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  CYBERKNIFE  OSTRAVA

Frequently asked questions

What is a CyberKnife?

A CyberKnife is a robotically controlled irradiation tool which allows stereotatic radio surgery to be performed. It is the application of very small volumes of doses of very high radiation into the human body. It provides a non-invasive alternative to the classical surgery applied to both malignant and non-malignant tumours throughout the entire body (brain, spine, lungs, liver, pancreas and prostate). In order to deliver such high radiation doses, the CyberKnife is equipped with a light linear accelerator located on the robotic arm with a six-degree freedom of movement. The CyberKnife is the only such robotic irradiation device in the world. The healing dose is applied painlessly and it allows for a non-surgical treatment for patients whose tumours cannot be operated on by conventional means.

How does the CyberKnife heal?

The device is composed of hundreds of thin radiation beams with extreme accuracy and directs them to a pre-defined target. Unlike other irradiation tools, the CyberKnife is able to reflect any real time corrections – this means that it is capable of modifying the targeting of the tumour during the treatment process meaning that this treatment is also suitable for moving targets. Nearly 100 000 patients around the world have already benefited from treatment by this exceptional tool.

What, exactly, can be treated by a CyberKnife?

Cyberknife treatment is usually applied in cases where the tumours are small in size and number. Typical indications for CyberKnife treatment are brain tumours and metastasis, small lung, spine, liver, pancreas and prostate tumours. The CyberKnife is also involved in the treatment of non-malignant diseases, such as arteriovenous malformations (AVM) or trigeminal neuralgia, which cannot be treated by the application of standard medications.

How do I know if CyberKnife treatment is suitable for me?

If you want to know if this treatment is suitable for you, please contact our centre between 4-5 pm daily on 737 208 148 or by e-mail This e-mail address is being protected from spambots. You need JavaScript enabled to view it .

What are the main benefits of CyberKnife treatment?

Above all, the intervention is non-invasive. Cyberknife treatment is based on the application of ionizing irradiation which destroys cancer cells. The damaged tumour cells, unlike the cells forming healthy tissue, are not able to regenerate completely, which makes it possible to remove the tumour tissue without the need for surgery.

The treatment is also painless, mainly because the ionizing irradiation is applied from a previously determined distance.

There is no need of anaesthesia: As the intervention is non-invasive, there is no need to apply anaesthesia and shortly after the treatment is completed, patients are able to get back to their day-to-day lives.

Treatment is an outpatient procedure: as the treatment in non-invasive, there is no need to hospitalize the patient and the treatment can thus be preformed at a pre-agreed time.

The overall short duration of treatment: the device applies high doses of radiation to the target area with maximum possible accuracy, therefore the treatment period is shortened from weeks to days.

What can I expect before and during CyberKnife treatment?

Before the treatment the patient must undergo an investigation on planning tomography device (CT) which creates an image of the internal anatomy of the entire body. The size and shape of the tumour is projected into the series of profiles, which can then allow the exact mapping of the tumour itself together with its close surroundings. In some cases, special procedures are followed before planning tomography examination in order to increase the efficiency of the treatment (e.g. introduction of a contrast substance into the surrounding areas of prostate tumours or the creation of a fixation mask in cases where there is a tumour in the cerebral area).

After the definition of the target volume for particular CT profiles, an irradiation plan is developed, which defines the number of irradiated fields, the size of the beam and the intensity of particular fields. Each plan goes through an approval process where a team of physicians and physicists evaluate the quality of the given irradiation plan. After their approval, the treatment can commence.

The treatment is applied to the patient in the same corporal position as the CT examination – the patient lies on their back as the various fixation tools and pads are applied, in order to minimise discomfort. The treatment process can be time-consuming and therefore patient comfort is one of our top priorities. The healing application usually takes from 30 to 120 minutes, depending on the type and size of the tumour(s). The treatment time is approximate and depends on other factors such as the proper preparation before the treatment, regular breathing and above all on the patient’s cooperation with the CyberKnife team. All precautions and procedures are explained to the patients by their attending physician.

Before the treatment commences, the correct targeting must be verified in order to ensure the same positioning that was in place during the CT examination. The pre-treatment preparation is therefore approximately half of all time spent by the patient in our department. After the exact positioning is complete, the treatment commences. During the application, the robotic shoulder will change its position and move around the patient so that the healing dose can be applied according to the approved plan. See video reference for more detail. During the treatment, the position of tumour is continually checked – visual check on X ray images, monitoring of breathing cycle, targeting with the help of implanted “golden grains”, etc.).

Why are “golden grains” implanted before the treatment?

Some tumours (pancreatic, liver and prostate) are not visible to the CyberKnife. In order that the robot is able to follow the target in real time, “golden grains” must be implanted into certain organs, (under ultrasound or CT supervision). These grains are then traced and followed by the Cyberknife during the irradiation process. Thus, the maximum possible accuracy is ensured even for poorly visible or detectable tumours.

What adverse effects can I expect during or after the treatment?

Most patients suffer from adverse effects either during or after the treatment. However, some side effects can occur depending on what area has been treated, these would be more likely to occur after the treatment is over. A specialist will explain the possible side-effects to you and will also explain how to reduce or influence them.

How often do I have to undergo CyberKnife treatment and when will I notice the results?

The frequency of treatment procedures depends on the quantity of the dose necessary to destroy the tumour cells and also on the location of the tumour. Some tumours can only be irradiated once whereas, in other cases, the dose can be administered in 3-5 sub- doses. Sometimes, the procedures are held on a daily basis, sometimes every second day. Nevertheless, the treatment period never exceeds ten days.

Although the resulting effect may appear within days, it usually takes weeks or months. After completion of the treatment you must undergo follow-up examinations for CT tomography, magnetic resonance imagining (MRI) or other diagnostic tools depending on the affected location.

What is the difference between CyberKnife and standard irradiation?

In standard radiotherapy a wide beam of irradiation is applied, this often affects larger volumes of tissue. These beams can be targeted with an accuracy of 3-5 mm, which is sufficient for most indications. In order to avoid undesired effects and injuries to the patient, the treatment must be distributed in a higher number (25-40) of smaller doses.

CyberKnife radio surgery utilizes a thin beam of high dose irradiation with extreme accuracy and guarantees minimum damage to surrounding tissue. CyberKnife applies large number of thin beams of irradiation targeted to the desired volume with maximum accuracy. Due to the extreme accuracy of the device it is possible to apply a high dosage in just 1 – 5 treatment sessions.

Where you can find us?

Address

Fakultní nemocnice Ostrava
17. listopadu 1790, 708 52 Ostrava-Poruba
GPS: 49° 49' 36" N / 18° 09' 40" E
Phone: +420 597 371 111, E-mail: fno@fno.cz

Visiting hours

Each day from 3.00 p.m. to 6.00  p.m.

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