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A Robotic Cyberknife To Fight Cancer

Roland Piquepaille writes "The Cyberknife is not a real knife. This is a robot radiotherapy machine which works with great accuracy during treatment, thanks to its robotic arm which moves around a patient when he breathes. According to BBC News, the first Cyberknife will be operational in February 2009 in London, UK. But other machines have been installed in more than 15 countries, and have permitted doctors to treat 50,000 patients in the first semester of 2008. And the Cyberknife is more efficient than conventional radiotherapy devices. The current systems require twenty or more short sessions with low-dose radiation. On the contrary, and because it's extremely precise, a Cyberknife can deliver powerful radiation in just three sessions."

80 comments

  1. Not a perfect solution, but a nice step by KingAlanI · · Score: 2, Insightful

    not the cure for cancer (prevention > treatment), but this sure looks like an improvement in treatment

    first post?

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    1. Re:Not a perfect solution, but a nice step by MyLongNickName · · Score: 0, Offtopic

      First 2009 post (eastern time zone)?

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  2. Dangit... by Landshark17 · · Score: 0

    "The Cyberknife is not a real knife"

    Dangit, that headline got my hopes up...

    --
    This sig is false.
    1. Re:Dangit... by syousef · · Score: 2, Funny

      "The Cyberknife is not a real knife"

      Dangit, that headline got my hopes up...

      The sharks with freaking laser beam union would never put up with that. With a name like Landshark17 I'd have thought you'd know that!

      --
      These posts express my own personal views, not those of my employer
    2. Re:Dangit... by Anonymous Coward · · Score: 1, Funny

      "The Cyberknife is not a real knife"

      They were just quoting Crocodile Dundee's opinion.

  3. I was JUST looking at this by Datamonstar · · Score: 1, Interesting

    on our hospital intraweb. We're doing a re-cap of the year and I happened to see something about our "Cyberknife" center. Low-and-behold, I log into /. to waste some... er... research a bit and here it is again! Pretty interesting stuff. Perhaps I can get a tour of the facility here some time.

    --
    The eternal struggle of good vs. evil begins within one's self.
    1. Re:I was JUST looking at this by Anonymous Coward · · Score: 2, Informative

      It's lo and behold, not "low".

    2. Re:I was JUST looking at this by Anonymous Coward · · Score: 2, Funny

      It's an overused, died-in-the-wool, tow-the-line kind of expression, for all intensive purposes.

    3. Re:I was JUST looking at this by Anonymous Coward · · Score: 0

      That begs the question of why you were looking at it.

    4. Re:I was JUST looking at this by arpad1 · · Score: 2, Insightful

      Only nineteen years after the first installation of a Cyberknife English cancer patients don't have to take a plane to the US to get treatment?

      Well all hail the National Health Service!

      I wonder how important you'll have to be for the NHS to pop for Cyberknife treatment at a private clinic? Prime minister? PM's mum? Head of the PM's security detail? Cousin of an MP?

      But maybe England's one of those places where those with political influence don't use it to save the lives of those closest to them. A place where noble dedication to the public good is the norm and prevents elected officials from taking advantage of the privileges of office for personal benefit at the expense of the public.

      Naw, that's just stupid. Of course there's corruption of the system. The only questions are; how extensive it is and whether the news media sees fit to investigate and report.

      --
      Minutus cantorum, minutus balorum, minutus carborata descendum pantorum.
    5. Re:I was JUST looking at this by Anonymous Coward · · Score: 0

      Well, here in the US, we'll have them but they are probably too expensive for a normal person. Many people have no insurance, and at over $100,000 for the treatments, will not be able to afford it. With insurance, apparently just within the last year insurance cos have denied claims for it as "experimental" (although most apparently cover it.)

                Many plans are also non-comprehensive... you'll pay up to a $5,000 deductable, then still have like $10,000 in medical bills to pay off. Better than $100,000, but I mean for many people it just means you'd be bankrupt instead of super-bankrupt.

  4. not news by bokmann · · Score: 4, Informative

    Georgetown University Hospital in Washington DC has had several models of these going back years. They do radio ads for using it for prostate cancer.

    http://www.georgetownuniversityhospital.org/body.cfm?id=451

    1. Re:not news by Anonymous Coward · · Score: 0

      Maybe it's the robotic part that's "new"?

    2. Re:not news by jhaygood86 · · Score: 2, Informative

      Kennestone Hospital in Marietta, GA (a suburb of Atlanta) has one to. They also do radio ads as well for various forms of cancer, as well as a big banner in front of the hospital) http://cancer.wellstar.org/content.aspx?id=38605&section=cyberknife

    3. Re:not news by Anonymous Coward · · Score: 2, Insightful

      You're right, this isn't really news to anyone outside of the UK, and the fact other countries have it first is not news to those inside the UK.

      We have a very long process of testing drugs (and machines), so advances in technology can hit the UK 5-8 years behind others.

      Plans are underway to speed up this process, and damn right when you consider France and Germany both have these machines, and yet we all belong to something called the EU.

