It is quite a difficult experience to learn that you, or somebody you love, has a tumor that requires an operation or radiotherapy, especially when the tumor is inaccessible.

With CyberKnife® technology put into service at Anadolu Saglik Merkezi (Anadolu Healthcare Center), many of these tumors, which could not be operated on until recently, may now be cured. (Acibadem Maslak Hospital in Istanbul will also have this service the second half of 2009)

CyberKnife® has the characteristics of a revolution in treatment through stereotactic methods.

This method provides patients who have tumors unreachable through surgical methods with a brand new, painless and bloodless treatment method.
Anadolu Healthcare Center is the first center in our country to provide its patients with CyberKnife® technology.

What is stereotactic radiosurgery?
Stereotactic radiosurgery is the penetration of radiation into any tumor or diseased area in the body with strict accuracy and in a way that will least affect healthy tissues as much as possible.

Such method, which does not require surgery, acts as an alternative to an operation and radiotherapy for many small tumors and for different illnesses.

During radiosurgery, a large number of radiation rays go directly to a specific destination to destroy the tumor or diseased area within the body or to stunt the tumor’s growth.  More than a hundred thousand people all over the world have been cured by this method for nearly 30 years.

CyberKnife®, used for the first time in the world in 1994, provides patients with brand new opportunities in stereotactic radiosurgery methods.

How does CyberKnife® work?
The two most critical parts of CyberKnife® are the linear accelerator and the robotic arm.  The linear accelerator, the radiation source, is attached to the robotic arm and has an ability to move, even sensitive to one tenth of a millimeter.

The radiation source can stop at more than 1,200 points during the treatment, thanks to the sensitive movements of the robotic arm.  Depending on the nature of the treatment planned beforehand, a large number of rays (generally between 100 and 150) are directed to the tumor or to the diseased area.  The robotic arm positions the radiation source at a different angle each time, then stops, and sends the ray to the tumor from another angle.

While the ray is sent to the tumor, motion cameras placed around the robotic arm detect the position of the patient.  Changes that might occur in the position of the patient, therefore in that of the tumor, are perceived by motion cameras so that the robotic arm prevents the rays from going into an area other than that of the tumor by correcting its position immediately.

When the treatment is completed, not only the results from destroying the tumor or hindering its growth are obtained by the cumulative effects of the rays directed at the tumor but also only a small number of rays will have been admiministered, not harmful to healthy tissues.

What distinguishes CyberKnife® form other radiosurgical methods?
• CyberKnife® is the only system that can move the radiation source with a robotic arm to control the position of the patient during treatment by real-time images.
• Distinct from other systems, it can be applied to tumors on the spine, the spinal cord, and in other parts of the body as well as those in the brain.  It is the only system that can apply radiosurgery to the spine, the spinal cord and other parts of the body.
• In addition, rays can be directed to the specific area desired, and there is no need to fit a metal framework around the patient’s head, as is the case with other radiotherapy methods that treat brain tumors.


What are the advantages of CyberKnife® ?
• CyberKnife® is a bloodless and painless procedure.
• There is no need to fit a metal framework around a patient’s head, as is the case with other radiotherapy methods.
• It does not require anaesthesia.
• There is no convalescence period.
• It goes directly to the destination with a sensitivity equal to one tenth of a millimeter.
• It administers the least number of rays to the surrounding tissues, as compared to other radiotherapy methods.
• The robotic arm can tolerate changes in a patient’s movements and can be adjusted during the treatment.
• This is an outpatient treatment (no hospitalisation is required).  
• Distinct from other methods, it can be used on the spine, the spinal cord or in other parts of the body (lungs, liver, pancreas, prostate glands, and more), as well as in brain tumors.
• It can serve as an opportunity for alternative treatment for inaccessible, inoperable tumors in some patients or for tumors requiring risky operations in others.
• The destination treated under advanced imaging guidance is monitored with real time images.
• Performed as outpatient treatment.


What are the stages of CyberKnife® treatment?
Patients are evaluated according to medical protocols from various areas of expertise such as radiation oncology, neurosurgery, general surgery, and urology for CyberKnife® treatment, all of which are applied by a multi-disciplinary working group that decides whether the treatment is suitable for the patient.

After our doctors agree on the application of CyberKnife® treatment, the patient undergoes these stages lasting only a few days:


Preparatory Stage
At this stage, preparations are made, depending on the treatment area of the patient’s body.  If the patient receives treatment for the brain, a veil-like plastic mask is made to fit the patient’s face and then special tomography and MRI images are taken.  If the patient receives treatment for the spine, the spinal cord, the abdomen, or the chest, three to six markers are emplaced for special images to be taken and then an appropriate operating bed is prepared for the patient to feel comfortable and to reduce the patient’s body movements.

Planning Stage
After the preparatory stage is complete, the patient returns home.  At that time, a plan is determined on how to send the rays to the tumor in the most suitable way possible without harming surrounding tissues.  Doctors and physics engineers work together on the patient’s radiological images on a computer to develop a treatment plan that suits the patient.


Implementation Stage
The patient’s treatment starts on the day and at the time specified to the patient upon his or her arrival at the CyberKnife® center.  The treatment takes one to two hours.  Under some special circumstances, treatment might be implemented in two to five phases.  In such a case, a 24-hour interval (minimum) is allowed for each phase of the treatment.  The patient may return home or to work after each treatment session.


Which types of cancer may be treated with CyberKnife®?
Benign and malignant tumors in some of the organs near the brain, on the spine or the spinal cord, and in the abdomen; neovascularisation and some functional diseases may be cured with CyberKnife®?