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Spine Tumor Treatment Options at Spokane CyberKnife

Discover your options for treating Spine tumors


At Spokane Cyberknife and Radiation Oncology Center we spare no compromise for the treatment of spinal tumors. Each patient’s condition is unique, therefore our cancer experts consult with patients on the best options utilizing the most advanced new technologies.

*CyberKnife and TrueBeam Spine tumor treatments are covered by Medicare and most all insurances.

What Sets CyberKnife Apart? 

CyberKnife Stereotactic
Radiosurgery For Spine 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 spine.

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 directly to spine tumors, sparing healthy tissues around the tumor.

The CyberKnife System offers patients who cannot undergo spine cancer surgery, those who refuse surgery, or for recurrent tumors that have already had radiation, a minimally invasive alternative treatment for spine cancer.

Spokane CyberKnife and Radiaton Oncology spine cancer treatments are performed on an outpatient basis over a period of one to five days, requiring no overnight hospital stays. Most patients experience minimal to no side effects with a quick recovery time.

 Spokane Cyberknife Treatment of Spinal Tumors

1. How Does CyberKnife Treat Spine Tumors? open

At Spokane Cyberknife and Radiation Oncology Center we spare no compromise for the treatment of spinal tumors. Each patient’s condition is unique, therefore our cancer experts consult with patients on the best options utilizing the most advanced new technologies.
 
Treatment of spinal cancer is determined by the type and location of the tumor. The most effective spinal treatment usually requires a multiple disciplinary approach – a combination of surgery, radiosurgery, radiation therapy and/or chemotherapy. Radiosurgery, Radiation Therapy or chemotherapy might completely relieve the symptoms if pain is caused by a spine tumor replacing the bone marrow in the bodies of the spine. However, if a spinal tumor has destroyed enough of the vertebra to cause a mild or severe break in the bone, surgery is required to remove the tumor to allow the bone to heal.
 
When a spine tumor is causing weakness or paralysis by putting pressure on the spinal cord, killing the tumor with radiation may be all that is necessary.  In severe cases of spinal compression, removing the tumor with surgery may be the best treatment option.
 
For patients with metastatic spinal lesions, the location of the primary cancer must be considered. Myeloma, breast, prostate and some types of lung cancer are usually sensitive to radiation, but renal cell cancers, melanoma and most sarcomas are not sensitive to normal doses of radiation. If a patient has a spinal tumor that is insensitive to radiation or has severe destruction of vertebra, surgery followed with radiosurgery or radiation therapy is an appropriate treatment.
 
*Spokane Cyberknife and Radiation Oncology Center has the two most advanced Radiation delivery technologies in one center. Spokane Cyberknife is the first center worldwide that has the only dedicated robotic full body Radiosurgery system, the Cyberknife M6 and the Truebeam radiation therapy system in one center.

The Spokane Cyberknife M6 Robotic Radiosurgery System uses similar technology to other radiation treatment techniques but it differs from conventional radiation therapy in many important ways:

Spokane Cyberknife M6 Removes Spinal Tumors with Surgical Accuracy - Animation

2. How Does TrueBeam Treat Spine 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 spinal 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:

 

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.

Spine Cancers and Tumor Information

1. What Is Spine Cancer? open

Spine cancer is a cluster of abnormal cells in or around the spinal cord that form a tumor. The abnormal cells usually originate in another cancerous location in the body that migrate to the spine (called metastatic disease) and may, rarely, originate in the spinal area (a primary spinal tumor). A spinal tumor or lesion can be caused by abnormal cells that have spread from the lung, breast, prostate, lung, colon, kidney or other areas and carried to the spine by blood or through the fluid that surrounds the spinal cord and the brain.

*Both primary and metastatic spine tumors are very dangerous. Patients may experience pain, gait and posture problems, and other neurological issues. As these tumors grow larger, patients can become paralyzed if the tumor cuts the spinal cord completely.

2. Types of Spinal Tumors open

Tumor Type - Summary

3. Symptoms of Spinal Tumors open

 What are the symptoms? 