    4. Re:not news by Da_Biz · · Score: 1

      Typical crap Roland summary. We've already got one in the Pacific NW:
      http://www.ohsu.edu/ohsuedu/academic/som/radiationoncology/cyberknife-sw-washington-medical-center.cfm

    5. Re:not news by Anonymous Coward · · Score: 1, Informative

      My brother just had cyberknife treatment for an aural tumor. A few MRIs to pinpoint the area of treatment and 5 sessions. Then they track the shrinking of the tumor for the next 6 months. Short term side effects were general pain in the ear area, headaches, but nothing much worse than what he was already experiencing.

      The alternative was brain surgery and we're all so far pleased the cyberknife was an option and George Washington University was nearby.

    6. Re:not news by ZombieWomble · · Score: 2, Informative

      No, there's absolutely nothing new about it. It's the same model that's been available all around the world for quite some time now - the summary is terribly worded, but this is simply the first of these devices to be installed in the UK. I suspect the private clinic which has had it installed has simply aggressively pushed press releases about how great they are to have bought it to get some free publicity.

    7. Re:not news by Anonymous Coward · · Score: 0

      According to wikipedia, "Several generations of the CyberKnife system have been developed since its initial inception in 1990."

      I guess UK's socialised medicine is just too scary for ordinary American.
      http://en.wikipedia.org/wiki/Cyberknife

    8. Re:not news by Anonymous Coward · · Score: 0

      A few years back I went under the cyberknife for a spinal hemangioma and in three sessions, and six months after the treatment, it was completely gone. I must say I am impressed with it especially since they don't even need to do the pylons in your body anymore.

  5. The Cure to Cancer by Afforess · · Score: 2, Insightful

    This forwards my idea that there is no holy grail-esque "cure to cancer." Instead therapies and treatments will continue to advance, and increase the survivability of cancer. This cyberknife, if I understand the procedure correctly, uses high intensity focused gamma rays to destroy cancer cells. I could go into detail... but wikipedia would be easier to go to, and more accurate. In any case, the cure for cancer is a technological journey, not a magical vial of fluorescent green liquid.

    --
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    1. Re:The Cure to Cancer by Cerium · · Score: 1

      Also, there's the whole theory that most of these diseases and illnesses won't ever be 'cured' because the repeated treatment brings in more money than the cure would.

    2. Re:The Cure to Cancer by samexner · · Score: 1

      uses high intensity focused gamma rays to destroy cancer cells

      If they're not careful, cancer patients are going to turn into The Incredible Hulk.

    3. Re:The Cure to Cancer by plover · · Score: 1

      That's because cancer is a catch-all word that describes the overall effect of unchecked mutated cell growth, but not the mechanism that causes it, nor the mutations that continue. Some cancers may have a common genetic cause, but the environmental cancers are thought be caused by damage to the DNA.

      Things like flaws on the BRCA1 gene are associated with breast cancer, for example, and may initiate the disease on their own over time. These might be eventually preventable with a gene therapy designed to target the mutation. Others, such as mesothelioma, are due almost exclusively to a specific external exposure (such as asbestos.) Mesothelioma is thought to act when a tiny sharp fiber works like a little blender, chopping up random bits of DNA inside a cell that are then propagated as hundreds of tiny chromosomes that mix and match with each other. It's completely unpredictable. Essentially, each individual case of mesothelioma is a unique disease.

      The other thing to understand is the "cure" is almost always surgical excision or other means of killing the cancerous cells (gamma radiation, chemotherapy, or whatever.) Prevention is likely to be the most effective solution we come up with. Gene therapy might someday help prevent BRCA1-caused breast cancers, but the cancerous cells that reproduce in weird, non-repeating ways will be likely be virtually impossible to target with off-the-shelf drugs. Avoiding exposure to those carcinogens is the only sure way to avoid the cancer.

      --
      John
  6. Disease-fighting robots by MillionthMonkey · · Score: 5, Funny

    A robot to fight cancer is impressive, but I hear the Japanese are working on a robot that can give you herpes.

  7. OR you can use a Gammaknife... by fdrebin · · Score: 0
    Which predates the Cyberknife, and often uses a single treatment. It looks like a 4 ton helmet... (older model) http://upload.wikimedia.org/wikipedia/commons/thumb/8/82/Gamma_knife.jpg/800px-Gamma_knife.jpg

    There's also the Trilogy system.

    /F

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    Stupidity... has a habit of getting its way.
    1. Re:OR you can use a Gammaknife... by Directrix1 · · Score: 1
      --
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  8. A device to stab someone over the internet by Anonymous Coward · · Score: 1, Funny

    That man is destined to be rich and famous

  9. ALMOST THERE... by wolf12886 · · Score: 0

    Am I the only one that immediately thought of the bio-etheric laser from the spirits within?

  10. Been around for years by Anonymous Coward · · Score: 0

    Cyberknife has been around for a while now... at least in the U.S. It was approved by the FDA in 1999.

  11. Is this new technology??? by Anonymous Coward · · Score: 0

    Wow! Not a new solution. Has been in the US market for a while. UK finally catching on? I thought our health care system sucked. I even work in the health sector!!!!!

