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Kidney Tumor Treatment Options

Discover your options for treating Kidney tumors

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 Kidney 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 and TrueBeam Lung tumor treatments are covered by Medicare and most all insurances.

What Sets CyberKnife Apart? 

CyberKnife Stereotactic 
Radiosurgery For Kidney Tumors

The CyberKnife® Robotic Radiosurgery System was cleared by the U.S. Food and Drug Administration in 2001 to treat tumors anywhere in the body, including the kidney. Despite its name, the CyberKnife System is not a surgical procedure. In fact, there is no cutting involved. Instead, the CyberKnife System delivers high doses of pin-point radiation directly to kidney tumors. The CyberKnife System offers patients who cannot undergo kidney cancer surgery due to their poor medical condition, or who refuse surgery, a minimally invasive alternative treatment for kidney cancer. Spokane Cyberknife kidney cancer treatments are performed on an outpatient basis and completed in only one to five sessions. Most patients experience minimal to no side effects with a quick recovery time.

 

How Does CyberKnife
Treat Kidney Tumors?

1. Treating Kidney Cancer With CyberKnife open

Treating kidney cancer with radiation therapy is a challenge because kidney tumors move with respiration.  In addition the tissue surrounding the kidney tumors is very sensitive and can be damaged easily.  The CyberKnife Radiosurgery System is able to deliver very high doses of radiation to both primary and metastatic kidney tumors with extreme accuracy. 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. With the CyberKnife System, doctors can zero in on a moving target – the kidney tumor – and irradiate it without harming the healthy surrounding tissue. As a result, the CyberKnife treatment is more comfortable for patients, radiation is delivered more accurately and treatments can be completed in one to five sessions.

Kidney cancer treatment with the CyberKnife System involves a team approach, in which several specialists participate. A team may include:

• Radiation Oncologist

• General Surgeon

• Medical Oncologist

• Medical Physicist

• Radiation Therapis

•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, the patient is scheduled for a short outpatient procedure in which three to six fiducials – tiny gold seeds each about the size of a grain of rice – are inserted into and around the liver tumor using CT guidance, ultrasound or via a camera that is passed through the mouth into the stomach and small intestine. The CyberKnife System uses those fiducial markers as reference points to identify the exact location of the 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 and positioned in the cradle, the patient then 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 or PET-CT scan also may be necessary to fully visualize the tumor, liver and nearby anatomy. Once the imaging is done, the Synchrony vest and body cradle will be stored for use during CyberKnife treatment.

Next a treatment plan will be specifically designed by our medical physicist in conjunction with our Radiation Oncologists. The patient does not need to be present at this time. During treatment planning, the imaging 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 liver cancer treatment.

After a treatment plan is developed, the patient returns to the CyberKnife center for treatment. Our Cancer Experts may choose to deliver the kidney cancer treatment in one session, or stage it for up to 5 sessions. Kidney cancer treatments 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 kidney 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 liver 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 kidney tumor as it moves. Nothing will be required of the patient during treatment, except to relax and lie still.

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. After CyberKnife treatments, most patients experience minimal side effects, which typically go away within the first week or two after treatment. Our doctors will discuss all possible side effects prior to treatment. In addition, our 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 kidney cancer treatment varies from patient to patient. It could take up to 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 through physical exams, blood tests and imaging techniques, such as CT or PET-CT scan.

2. How Does TrueBeam Treat Kidney Tumors? open

Spokane Cyberknife is pleased to announce the arrival of the new TrueBeam™ system to Spokane. TrueBeam™ is an advanced radiation therapy technology for treating cancers throughout the body, including kidney tumors. Spokane Cyberknife is the only center in the United States with not one, but the two most advanced Radiation Treatment Technologies in one center – Cyberknife M6 and Truebeam. Your Cancer Experts at Spokane Cyberknife work with your unique condition to personalize the most effective treatment plan, that at times involves multiple technologies and methodologies, and only Spokane Cyberknife can offer this with the Cyberknife M6 and Truebeam from one center.

TrueBeam can be used for many forms of advanced radiation treatment techniques including:

• IGRT - Image-Guided RadioTherapy

• IMRT - Intensity-Modulated RadioTherapy

• RapidArc ® Radiotherapy – Stereotactic Radiosurgery (SRS) and Stereotactic Body Radiotherapy (SBRT)

• 3-D Conformal

• VMAT – Volumetric Modulated Arc Therapy

Because of this, patients can receive the treatment that is best suited for their specific clinical circumstances.

Opening up treatment options for patients with cancers of the spine, it targets tumors with accuracy measured in millimeters. With its power and flexibility, our cancer experts can develop treatments that are best suited for patients’ individual circumstances.

Advanced Features of the leading edge Radiation Therapy Truebeam system:

• Gantry Design – the TrueBeam rotates around the patient to deliver a prescribed radiation dose from nearly any angle.

• Multi-Leaf Collimator (MLC) - An accessory that is shapes the beam to the size and outline of the tumor itself. It has 120 computer-controlled “leaves” or “fingers” that create apertures of different shapes and sizes. The leaves sculpt the beam to match the 3-D shape of the tumor. These can move and change during treatment to target the tumor and minimize dose to the surrounding healthy tissues.

