Georgetown has treated over 2,000 patients with CyberKnife. Patient care extends well beyond treatment and includes follow-up and care for patients for the rest of their lives.

CyberKnife is now considered standard of care treatment for all men with localized prostate cancer. Dr. Unger adds that, “It’s now even more convenient. Don’s treatments took an hour each. Now they’re just 30 minutes.” “Oh, that would be terrible,” jokes Don, recalling his naps. “I’d hardly get any sleep.”

“CyberKnife is highly accurate and precisely targets cancer cells with high doses of radiation,” explains Michael Carrasquilla, MD, director of the Prostate Cancer Program at MedStar Georgetown University Hospital.

David was thrilled to learn that most CyberKnife patients only need five treatments, versus the 40 required with conventional radiation. Plus, with CyberKnife, there is virtually no recovery time.

Because of its precision, CyberKnife protects surrounding healthy tissues and organs. The procedure itself is painless, and the likelihood of significant side effects is minimal. “I knew it was the optimal solution for me,” says David. “It would take care of the cancer and let me get back to playing sports and living the kind of lifestyle that I had before.”

“My treatments were after work at MedStar Georgetown. I’d drive down from work; go do my CyberKnife therapy; then I’d drive home and go to work the next day. I never even stopped traveling. I traveled both domestically and internationally for work. Nothing slowed me down,” David says. Then, there was the ease of treatment. “You don’t feel it,” he says. “CyberKnife is painless. There’s always soft music playing in the background. The doctors and the staff at MedStar Georgetown put you at ease. They treat you as part of their Radiation Oncology MedStar family! I am so happy with my decision to select CyberKnife to treat and eliminate my prostate cancer!”

MedStar Georgetown was the first hospital on the east coast to treat patients with CyberKnife and has treated more than 2,000 prostate cancer patients with this technology. “We continue to follow all of them,” says Keith Unger, MD, physician executive director of MedStar Health's Radiation Oncology Service Line and chief of Radiation Oncology at MedStar Georgetown University Hospital.

David is living proof that for patients with low- and intermediate-risk prostate cancer, CyberKnife is an excellent option. And it's not just David's case that supports this. In fact, the CyberKnife system has more than two decades of clinical proof. Studies following patients since 2000 show that long-term survival with CyberKnife is as good as with traditional prostate cancer treatments—while being quicker and much less disruptive to the patient, with minimal side effects.

More than a decade after treatment, David says he’s enjoyed great quality and quantity of life. “For me,” he says, “CyberKnife, and my team at MedStar Georgetown, fulfilled their mission. I’m living proof.”