CyberKnife Centre London: Cancer treatment in London

CyberKnife Centre London is the first provider in the UK to offer CyberKnife^® treatment: A new painless treatment solution for those who suffer from tumours and other medical conditions that have previously been considered inoperable or untreatable.

 
The London CyberKnife Centre at The Harley Street Clinic is the first in the UK to offer this treatment. CyberKnife® treatment requires no anaesthesia, there is no recovery time and patients can usually be treated and go home on the same day. For more information on how the CyberKnife® works, click here.

Worldwide, some 35,000 patients have already been helped by this revolutionary, safe, non-surgical procedure that delivers highly focussed radiation therapy precisely to where it is needed, minimising significant dose to surrounding normal tissues that would be vulnerable to damage from high radiation doses. For a list of conditions that might be suitable for treatment with CyberKnife®, click here.

The CyberKnife® System is the world's first and only radiosurgery system that uses advanced robotics to treat tumours anywhere in the body. Patients are typically treated in one to five sessions and treatment is able to target individual tumours with greater precision and less damage to surrounding healthy tissue than any other form of radiotherapy.

What is CyberKnife® cancer treatment?

The CyberKnife® is not actually a knife at all. It's a state-of-the-art piece of equipment that allows specialist oncologists to treat tumours and other medical conditions painlessly without the need for an operation.

CyberKnife^® uses pencil beams of radiation which can be directed at any part of the body from any direction via a robotic arm. The robotic arm tracks the tumour's position, detects any movement of the tumour or patient, and automatically corrects its positioning before targeting the tumour with multiple beams of high-energy radiation, destroying abnormal tissue without damaging surrounding areas.

The treatment is so accurate that it's now possible to treat tumours previously thought to be inoperable. Although the results of treatment do not always show immediately, in most cases the procedure will initially stop the growth of tumours before gradually reducing their size.

As there is no open surgery, the complications normally associated with an operation are eliminated, as is the need for a long recovery time. This makes treatment suitable for those who are not well enough to cope with the side-effects of surgery and most patients leave the clinic the same day as their treatment.

The advanced technology also eliminates the need for patients to be fitted with a brace or restraining device during the treatment phase, making the whole procedure less stressful for patients.

How the CyberKnife works

The vast array of different angles/trajectories from which pencil beams of radiation converge upon the tumour lead to an extremely high cumulative dose of radiation therapy at the convergence point (the target/tumour) and yet a very fast 'fall-off' of dose at the periphery of the carefully mapped target. The surrounding normal tissues/organs only receive a small fraction of the high central dose of therapy.

Whilst any tumour may be destroyed by a very high dose of radiation therapy, it has very often been the case, with orthodox radiotherapy, that it has not been possible to deposit the required dose on a tumour without also depositing a toxically high dose of radiation on the surrounding organs. CyberKnife® often overcomes this problem by its capability to so accurately target and achieve a fast dose gradient ('fall-off') at the perimeter of the tumour/target.

Brain tumour treatment

Arteriovenous malformations, other vascular anomalies (cavernoma, haemangioblastoma, glomus tumour), meningiomas, and acoustic neuromas are now (in many cases) preferentially treated by stereotactic radiosurgical techniques such as CyberKnife®. The success of radiosurgery has made orthodox surgery obsolete for many patients helps them to avoid the associated risks.

Spine cancer treatment

Many of the vascular problems that occur in the brain also occur in the spine and CyberKnife® has marked advantages over other radiosurgical techniques in that it is capable of targeting spinal lesions. Thus arteriovenous malformations of the spine are amenable to this radiosurgical technique and some other vascular anomalies that do not encompass too much of the normal spinal cord.

Other spinal cord tumours may be considered for CyberKnife® therapy and vertebral tumours may similarly be treated by this technology.

Lung cancer treatment

Single or several tumours in the lung may be obliterated by single or a few fractions of CyberKnife® radiation therapy. Highly focussed obliterative doses of therapy can be used to both kill/ablate individual lung cancers (primary or secondary) with sparing of the surrounding lung (more so than other radiotherapeutic techniques).

At the same session, the CyberKnife® can treat up to several lung tumours notwithstanding the fact that they may be sited in different lung areas.

