Radiation Therapy for Pancreatic Cancer, Los Angeles, CA
Cyberknife is the first and only Robotic Radiotherapy system for detecting and treating tumors in real time, maintaining sub-millimeter accuracy. This is particularly important for the treatment of pancreatic tumors. Treatments are completed in 5 days or less in our comfortable outpatient setting. Most patients experience minimal to no side effects with a quick recovery time.
Cyberknife – Pancreas Cancer Overview
Learning you have pancreatic cancer is devastating news. We understand this at Pasadena CyberKnife Center and are proud to offer patients new hope with the most advanced treatment option available, Cyberknife. In the past radiation treatments and surgical options could take weeks and even months to complete. Cyberknife treatments are completed in 5 days or less. We hope the information on our website helps patients, family, friends and physicians, the benefits of Cyberknife treatment. We suggest a consult with one of our expert Radiation Oncologists to help you in making the best decisions for your condition.
The CyberKnife® Robotic Stereotactic Body Radiotherapy (SBRT) System was cleared by the FDA in 2001 to treat tumors anywhere in the body, including the pancreas. Despite its name, the CyberKnife System is not a surgical procedure. In fact, there is no cutting, anesthesia or needles involved. Instead, the CyberKnife System delivers high doses of pin-point, sub-millimeter radiation beams directly to the tumor ablating the cancer and preserving healthy tissue.
The CyberKnife System offers new hope to those patients as an adjunct to chemotherapy, and/or surgery, as well as those who cannot undergo pancreatic cancer surgery due to their condition, or who refuse surgery, a minimally invasive alternative treatment for pancreatic cancer.
CyberKnife pancreatic cancer treatments are completed at our outpatient Cyberknife treatment center in one to five days, requiring no overnight hospital stays.
What Patients Can Expect
Patients experience minimal to no side effects with a quick recovery time. This is because the CyberKnife system delivers pancreatic cancer radiation directly to the tumor without exposing healthy tissue to radiation damage like conventional radiation therapy for pancreatic cancer does.
It has been challenging to use radiation for pancreatic cancer treatment in the past because tumors in and around the pancreas move around when you breathe. This movement makes it tough for oncologists to accurately focus radiation on the tumors themselves. With conventional radiation therapy, damage to healthy tissue has been nearly impossible to avoid.
As a result, conventional radiation treatment for pancreatic cancer must be delivered in small doses to minimize any radiation damage to the healthy tissue surrounding the tumors. If you received conventional radiation therapy for pancreatic cancer, you’d need at least 25 and as many as 40 sessions. This is compared to the one to five sessions you need with CyberKnife.
What CyberKnife Does
CyberKnife is an incredibly accurate means of delivering concentrated radiation where it needs to go to destroy tumors. There’s no breath-holding, respiratory gating or uncomfortable contraptions designed to restrict movement with CyberKnife. CyberKnife’s sophisticated Synchrony® Respiratory Tracking System tracks your tumor’s movement as you breathe normally during treatment.
Your treatment team will insert fiducials into your tumor to give the CyberKnife System a reference point for its location. Fiducials are gold-colored markers that tend to be about the same size as rice grains. They’re inserted into the tumor using a needle. You’ll wear a special vest that will help the system track your tumor’s position.
Once your treatment is over, you should be able to resume your daily routine.
Treating Pancreas Cancer With CyberKnife®
How Does Cyberknife Treat Pancreatic Cancer?
The CyberKnife System has been used to treat pancreatic cancer in patients who are poor surgical candidates, those who refuse surgery and in patients for whom surgery or other treatments have failed. Two clinical studies from Stanford University have shown the growth of pancreatic tumors in patients with advanced disease has been controlled by CyberKnife radiosurgery. One study estimated the six-month survival at 80 percent and the estimated one-year survival at 15 percent. In another preliminary study, CyberKnife treatment was shown to provide pain control in 85 percent of the treated patients. Pain control is accomplished because the Cyberknife radiation is so accurate it is ablating the tumor only and sparing healthy tissue. In addition, treatments are completed in 5 days or less vs. 7 weeks with regular conventional therapy.
Treating tumors in and near the pancreas with radiation is challenging because those tumors move as you breathe, making it difficult to target them accurately with radiation. As a result, the tumor may not receive enough radiation and healthy tissue near the tumor may be damaged. With other kinds of ordinary radiation therapy – often referred to as conventional, external-beam, image guided or intensity-modulated radiotherapy – the total radiation dose is divided up into smaller doses delivered over 25 to 40 sessions in order to minimize damage to surrounding healthy tissue. CyberKnife radiosurgery destroys and ablates the tumor tissue with high doses, of extremely accurate radiation delivered in one to five sessions. To do this safely requires a highly accurate system that detects the movement of the tumor throughout treatment sessions and delivers the radiation with pinpoint precision.
Working in conjunction with the CyberKnife System is the Synchrony® Respiratory Tracking System, which enables the radiation beam to track tumor movement in real time and allows patients to breathe normally during their treatment sessions.
CyberKnife Pancreatic Tumor Treatment Process
Pancreatic cancer treatment with the CyberKnife System involves a team approach, in which several specialists participate. A team may include:
- 1. Surgeon
- 2. Board Certified Radiation Oncologist
- 3. Interventional Radiologist
- 4. Medical Physicist (PhD)
- 5. Radiation Therapist
- 6. Medical Support Staff
Once the team is in place, the patient will begin preparation for CyberKnife treatment. The CyberKnife treatment generally involves four steps:
- 1. Fiducial placement
- 2. Set-up and imaging
- 3. Treatment planning
- 4. CyberKnife treatment
During the first step of the treatment process, the patient is scheduled for a short outpatient procedure in which three to five fiducials – tiny gold seeds each about the size of a grain of rice – are inserted into the pancreatic tumor using CT guidance. The CyberKnife System uses those markers as reference points to identify the exact location of the pancreatic tumor during treatment. Once fiducials are implanted, the patient must wait approximately one week before CyberKnife treatment planning can begin to ensure that fiducial movement has stabilized.
