Cyberknife is at Your Service in Health Tourism Turkey Coordinatory

Cyberknife, which is available only in a limited number of centers worldwide, is AT YOUR SERVICE only in Health Tourism Turkey Coordinatory in Turkey.

Cyberknife, which is used for the radiotherapy of many types of cancer, removes the tumor precisely as a surgical method while preventing harmful effects of radiation on normal intact tissues. Patients can return to their work soon after the procedures performed with Cyberknife technology, which is the most sophisticated method of radiosurgery. Cyberknife confers additional benefits too!

From 2002 on Cyberknife has been used successfully in thousands of patients in the most respectable cancer institutes mainly in the US and Japan. Many patients from our country have been referred to Stanford University Cyberknife Center, which is accepted as one of the best healthcare centers in the world. Cyberknife is now available in 70 healthcare centers in the world including Health Tourism Turkey Coordinatory in Turkey. Cyberknife, which was approved by FDA for usage in any part of the body, is the latest technology used for the radiotherapy of cancer. It is the most advanced method of radiotherapy, which minimizes exposure of intact peritumoral tissue to radiation Cyberknife is defined as painless non-operative treatment approach. Tumor or affected areas are targeted precisely, and killed with higher radiation doses.



What is Cyberknife ?
Cyberknife is the latest technology used for the radiotherapy of every type of cancer. It works with 6 MV Linac mounted on a robotic arm.
It is the most advanced radiotherapeutic method minimizing exposure of normal intact peritumoral tissues to irradiation.

With a robotic arm that can be rotated, and stopped at every position, focussed radiation beams can be delivered to the patient.
Any body region can be easily irradiated with a robotic arm. This characteristics offers opportunity of treatment to many patients incurable with other radiotherapy equipments.

Cyberknife is defined as a painless, non-operative treatment modality. With Cyberknife, tumor or affected areas in the body are targeted precisely, and destroyed with higher radiation doses.

For which body parts it is used?
Cyberknife is an effective method for brain tumors. Cyberknife may offer an alternative for inoperable patients. After contouring of tumor seen in computerized tomography, CyberKnife system irradiates and destroys tumor meticulously like a surgeon with the help of a robot in a session lasting nearly an hour.

It has a potential widespread usage in many types of tumors. It can irradiate organs having higher incidence of cancer such as brain, brainstem, spinal cord, throat, lungs, liver, pancreas, kidney, adrenals and prostate without any side-effect. This superior technology allows patients return to their homes, or even drive home soon after the therapy.

The probability of treatment errors drops to negligible levels!
Cyberknife is used for cancer radiotherapy. The equipment has a robotic arm that works with an integrated 6 MV Linac, rotates in every direction, and stops at every position. It delivers precisely directed radiation beams to the tumor area within the patient. Thus, any body region can be easily irradiated using this robotic arm. This feature offers a chance of treatment for patients, considered as untreatable with other types of radiotherapy equipments.

Besides, during treatment with Cyberknife, 100% real-time images can be obtained, and these images guide the radiation procedure. Organs, with the exception of brain, can sometimes move. This feature prevents desired dose distribution. With the guidance of the markers placed inside tumor / on the skin surface and Synchrony software program, mobile organs are monitorized continuously during therapy session with Cyberknife, and the organ is irradiated when it is in the desired position. Perfect homogeneity and distribution of doses are obtained with non-isocentric and non-coplanar single or multiple fractionated radiation doses, and radiotherapy can be achieved with minimal deviation (<1 mm). As a result of these benefits, probability of a treatment error drops to minimum.
Painless and without adverse effects
It is possible to protect normal tissues from harmful effects of radiation using robotic orientation system with a accuracy rate less than 1 mm. In other words, it removes the tumor precisely as a surgical method while preventing harmful effects of radiation on normal intact tissues. Robot-assisted operations do not carry any adverse effect or risk of traditional surgery, in that it is a bloodless and painless intervention performed without anesthesia. Therefore, it is also known as a radiosurgical equipment. Owing to the monitoring system of organs moving up and down with respiration, it is at least as effective as surgery for the treatment of many types of cancer and their metastases.

