Cyberknife Treatment for Prostate Cancer

This post will enable you to know the importance of cyberknife treatment for prostate cancer and patient liable for cyberknife treatment.

What is CyberKnife         

The cyberknife System is a radiation therapy device manufactured by Accuray Incorporated. This system is used to deliver radiosurgery for the treatment of tumors, malignant tumors and other medical conditions. The cyberknife allows patients to lie comfortably on the procedure table without anesthesia while the robotic arm moves, without touching them, to treat all areas of the tumor. Recovery is often immediate, given its low risk of complications and damage to healthy tissue.

The Cyberknife System is a non-invasive, non-surgical, pain-free treatment option for prostate cancer with proven results. It is the first and only radiotherapy device that brings true robotic precision and has the ability to track, detect and correct tumor motion in real-time, to the treatment of all types of cancer. These capabilities enable the medical team to render radiation with sub-millimeter accuracy, this helps to minimize the risk of side effects and preserve the quality of life during and after treatment. Although the cyberknife treatment for prostate cancer technology is not new, the system has more than a decade of clinical evidence and has helped thousands of men with prostate cancer.

It is a treatment that uses external beam radiation, it is the brand name of a machine that delivers stereotactic radiation therapy or “radiosurgery.” Cyberknife does not involve a knife, cutting or surgery for treatment but uses a linear accelerator i.e a machine that makes radiation on a robotic arm that allows the radiation beam to be delivered from thousands of directions. Cyberknife uses real-time image guided radiotherapy (IGRT) in order to treat tumors in different parts of the body, including the prostate.

The motion of the tumor is tracked, and the radiation can be directed and delivered accurately based on the motion of the tumor. The cyberknife device combines a compact linear accelerator mounted on a robotic manipulator and an integrated image guidance system. The image guidance system acquires stereoscopic KV images during treatment, tracks tumor motion, and guide the robotic manipulator to precisely and accurately align the treatment beam to the moving tumor.

The system is designed for stereotactic radiosurgery (SRS) and stereotactic body radiation therapy (SBRT). The system is also used for select 3D conformal radiotherapy (3D-CRT) and intensity modulated radiation therapy (IMRT). This cyberknife system is used to treat tumors of the pancreas, liver, prostate, spine, cancer of the throat and brain and even benign tumors.           

The Cyberknife system uses advanced technologies to track tumors in all parts of  the body while its unique robotic design keeps the radiation on target even while the tumor moves before delivering the radiation beam, the system is the only device that validates the exact tumor position then adjusts the robot to precisely target the tumor and this helps to ensure radiation is delivered to where the tumor is, not to where it was moments before.           

Additionally, the cyberknife system features synchrony, the world’s only real-time adaptive delivery technology. Synchrony adapts the delivery of the radiation treatment to tumors while they are in motion by synchronizing the treatment delivery beam position to the target location precisely and accurately during the delivery of a treatment fraction. The sophisticated motion synchronization technology eliminates the need to use uncomfortable patient restraints, or ask patients to hold their breath for example.

Things involved in Cyberknife Treatment for Prostate Cancer

A doctor called urologist will schedule a meeting with the patient a week or two before treatment. This doctor will place gold markers, known as “fiducials”, in the prostate region as a way of marking the target and this is done under ultrasound guidance, similar to the procedure for prostate biopsy and the tumor position will be tracked during the cyberknife treatment for prostate cancer using the fiducials.       

After the gold markers has been placed in the prostate region, a CT simulation is performed and during this CT scan the patient will be positioned in the same way ones will be positioned during the actual treatments of prostate cancer. The physician will use this scan to outline the treatment area and organs or tissues to be avoided.

Note: This information is used to create the treatment plan. The number of treatments called fractions and the amount of radiation (dose) per fraction varies. Each fraction is a higher radiation dose than is used with traditional radiation but less fractions are given. Typically, treatments include;

  • Four or five fractions (treatments)
  • Treatment is given over 1-2 weeks
  • The total number of dose in the mid to high 30 Gray range
  • Each treatment session is 30 to 90 minutes although larger tumors take longer to treat than smaller ones. 

While patient is being treated, the machine automatically takes pictures of the tumor which are compared in real-time to the images from the CT simulation. The cyberknife robot moves around to deliver precise treatment that can be adjusted as the prostate moves when the patient breathe.