During set-up and imaging, the patient will be fitted for a custom body cradle, which is designed to help keep him or her more comfortable and ensures consistent positioning for both imaging and treatment. The patient also will be fitted with a special Synchrony vest, which is worn during CyberKnife treatment and enables the robot to correlate chest motion and breathing patterns with the tumor position. The data generated with the vest allows the CyberKnife robot to precisely follow the tumor’s motion as it delivers each beam of radiation, ensuring safe and accurate radiation delivery.
While wearing the vest, the patient will undergo a series of CT imaging studies, which will enable the CyberKnife team to determine the exact size, shape and location of the tumor. An MRI scan also may be necessary to fully visualize the tumor, pancreas and nearby anatomy. Once the imaging is done, the body cradle will be stored for the remaining CyberKnife treatments.
Next a treatment plan will be specifically designed by a medical physicist in conjunction with the patient’s doctors. The patient does not need to be present at this time. During treatment planning, the CT and MRI scan data is downloaded into the CyberKnife System’s software. The medical team determines the size of the area being targeted by radiation and the radiation dosage, as well as identifying critical structures where radiation should be minimized. Each patient’s unique treatment plan will take full advantage of the CyberKnife System’s extreme maneuverability, allowing for a safe and accurate pancreas cancer treatment.
After a treatment plan is developed, the patient returns to the CyberKnife center for treatment. Pancreatic cancer treatment is usually delivered in four to five sessions, which are typically completed within one week.
For most patients, the CyberKnife treatment is a completely pain-free experience. Patients dress comfortably in their own clothes and, depending on the treatment center, they may be allowed to bring music to listen to during the treatment. Patients also may want to bring something to read while they wait, and have a friend or family member with them to provide support before and after treatment.
When it is time for treatment, the patient will be asked to put on their Synchrony vest and lie on their custom body cradle. The radiation therapist will ensure the vest is properly adjusted and that the patient is positioned correctly on the treatment couch.
As treatment begins, the location of the pancreas tumor will be tracked and detected continually as the patient breathes normally. The medical team will be watching every step of the way as the CyberKnife System tracks the patient’s pancreas tumor as it moves, and safely and precisely delivers radiation to it.
The CyberKnife System’s computer-controlled robot will move around the patient’s body to various locations from which it will deliver radiation. At each position, the robot will stop. Then, special software will determine precisely where the radiation should be delivered by correlating the location of the tumor using digital images of the fiducials and information from the Synchrony vest. The CyberKnife’s robotic arm will adjust the radiation source automatically, to follow the pancreas tumor as it moves. Nothing will be required of the patient during treatment, except to relax and lie as still as possible.
Once treatment is complete, most patients quickly return to their daily routines with little interruption to their normal activities. If treatment is being delivered in stages, the patient will need to return for additional treatments over the next several days as determined by their doctors. Early results indicate that patients tolerate the CyberKnife procedure well, and it does not impair pancreas function. Doctors will discuss all possible side effects prior to treatment. In addition, doctors may prescribe medication to control any side effects, should they occur.
After completing CyberKnife radiosurgery treatment, it is important for the patient to schedule and attend any follow-up appointments. The patient should be aware that his or her tumor will not suddenly disappear. Response to pancreas cancer treatment varies from patient to patient. It could take several months or longer to determine the effectiveness of the CyberKnife treatment. Doctors will monitor the outcome in the months and years following a patient’s treatment using imaging studies and evaluating his or her symptoms.
Learn more about Pancreas Tumors
What is Pancreatic Cancer?
Pancreatic cancer is the abnormal growth of cells in the pancreas that results in a tumor.
Primary Pancreatic Cancer: If the abnormal cells originated in the pancreas, it is considered a primary pancreatic tumor. In this case, most tumors begin in the ducts of the pancreas and are called adenocarcinomas.
Metastatic Pancreatic Cancer: If the abnormal cells originated in the pancreas and were carried to other parts of the body through blood or other bodily fluids, then it is considered a metastatic pancreatic tumor.
It is estimated that 37,000 new cases of pancreatic cancer will occur in the United States in 2008, and an estimated 34,000 people will die from this disease in 2008 alone.1 Over 200,000 cases of pancreatic cancer occur annually throughout the world. Left untreated, median survival is about 4 months; although only 2% of cancers in the United States are pancreatic, it is the 4th leading killer.3 Its low rate of cure reflects, in part, the fact that a large proportion of pancreatic cancers are advanced when they are first detected.
How Is Pancreatic Cancer Detected?
How is Pancreatic Cancer Detected?
Early Stage Pancreatic Cancer usually does not cause symptoms. Unfortunately when symptoms occur, the cancer is often advanced.
Symptoms of Pancreatic Cancer may include:
- Weight Loss
To detect Pancreatic Cancer:
- A physical exam and blood tests may be used in the initial diagnosis, but blood tests alone cannot confirm pancreatic cancer.
- Computed tomography (CT) scans, magnetic resonance imaging (MRI) scans, ultrasound and positron emission tomography-CT (PET-CT) scans may be used to aid in the diagnosis.
- A biopsy may be needed to determine the nature of the cancer cells in patients who are not surgical candidates.
Doctors then determine the “stage” – or extent of the disease – by establishing how big the tumor is and how much it has spread.
Learn more about CyberKnife® and Pancreatic Cancer
For more information on CyberKnife’s ability to treat Pancreas Cancer, check out our Case Studies.