Prostate cancer treatment

Since the introduction of PSA screening in men, the discovery of early prostate cancer has greatly increased in the Western world. Importantly, the disease is highly curable at this time, and there are a number of treatment options for such patients. The main three options available in recent years have been surgery, prostate radiation seed brachytherapy, and external beam radiotherapy/IMRT.

CyberKnife^® now offers a fourth radiotherapeutic method, with potential to cure with equal success to IMRT methodology, but with far fewer visits to the radiotherapy department for therapy; perhaps 5 visits, versus 38 or more for IMRT.

Pancreatic cancer treatment

Cancer of the pancreas is a particularly difficult cancer to treat. The pancreas is surrounded by delicate and radiosensitive structures such as the duodenum and the sophisticated deposition of dose that is effected by CyberKnife® allows maximal deposition of radiation dose on the pancreatic tumour and yet sparing of these surrounding organs - in this regard CyberKnife® seems advantageous over other radiotherapeutic methods.

Liver cancer treatment

Cancer of the liver has been rarely treated by radiotherapy because the normal liver tissue is radiosensitive and harm could come to it if receiving the high dose of radiation necessary to obliterate cancer. CyberKnife® focuses or targets a high dose of radiotherapy on a liver tumour whilst maximally sparing uninvolved liver. For metastatic cancer, that is not responding to chemotherapy or is too large for other focal methods (e.g. thermoablation), CyberKnife® can target more than one lesion at a time.

Kidney cancer treatment

Renal cancer is recognised as being one of the more radioresistant cancers and the need for higher dose therapy is restricted by the dose that surrounding tissues will tolerate. Focussed radiation therapy by CyberKnife® can be most useful in these situations. With its high degree of dose deposition accuracy, CyberKnife® may be the optimal method of delivering an ablative radiation dose. Treatment is usually delivered in 1-5 fractions.

Other cancers

Sometimes the tumour is too close to sensitive normal organs for a very high dose to be delivered and it proves to be inoperable. Difficult sarcoma problems not infrequently fit into this category and not uncommonly recurrent carcinoma - primary site control problems or those associated with metastatic disease. The use of CyberKnife® for discrete metastases is perceived to be an important advancement.

Re-treatments

The ability of CyberKnife® to focally deposit high doses of ablative radiation on discrete sites of cancer has led to the safer re-treatment of cancers that may have re-grown after previous radiotherapy - as the surrounding normal tissues (almost at tolerance dose to radiation exposure) is spared much of the re-treatment dose.

The treatment process

Scanning

Prior to treatment with the CyberKnife® System, the patient undergoes imaging procedures to determine the size, shape and location of the tumour. The process begins with a standard high-resolution CT scan, or for certain tumours other imaging techniques, such as MRI, angiography or PET, may also be used.

Planning

Following the scanning, the image data is then digitally transferred to the CyberKnife® System's treatment planning workstation, where the treating physician identifies the exact size, shape and location of the tumour. A qualified physicist then uses the CyberKnife® software to generate a treatment plan to provide the desired radiation dose to the identified tumour location while avoiding damage to the surrounding healthy tissue. The patient does not need to be present during this step in the process.

Treatment

During a CyberKnife^® procedure, a patient lies comfortably on the treatment table, which automatically positions the patient. Anesthesia is not required, as the procedure is painless and non-invasive. The treatment generally lasts between 30 and 90 minutes and is typically completed in one to five visits.

Follow-up

Follow-up imaging, generally performed with a combination of CT, MRI and/or PET scanning, is usually performed in the months following treatment to assess the tumor's response to the delivered radiation.

Contact details

The CyberKnife Centre London
81 Harley Street
London W1G 8PP

Initial enquiries: HCA Connect (open 7 days a week)

Tel:          +44 (0) 20 7079 4344
Email:       hcaconnect@hcahealthcare.co.uk

Patient enquiries: Lorna Ayres, CyberKnife Secretary

Tel:          +44 (0) 20 7034 8588

Email:       lorna.ayres@hcahealthcare.co.uk

Website:  www.cyberknifecentrelondon.co.uk