Cyberknife in clinical applications.

AVM (Arteriovenous Malformations)
AVM is a vascular disease in brain and spinal cord. It carries a 3-4% risk of bleeding. Besides, it can cause epileptic seizures, pain and neurologic deficits. They can be treated with embolization or other surgical methods. However, these procedures are risky and invasive interventions. Although its effects are seen later than other methods, radiosurgery is a safe treatment modality.

In other methods, a metal frame must be placed around skull to localize and stabilize the target. This apparatus must stay around patient's head for nearly 3-6 hours. However, during treatment with Cyberknife, a metal frame causing pain is avoided. Besides, AVMs in spinal cord of near skull base can not be treated with other radiosurgical methods. However, with Cyberknife, any lesion within the body can be treated easily and precisely.

Brain Tumors
In a majority of tumors arising from brain tissue, Cyberknife treatment is applied as a monotherapy or post-operatively.

In benign tumors of brain, Cyberknife reduces and destroys tumor or stops its growth and allows non-operative management of the patients.
In malign tumors of brain, pre-, and post-operative applications aid in recovery of patients. The greatest advantage of Cyberknife is the avoidance of metal skull frame apart from other radiosurgical methods, and completion of therapy usually within 1-5 sessions instead of 30-40 sessions.

Brain metastases
Cancer cells transport in blood circulation to other organs, settle there and continually damage the tissue. They mostly settle inside brain. In 20-40% of cancer patients, brain metastases are observed. Up to 75% of them metastasize to more than one foci. They can lead to epileptic seizures, headache and neurologic deficits.

For the treatment of brain metastases, surgical treatments, whole-brain radiotherapy, and some chemotherapeutic agents have been used. Studies performed have shown that radiosurgery is as effective as surgical treatment. With this modality, patients are freed from a heavy burden as brain surgery. However, as in many radiosurgical methods, for the treatment of AVMs a metal frame must be fixed to the skull to determine the target to be radiated, to plan and apply the treatment. This apparatus must stay on patient's head for nearly 3-6 hours. However, during treatment with Cyberknife, a metal frame causing pain is avoided. In addition, patients will not feel pain since a metal frame is not fixed for planning and application of Cyberknife therapy. Besides, with other radiosurgical methods, only one fraction of radiotherapy is applied, while with Cyberknife, radiosurgical therapy can be instituted in 1-5 fractions.
In addition, with similar reasons, Cyberknife maintains its superiority for glial tumors, acoustic neurinomas and trigeminal neuralgias.

Liver cancers
For primary cancers of liver (hepatocellular carcinoma) and intrahepatic biliary tract, surgical treatment is preferred. Especially patients with small tumors can survive longer after surgery. However, only 30% of the patients are operable. The remaining 70% can not use their chance of surgery, and they do not survive longer despite many systemic treatments. Similarly, in metastatic diseases of liver, surgical approaches are less suitable, and chemotherapy is not sufficiently effective. Conventional radiotherapy can not be applied for these patient groups or only very limited doses can be given to a small number of patients because of mobility of liver and damage incurred on intact liver tissue. Even these doses could not demonstrate the desired effect. Although, with radiosurgery, intact tissues can be protected maximally, technically it can not be performed for tumors outside skull, and a planning can not be done for movable organs. However, with Cyberknife, radiosurgery of mobile organs can be performed with a minimal intervention. Intact tissues can be protected maximally, while higher doses can be applied to cancerous tissues when compared with conventional methods. For inoperable primary or metastatic hepatic cancers, with effective doses of radiosurgery, patients can survive longer.

Lung Cancers
Cancers arising from the lung tissue or those metastasize to the lungs are fatal because of damage incurred on the lungs. Coughing, dyspnea, bleeding, pain, rapid weight loss are usually the most commonly seen symptoms. For the treatment of primary lung cancer, surgical therapy plays an important role. In early stages, with surgical treatment, patients can survive longer. In late stages, radiotherapy and chemotherapy are used. Despite all of these treatment modalities, mostly the disease can not be controlled and the tumor can continue to grow. For these cases, reoperation and / or radiotherapy with conventional methods can not be instituted. Even applicable, the chance of increasing doses to desired levels are very low. For that reason, effective results can not be obtained. However, with Cyberknife, intact tissues are protected maximally, and tumor tissues can be exposed to higher doses that can not be delivered with other conventional methods. In primary lung cancers not amenable to surgical treatments and radiotherapy, effective doses of radiosurgery can control the disease and the patients can survive longer.