Most patients with spinal cancer experience persistent neck or back pain. The pain may be mild at first and mistaken for a mild back strain or arthritis. Initially, it may be treated with ibuprofen or acetaminophen, but the pain will generally become more severe and constant over days or weeks. Some patients will have minimal pain with a sudden increase of symptoms for no reason. Patients with tumors in the chest area may experience pain or tightness that wraps around the chest. Spinal cancer in the lower spine may cause pain that runs down a leg due to spinal nerve compression and weakening of the vertebral structure.

 

4. Diagnosis of Spinal Tumor open
 Spine tumors are difficult to diagnose because the symptoms are not unique to a tumor in the spinal area. A patient may experience mild to severe back pain, difficulty walking, limb weakness or pain that radiates to the arms or legs due to compression of the nerves in the spine. If a patient has a known cancer or malignancy, a physician may order a bone scan to confirm or exclude spinal metastasis. A cancerous spine lesion may be asymptomatic and found incidentally when imaging studies are done as part of a routine surveillance in patients that have been previously treated for cancer.

When a spinal tumor is suspected, several tests may necessary for diagnostic purposes:

 

5. How are Spinal Tumors Treated open
 

Treatment of spinal cancer is determined by the type and location of the tumor. The most effective spinal treatment usually requires a multiple disciplinary approach – a combination of surgery, radiosurgery, radiation therapy and/or chemotherapy. Radiosurgery, radiation or chemotherapy might completely relieve the symptoms if pain is caused by a spine tumor replacing the bone marrow in the bodies of the spine. 

When a spine tumor is causing weakness or paralysis by putting pressure on the spinal cord, killing the tumor with radiation may be all that is necessary.  In severe cases of spinal compression, removing the tumor with surgery may be the best treatment option.

For patients with metastatic spinal lesions, the location of the primary cancer must be considered. Myeloma, breast, prostate and some types of lung cancer are usually sensitive to radiation, but renal cell cancers, melanoma and most sarcomas are not sensitive to normal doses of radiation. If a patient has a spinal tumor that is insensitive to radiation or has severe destruction of vertebra, surgery followed with radiosurgery or radiation therapy is an appropriate treatment. Your cancer experts at Spokane Cyberknife will help you in determining the best treatment options for your unique condition.

Spinal cord tumors can often be difficult to treat and may require care from a team of several different doctors. This team is often led by a neurosurgeon, a doctor who uses surgery to treat brain and nervous system tumors.

The primary goal in treating Spinal Metastases is pain relief and preventing neurological deterioration. These tumors can be treated with Medication, Surgery, Conventional Radiation Therapy or Radiosurgery.

Spokane CyberKnife M6 Treatment - Spine Overview

 

CyberKnife Comparison Chart - Why CyberKnife Is Leading Edge Technology

Brain – Head & Neck Technology Treatment ComparisonCyberKnifeGamma KnifeTomotherapyConventional Radiation Therapy

(IMRT - IGRT)
Targeted Accuracy< 1 Millimeter< 1 Millimeter3-20 Millimeters5-20 Millimeters
Invasive Head-FrameNeverRequired for all TreatmentsRequired in most TreatmentsRequired
Number of TreatmentsFlexible(1 to 5)

*See Clinical Studies

Limited to 1FlexibleFlexible
Motion ManagementYesNoNoNo
Real-time Imaging with auto correctionYesNoNoNo
Dedicated Radiosurgery TechnologyYesYesNoNo
ApplicationsBrain - Full Spine
& Body
Brain & Limited Cervical SpineFull BodyFull Body

Learn More About How Spokane CyberKnife Can Treat Brain Cancer

TrueBeam Treatment Overview

Patient Testimonial - Patsy's Cancer to the Liver and Spine

CyberKnife Case Studies

Spine Metastases Treatment – 500 Cases
A Cyberknife Case Study – University of Pittsburgh Medical Center

Spinal Reirradiation Treatment
Stereotactic Body Radiation Therapy (SBRT) – MD Anderson