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Pancreas Tumor Treatment Options

Discover your options for treating Pancreatic cancer

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

What Sets CyberKnife Apart? 

CyberKnife Stereotactic 
Radiosurgery For Pancreatic Tumors

The CyberKnife® Robotic Radiosurgery System was cleared by the FDA in 2001 to treat tumors anywhere in the body, including the pancreas.

 

What Patients Can Expect

Patients can experience minimal to no side effects with a quick recovery time. This is because the CyberKnife system delivers radiation directly to the pancreatic tumor without damaging healthy tissue with radiation like conventional radiation therapy.

It has been challenging to use radiation for pancreatic cancer treatment in the past because tumors of the pancreas move with a patients respiration. This movement makes it tough for Radiation 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 from between 25 to 40 sessions, to minimize radiation damage to the healthy tissue surrounding the tumors. This is compared to only one to five sessions with CyberKnife.

What CyberKnife Does

CyberKnife is an incredibly accurate means of delivering concentrated radiation where it needs to go to destroy tumors. There are no breath-holding, respiratory gating or uncomfortable compression systems used to restrict movement. Instead the CyberKnife’s sophisticated Synchrony® Respiratory Tracking System combined with real-time imaging - tracks your tumor’s movement, remaining on target throughout treatment.

Pancreatic Tumor Treatment
At Spokane CyberKnife

1. Treating Pancreatic Cancer At Spokane CyberKnife open

The challenge that doctor’s face with cancer of the pancreas is that the tumor moves as the patient breathes, 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.

The CyberKnife® Robotic Radiosurgery System offers patients a new option for the treatment of pancreatic cancer. Unlike traditional radiation therapy, the CyberKnife System utilizes the Synchrony® Respiratory Tracking System that precisely identifies the tumor location as the patient breathes normally during treatment. The Cyberknife system continuously synchronizes beam delivery in real-time to the motion of the tumor, allowing clinicians to significantly reduce margins (1-2 mm), while eliminating the need for gating or breath-holding techniques.

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

2. CyberKnife's Real Time Tumor Tracking open

This video shows how Breath Holds and Gating techniques used on conventional radiation therapy systems compare to the real0-time Cyberknife Syncrony Tumor Tracking.

Video : Cyberknife ‘Tumor Tracking’ vs. ‘Gating’ and ‘Breath Hold’ Techniques

The CyberKnife System has been used to treat pancreatic cancer in patients as a replacement to conventional radiation therapy alone or in combination with chemotherapy and/or surgery. Cyberknife is also an option for poor surgical candidates, those who refuse surgery, or patients for whom surgery or other treatments have failed.

Two clinical studies from Stanford University2,3 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.3  In another preliminary study, CyberKnife treatment was shown to provide pain control in 85 percent of the treated patients.4

With other kinds of radiation therapy – often referred to as conventionalexternal-beamor intensity-modulated radiotherapy – the total radiation dose is divided up into smaller doses delivered over 25 to 40 sessions, using gating or breath hold techniques, in order to minimize damage to surrounding healthy tissue. CyberKnife radiosurgery is intended to destroy, or ablate, the tumor tissue with high doses delivered in one to five sessions. To do that safely requires a highly accurate system that detects the movement of the tumor throughout treatment sessions and delivers the radiation with pinpoint precision.

With the CyberKnife System, doctors can zero in on a moving target – the pancreatic 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.

3. How Does TrueBeam Treat Liver Tumors? open

Spokane Cyberknife is pleased to announce the arrival of the new TrueBeam™ system to Spokane. TrueBeam™ is an advanced radiotherapy technology for treating cancers throughout the body, including pancreatic 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:

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:a

 

4. 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.

 

Learn More About Pancreas Tumors

1. What is Pancreatic Cancer? open
 

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.

2. How Is Pancreatic Cancer Detected? open
 

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:

To detect Pancreatic Cancer:

Doctors then determine the “stage” – or extent of the disease – by establishing how big the tumor is and how much it has spread.

Video - Learn More About Treating
Pancreas Tumors At Spokane CyberKnife

 

CyberKnife – Tumor Tracking with Real-Time Imaging

Video – The treatment of pancreatic tumors is the same process as is the treatment of a lung tumor – represented in this video.


 Learn About TrueBeam

CyberKnife Case Studies

Advanced Pancreatic Cancer and Single Fraction SBRT
(Cyberknife) Multi-Institutional (Stanford University, Sloan Kettering, BC Cancer Agency)

Pancreatic Cancer Treatment – SBRT (Cyberknife)
Emerging Treatment Option