In studies performed recently, evidence suggested that the treatment of metastases ( with surgery and / or radiotherapy) provides a better and a longer life span. In these cases, where surgery is inadequate, Cyberknife is preferred as an effective treatment modalities. Sometimes Cyberknife saves patients from serious operations.

Pancreatic Cancer
Every year in the USA, 30,000 individuals are diagnosed as pancreatic cancers, and 30,000 patients are dying from pancreatic cancer. As can be understood from these statements, mortality from pancreatic cancer is relatively higher. They can lead to complaints as jaundice, pain, weakness and indigestion. Surgical treatment is the basic therapy. However, surgery can only be applied only during early stages. Since findings other than jaundice are not specific to the disease, it can not be detected during early stages. In patients who lost their chance of operability, chemotherapy or radiotherapy alone can not provide desired outcomes. Although better outcomes have been achieved with concomitant use of chemotherapy and radiotherapy, the desired levels have not been achieved. Radiotherapy can not be applied with satisfactorily higher levels on small intestines, liver, kidney and spinal cord. Cyberknife will reach the doses not attainable with classical radiotherapy, and offers an opportunity to accomplish outcomes nearly similar to surgery.

Prostate Carcinomas
Studies aiming at achieving definitive treatment outcomes with single sessions of Cyberknife similar to those obtained with classical radiotherapy have reached its last phase. Cyberknife application in prostate cancers has been started in Health Tourism Turkey Coordinatory simultaneously with renown international centers.

Cyberknife

Available in five centers in Europe, and exclusively in Anadolu Health Center in
Turkey,Cyberknife is the most advanced form of radiosurgery that destroys the tumor with minimum exposure of radiation to the normal tissue surrounding the tumor.Cyberknife provides a treatment opportunity to patients otherwise untreatable with existing radiotherapy devices.

Advantages of Cyberknife

• Owing to its ability to follow body movements, Cyberknife can be utilized, besides brain tumors, for the treatment of spinal and spinal cord tumors, or tumors in other parts of the body, such as lung, liver, pancreas, and prostate.
• The robotic arm of Cyberknife tolerates patient position modifications, and can be adjusted during therapy.
• It is a painless, non-operative procedure and it does not require anesthesia. Therefore, it allows for outpatient therapy.
• The patients head does not need to be fixated in a metal frame as in other radiosurgery methods.
• There is no convalescence period involved.
• The therapeutic target is reached with a sensitivity of 0.1 millimeter. Thus, minimal radiation is conveyed to surrounding tissues, compared with other radiotherapy methods.
• The treatment target handled with the aid of advanced imaging guidance can be monitored via real-time images.
• It is the only device in the world that can treat medulla spinalis and spine tumors which have a high incidence.
  

For which body parts it is used?
Cyberknife is an effective method for brain tumors. Cyberknife may offer an alternative for inoperable patients. After contouring of tumor seen in computerized tomography, CyberKnife system irradiates and destroys tumor meticulously like a surgeon with the help of a robot in a session lasting nearly an hour.
It has a potential widespread usage in many types of tumors. It can irradiate organs having higher incidence of cancer such as brain, brainstem, spinal cord, throat, lungs, liver, pancreas, kidney, adrenals and prostate without any side-effect. This superior technology allows patients return to their homes, or even drive home soon after the therapy.

The probability of treatment errors drops to negligible levels
Cyberknife is used for cancer radiotherapy. Robotic arm is working with an integrated 6 MV Linac. The equipment has a robotic arm which rotates every direction, and stops at every position. It delivers precisely directed radiation beams to the tumor area within the patient. Thus, any body region can be easily irradiated using this robotic arm. This feature offers a chance of treatment for patients, considered as untreatable with other types of radiotherapy equipments.

