What are the latest modern cancer treatments?

Gamma Knife® and CyberKnife®. A combination of imaging and intelligent robotic radiosurgery means that tumours are detected and destroyed without even the need for an anaesthetic or a surgeon.Modern medicine has changed so fast that many diseases now including cancer are no longer a death sentence. For example, even up until relatively recently, an HIV positive diagnosis was effectively a death sentence, but these days given the right treatments people do not die of HIV. The same is now becoming true for many types of cancer thanks to new technologies such as Gamma Knife and CyberKnife. These treatment options mean that Star Trek technology is now a reality. A combination of imaging and intelligent robotic radiosurgery means that tumours are detected and destroyed without even the need for an anaesthetic or a surgeon.

Radiosurgery

According to Royal Marsden oncology expert Dr Chris Nutting: “If tumours only occurred in convenient locations the job of the surgeon and oncologist would be made so much easier. The trouble is that they don’t and many wrap themselves around or are close to other vital tissues or spread into delicate areas such as nervous tissue. This means that the surgeon’s skills can be stretched to the limit or the use of conventional radiotherapy would also damage too much healthy tissue. What is needed is a clear image of the precise location of the tumour (with all its irregularities) so that the delivery of radiation can be accurately pinpointed to these parts, and these parts alone. This is where CyberKnife® can come in. CyberKnife® is an example of a ‘stereotactic radiosurgical technique’ and combines the benefits of controlled irradiation with on-line tumour imaging and tracking.”

This technology is now available for many types of cancer including the following:

Spine

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. Also, vertebral tumours (the vertebra is the spine bone) may similarly be treated by this technology (with sparing of the radiosensitive spinal cord that runs through the vertebra).

Lung

Single or several tumours in the lung.
Individual lung cancers (primary or secondary).

Prostate

CyberKnife® now offers a new radiotherapeutic method with potential to cure but with far fewer visits to the radiotherapy department for therapy.

Pancreas

The pancreas is surrounded by delicate and radiosensitive structures such as the duodenum and a sophisticated deposition of dose is required to allow maximal deposition of radiation dose on the pancreatic tumour and yet sparing of these surrounding organs.

Liver

Quite simply, CyberKnife® seems the important advance that we have been waiting for, and more than one lesion can be targeted.

Kidney

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.

When other treatments have failed

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.

Clinical oncologists are excited about this major leap in the application of the new technologies to treat cancer. In a way there is nothing particularly new as all of the theory has been in place for some time, but it is the ability to combine all the technologies into one unit that suddenly opens the door to a host of new treatment possibilities.