• Cone Beam CT - a form of CT, using 25% less X-ray dose than compared with earlier Radiation Therapy systems with image-guided technologies. This means patients can be exposed to less X-rays/radiation.

• Real-time Imaging - allows clinicians to “see” the tumor they are about to treat. This gives them confidence, and they can target tumors with accuracy measured in millimeters. 

• Advanced ‘Gating’ option - The system includes a new option for synchronizing beam delivery with respiration. This helps maintain accuracy as the system changes its targeting whenever tumor motion is an issue, for example during lung cancer treatments.

3. What Is Radiosurgery?? open

What is Radiosurgery? 

Radiosurgery = Stereotactic Radiosurgery (SRS) and Stereotactic Body Radiotherapy (SBRT) 

Many cancers cannot be completely eradicated with traditional radiation therapy (RT) techniques. The goal of radiation treatment has always been to maximize the delivery of radiation to tumors while minimizing the amount of radiation to normal tissue. The higher the radiation dose delivered to a tumor, the greater the chance of tumor destruction. Likewise, the lower the radiation dose delivered to surrounding normal tissue, the less destruction. Historically, the available technology, found at other centers, was unable to accurately deliver high dose radiation to a tumor without also affecting the surrounding tissue. To minimize collateral damage to the surrounding tissues, radiation oncologists traditionally deliver radiation over many sessions, giving low doses each day over usually several weeks, (25 to 45 days). Following each fraction of radiation the normal tissue cells can recover better than many cancerous cells. Over many sessions, the hope is that more tumor cells die than normal tissue cells. Unfortunately, this strategy is often unsuccessful. 

With the development of SRS & SBRT, physicians are now able to deliver lethal (surgical) doses of radiation to a tumor with sub-millimeter (surgical) accuracy, in 1 to 5 treatments. This methodology maximizes the amount of radiation going directly to the target tissue (and thus maximizing tumor response rate) while minimizing the radiation exposure to surrounding tissue. This is evidenced in the studies that compare the clinical treatment volume (CTV) to the planning treatment volume (PTV). With SRS & SBRT, unlike RT, the CTV and PTV are more closely aligned, which means that SRS & SBRT is able to precisely deliver lethal doses of radiation to the target tissue. By minimizing the impact on healthy tissue, SRS & SBRT shortens patient recovery time and decreases complication rates. 

As technology has continued to evolve advancements have enabled physicians to apply SRS & SBRT to lesions in the body, as well as to lesions in the cranium, head, and neck. Procedures were originally performed on cranial tumors because the technology at the time required a frame, which can easily be screwed into the skull, as with the Gamma Knife. Attempts to develop body frames were cumbersome and unsuccessful. As a result, initially, no technological solution was available to accurately deliver lethal doses of radiation to tumors below the head without also destroying normal tissue. 

Then came CyberKnife, the first and only dedicated robotic, SRS & SBRT treatment technology. And for the first time we now have a technology that allows for real time tracking of a tumor regardless of where it is in the body. Physicians are now able to achieve sub-millimeter (.3MM) accuracy in the head, without the frame, by using the anatomical markings of the skull and taking advantage of the stable relationship between the skull and an intracranial tumor. In the same manner, we are now able to use the anatomical markings of the spine to treat spinal lesions. For other tumors in soft tissue throughout the body, we are able to track, in real time, small gold fiducials placed in the tumor to accurately deliver radiosurgical doses. 

Over the last 17 years, SRS & SBRT has case study data proving the clinical effectiveness in treating intra-cranial, extra-cranial neck, and body tumors. In many cases SRS & SBRT provides a clinically superior alternative to either surgery or traditional RT for head and body lesions. In some cases, SRS & SBRT is the only effective option. The SRS & SBRT approach allows for dose escalation, hypo-fractionation, and 

heterogeneity of dosage within the tumor volume, and improved conformality and accuracy. As a result, SRS & SBRT delivers unique benefits to the patient, including improved tumor response, higher cure rates, improved pain control, success against tumors that had been radio-resistant or had exceeded tolerance levels, reduction in organ damage, and improved tolerance. These unique benefits apply to tumors regardless of their location in the head/neck or body.


Treating Kidney Cancer

At Spokane CyberKnife

1. What Are The Symptoms of Kidney Cancer? open

Primary symptoms of renal cell carcinoma include:

2. What Are The Options For Treating Kidney Cancer?? open

What are the treatment options?

Stereotactic Radiosurgery

At Spokane CyberKnife Center we offer Stereotactic Radiosurgery for kidney tumors is noninvasive, and typically carries less risk of complications than conventional surgery. For patients who refuse surgery or have medically inoperable kidney tumors, radiosurgery can be an effective treatment option. CyberKnife, which delivers high-dose radiation over one to five treatments, can be particularly effective for treatment of small kidney tumors.

CyberKnife has the ability to compensate for normal patient movements, precisely targeting the tumor during the entire procedure and minimizing damage to surrounding healthy tissue. This is important when treating kidney tumors, which can shift during treatment due to regular patient movements such as breathing. Radiosurgery treatment with CyberKnife also can be an effective option for treating renal cell carcinoma metastases to the spine, which are not uncommon.

Video - Learn More About Treating 
Kidney Tumors At Spokane CyberKnife 

Video – This video animation shows how Cyberknife tracks and treats a lung tumor that moves with respiration, just like the kidney tumors move during treatment.