Besides, during treatment with Cyberknife, 100% real-time images can be obtained, and these images guide the radiation procedure. Organs, with the exception of brain, can sometimes move. This feature prevents desired dose distribution. With the guidance of the markers placed inside tumor / on the skin surface and Synchrony software program, mobile organs are monitorized continuously during therapy session with Cyberknife, and the organ is irradiated when it is in the desired position. Perfect homogeneity and distribution of doses are obtained with non-isocentric and non-coplanar single or multiple fractionated radiation doses, and radiotherapy can be achieved with minimal deviation (<1 mm). As a result of these benefits, probability of a treatment error drops to minimum.

Painless and without adverse effects
It is possible to protect normal tissues from harmful effects of radiation using robotic orientation system with a accuracy rate less than 1 mm. In other words, it removes the tumor precisely as a surgical method while preventing harmful effects of radiation on normal intact tissues. Robot-assisted operations do not carry any adverse effect or risk of traditional surgery, in that it is a bloodless and painless intervention performed without anesthesia. Therefore, it is also known as a radiosurgical equipment. Owing to the monitoring system of organs moving up and down with respiration, it is at least as effective as surgery for the treatment of many types of cancer and their metastases.

Cyberknife in clinical applications.

AVM (Arteriovenous Malformations)
AVM is a vascular disease in brain and spinal cord. It carries a 3-4% risk of bleeding. Besides, it can cause epileptic seizures, pain and neurologic deficits. They can be treated with embolization or other surgical methods. However, these procedures are risky and invasive interventions. Although its effects are seen later than other methods, radiosurgery is a safe treatment modality.
In other methods, a metal frame must be placed around skull to localize and stabilize the target. This apparatus must stay around patient's head for nearly 3-6 hours. However, during treatment with Cyberknife, a metal frame causing pain is avoided. Besides, AVMs in spinal cord of near skull base can not be treated with other radiosurgical methods. However, with Cyberknife, any lesion within the body can be treated easily and precisely.

Brain Tumors
In a majority of tumors arising from brain tissue, Cyberknife treatment is applied as a monotherapy or post-operatively.
In benign tumors of brain, Cyberknife reduces and destroys tumor or stops its growth and allows non-operative management of the patients.
In malign tumors of brain, pre-, and post-operative applications aid in recovery of patients. The greatest advantage of Cyberknife is the avoidance of metal skull frame apart from other radiosurgical methods, and completion of therapy usually within 1-5 sessions instead of 30-40 sessions.

Brain metastases
Cancer cells transport in blood circulation to other organs, settle there and continually damage the tissue. They mostly settle inside brain. In 20-40% of cancer patients, brain metastases are observed. Up to 75% of them metastasize to more than one foci. They can lead to epileptic seizures, headache and neurologic deficits.
For the treatment of brain metastases, surgical treatments, whole-brain radiotherapy, and some chemotherapeutic agents have been used. Studies performed have shown that radiosurgery is as effective as surgical treatment. With this modality, patients are freed from a heavy burden as brain surgery. However, as in many radiosurgical methods, for the treatment of AVMs a metal frame must be fixed to the skull to determine the target to be radiated, to plan and apply the treatment. This apparatus must stay on patient's head for nearly 3-6 hours. However, during treatment with Cyberknife, a metal frame causing pain is avoided. In addition, patients will not feel pain since a metal frame is not fixed for planning and application of Cyberknife therapy. Besides, with other radiosurgical methods, only one fraction of radiotherapy is applied, while with Cyberknife, radiosurgical therapy can be instituted in 1-5 fractions.
In addition, with similar reasons, Cyberknife maintains its superiority for glial tumors, acoustic neurinomas and trigeminal neuralgias.