Importance of Cyberknife Treatment for Prostate Cancer

Cyberknife is a good option for prostate cancer because; treatment is convenient and it’s completed in fewer fractions (5 compared to 44 fractions in traditional radiation). Although Prostate cancer treatment is not the same for everyone. Surgery, radiation therapy, chemotherapy, and hormone therapy are designed to do different things. Below are a few benefits of cyberknife treatment for prostate cancer when compared to other treatments;

  • There’s no incision or pain compared to normal surgery.
  • There is no need for anesthesia or a hospital stay.
  • As soon as cyberknife is over, one can get up and return to the normal activities.
  • It’s a lot less time-consuming than conventional radiation or chemotherapy.
  • There is no extended recovery period.
  • It spares more normal tissue.
  • It is more accurate than traditional radiation.
  • There are less side effects compared to surgery
  • Treatment is performed as an outpatient procedure.

In addition, prostate cancer is a slower-growing tumor because prostate cancer cells are growing slowly and they may be more sensitive to higher doses of radiation per fraction than other cancers. This means that delivering radiation in larger doses in fewer treatment sessions may improve outcomes.

Patient Liable for Cyberknife Treatment for Prostate Cancer

Cyberknife is typically used for patients with;

  • Early-stage disease.
  • Localized disease (confined to the prostate)
  • A prostate volume (size) of less than 80-100 cm
  • A lesion or tumor that is untreatable by surgery or other radiation modalities.

Most people with enlarged prostates may be given hormone therapy and try to shrink the prostate to be able to get cyberknife treatment for prostate cancer. Patients who are considered high risk for spread to the lymph nodes or have cancer in the lymph nodes are not good candidates for cyberknife treatment for prostate cancer.

Potential side effects of Cyberknife Treatment for Prostate Cancer

Cyberknife treatment for prostate cancer system involves a multi-disciplinary team approach, which may include several specialists;

  • Urologist
  • Radiation Oncologist
  • Medical Physicist
  • Dosimetrist
  • Radiation Therapist
  • Medical Support Staff

Cyberknife treatment for prostate cancer system is a non-surgical, outpatient procedure that does not require incisions or general anesthesia. Most patients will not require hospitalization or a long recovery period. Additionally, cyberknife treatments are non-invasive and avoid the inconvenience and risk associated with radioactive seed or catheter implants.

Note: Most side effects of radiotherapy, including radiotherapy delivered with Accuray systems, are mild and temporary and often involves fatigue, nausea, and skin irritation. Side effects can be severe, however, leading to pain, alterations in normal body functions (for example, urinary or salivary function), deterioration of quality of life, permanent injury and even death. Side effects can occur during or shortly after radiation treatment or in the months and years following radiation.

The nature and severity of side effects depend on many factors, including the size and location of the treated tumor, the treatment technique (for example, the radiation dose), the patient’s general medical condition, to name a few. 

Side Effects of Cyberknife Treatment for Prostate Cancer

Most radiation side effects are minimal and last only a short time and side effects can sometimes be very severe because of rectum or bladder wall exposure to radiation.

  • Constipation, fecal urgency, fecal incontinence, hemorrhoid, rectal bleeding
  • Urinary retention, urinary urgency, increased frequency, incontinence, urinary bleeding
  • Blood in stool
  • Erectile dysfunction
  • Radiation fibrosis
  • Complications (such as pneumothorax) resulting from fiducial marker insertion
  • Exposure to airways and or nearby tissue

Approximately one week after the Cyberknife treatment for prostate cancer the plan is finalized, the patient will begin treatment sessions.  Usually they are 4-5 sessions of short duration over 1-2 weeks. During the treatment, the CyberKnife System’s computer-controlled robot will move around the patient body to various locations from which it will deliver radiation.


Radiation therapy is a treatment option for many types of tumors throughout the body. Precise and accurate delivery of radiation to the tumor is the key to killing cancerous cells while minimizing dose to the healthy tissues. Accurate and precise delivery helps minimize irradiation of the healthy tissues surrounding tumors and potentially the risk of side effects, which may lead to better quality of life for the patient both during and after treatment.

The cyberknife System is the only device designed to accommodate all forms of patients and tumor motion, even while the treatment is being delivered. With its motion adaptive delivery technology, the cyberknife system enables smaller treatment margins around the tumor, minimizing the amount of healthy tissue exposed to high-dose radiation.

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