Spinal Tumors:
The CyberKnife has the potential to treat most types of spinal tumors. Both benign (non-cancerous) and malignant (cancerous or capable of spreading to other sites in the body) spinal tumors can be treated with the CyberKnife. While some types of lesions develop within the substance of the spinal cord itself, these tumors more commonly develop in and around the vertebral column and disrupt neurologic function by compressing the spinal cord. The following lists detail the tumor pathologies that most commonly affect the spine and which can often be treated with the CyberKnife depending on clinical circumstances:

Benign Lesions:

• meningioma
• schwannoma
• neurofibroma
• hemangioblastoma
• arteriovenous malformations
• chondrosarcoma
• chordoma
• ependymoma
• other: giant cell tumor, aneurysmal bone cyst, epidermoid

Malignant Tumors:

• spinal metastases from many sources
• myeloma
• lymphoma
• Ewing sarcoma

Liver cancers
For primary cancers of liver (hepatocellular carcinoma) and intrahepatic biliary tract, surgical treatment is preferred. Especially patients with small tumors can survive longer after surgery. However, only 30% of the patients are operable. The remaining 70% can not use their chance of surgery, and they do not survive longer despite many systemic treatments. Similarly, in metastatic diseases of liver, surgical approaches are less suitable, and chemotherapy is not sufficiently effective. Conventional radiotherapy can not be applied for these patient groups or only very limited doses can be given to a small number of patients because of mobility of liver and damage incurred on intact liver tissue. Even these doses could not demonstrate the desired effect. Although, with radiosurgery, intact tissues can be protected maximally, technically it can not be performed for tumors outside skull, and a planning can not be done for movable organs. However, with Cyberknife, radiosurgery of mobile organs can be performed with a minimal intervention. Intact tissues can be protected maximally, while higher doses can be applied to cancerous tissues when compared with conventional methods. For inoperable primary or metastatic hepatic cancers, with effective doses of radiosurgery, patients can survive longer.

Lung Cancers
Cancers arising from the lung tissue or those metastasize to the lungs are fatal because of damage incurred on the lungs. Coughing, dyspnea, bleeding, pain, rapid weight loss are usually the most commonly seen symptoms. For the treatment of primary lung cancer, surgical therapy plays an important role. In early stages, with surgical treatment, patients can survive longer. In late stages, radiotherapy and chemotherapy are used. Despite all of these treatment modalities, mostly the disease can not be controlled and the tumor can continue to grow. For these cases, reoperation and / or radiotherapy with conventional methods can not be instituted. Even applicable, the chance of increasing doses to desired levels are very low. For that reason, effective results can not be obtained. However, with Cyberknife, intact tissues are protected maximally, and tumor tissues can be exposed to higher doses that can not be delivered with other conventional methods. In primary lung cancers not amenable to surgical treatments and radiotherapy, effective doses of radiosurgery can control the disease and the patients can survive longer.
In studies performed recently, evidence suggested that the treatment of metastases ( with surgery and / or radiotherapy) provides a better and a longer life span. In these cases, where surgery is inadequate, Cyberknife is preferred as an effective treatment modalities. Sometimes Cyberknife saves patients from serious operations.

Pancreatic Cancer
Every year in the USA, 30,000 individuals are diagnosed as pancreatic cancers, and 30,000 patients are dying from pancreatic cancer. As can be understood from these statements, mortality from pancreatic cancer is relatively higher. They can lead to complaints as jaundice, pain, weakness and indigestion. Surgical treatment is the basic therapy. However, surgery can only be applied only during early stages. Since findings other than jaundice are not specific to the disease, it can not be detected during early stages. In patients who lost their chance of operability, chemotherapy or radiotherapy alone can not provide desired outcomes. Although better outcomes have been achieved with concomitant use of chemotherapy and radiotherapy, the desired levels have not been achieved. Radiotherapy can not be applied with satisfactorily higher levels on small intestines, liver, kidney and spinal cord. Cyberknife will reach the doses not attainable with classical radiotherapy, and offers an opportunity to accomplish outcomes nearly similar to surgery.

Prostate Carcinomas
Studies aiming at achieving definitive treatment outcomes with single sessions of Cyberknife similar to those obtained with classical radiotherapy have reached its last phase. Cyberknife application in prostate cancers has been started in Health Tourism Turkey Coordinatory simultaneously with renown international centers.