  12. Not Remotely News by pcgabe · · Score: 1

    FTA:

    More than a dozen countries worldwide already use the machine[...]

    In fact, these have been around for about a decade, am I right?

    This is not news. This is olds.

    --
    Don't put advice in your sig.
    1. Re:Not Remotely News by MadAhab · · Score: 2, Insightful

      The real news os that it's been approved for use in England.

      But even in the USA, it's not like it's routine. It's not like you can get your health insurance to cover it no questions asked.

      It's not a panacea either.

      To my knowledge, in the USA it's primarily used for lung and liver tumors, and not even for first-line treatment, but for metastasis.

      Shows some promise, but cancer treatment doesn't move as fast as you think.

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  13. Warning: Known sockpuppet/troll by Anonymous Coward · · Score: 0

    User maintains more than a dozen sockpuppet accounts on Slashdot.

    1. Re:Warning: Known sockpuppet/troll by Anonymous Coward · · Score: 0

      Don't you have anything better to do? Seriously? Just asking.

  14. Re:OT: Greasemonkey fix for new /. user page by fahrbot-bot · · Score: 3, Funny

    I decided to whack out a Greasemonkey script.

    Is that code for masturbate? If not, it should be. :-)

    P.S. I hate the Firehose Tab too.
    Someone, please make this a configurable item.

    --
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  15. GENIUS. by Anonymous Coward · · Score: 0

    'The Cyberknife is not a real knife.'

    It's things like this that make me think they should stop writing posts and just link the article.

  16. Won't work for kidney tumors :( by Anonymous Coward · · Score: 0

    I was looking for treatment for a kidney tumor and I pinned my hopes on cyberknife. However I was told that insurance companies think that cyberknife treatment of kidney tumors is too "experimental" and they won't pay for the treatment. That's why I voted for Obamba. I want the government to pay for cyberknife treatments.

  17. test by Anonymous Coward · · Score: 0

    test

  18. Re:Note the nod to socialized medicine by hrvatska · · Score: 2, Informative

    I'm not sure if medicine is always rationed, but I suspect that in the US it's rationed to a varying degree for the great majority of people, even when you have private health insurance. I've known of plenty of cases where insurance companies will not pay for more expensive treatment options until you first try a more conservative and inexpensive approach. Even when the more advanced treatment is clearly indicated. You can find plenty of cases of US insurance carriers who won't cover cyberknife treatments, as they judge the cyberknife to be experimental. Experimental doesn't necessarily mean it's not effective, but that they have not determined that it's more effective than existing treatments that cost less. Not an unreasonable position, if they're making an honest effort to evaluate the available data. It's difficult to determine how often these sorts of determinations are made with the best interest of the patient as opposed to financial interest of company executives and owners. Also, sometimes advanced treatments have a better short term outcome for many patients, but long term studies don't show a significant increase in longevity. Long term studies may have clearly indicated cyberknife is the most effective treatment for some conditions, but if that's not the case, should an insurance company burden all it's participants with higher premiums for marginally better outcomes? This article, for instance, discusses the issues related to treating prostrate cancer with the cyberknife. How much more per month are most people willing to pay for health insurance so that some people can live two or three months longer or have fewer side effects? $50? $100?

  19. Conspiracy theories... by moosehooey · · Score: 1

    You're forgetting that there's more than one drug company, and that they're all very greedy. If one company came out with a cure, they'd be able to take the business from all of their competitors who are merely selling treatments. Also, as the recent economic situation should make clear, these companies would rather have some money now than more money later.

    1. Re:Conspiracy theories... by Bastard+of+Subhumani · · Score: 2, Insightful

      You're assuming they're competing and not colluding.

      --
      Only three things are certain; death, taxes, and apocryphal quotations - Ben Franklin.
    2. Re:Conspiracy theories... by arpad1 · · Score: 1

      Because as we all know the members of a cartel would never screw the other members by selling under the table.

      If it's one thing we can be sure of it's that there's honor among thieves.

      --
      Minutus cantorum, minutus balorum, minutus carborata descendum pantorum.
  20. A knife, you say? by Xenophore · · Score: 4, Funny

    Here now, what's all this then? Somebody has a knife? In the UK? No worries, a constable will be around shortly to confiscate it!

    1. Re:A knife, you say? by ByteSlicer · · Score: 1

      That's not a knife... That's a knife!

  21. Anonymous Coward by Anonymous Coward · · Score: 1, Informative

    www.tomotherapy.com

  22. Tomorrow's headline by Anonymous Coward · · Score: 0

    Tomorrow's headline: UK bans Cyberknife due to hoodie fears

  23. I tried.. by symbolset · · Score: 2, Interesting

    I tried to get an appointment with my doctor to get this treatment, but I have no coverage. The only doctor who would talk to me offered an appointment on 12/22/2012. Should I be concerned?

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  24. Jury Still Out On CyberKnife by meehawl · · Score: 1

    Evidence for Cyberknife's efficacy using lower dosages wrt convential treatments is still being gathered, especially for prostate cancer treatment.

    One of the more remarkable twists governing medical devices in the USA is that, unlike pharmaceuticals licensed with health claims, medical devices do not have to demonstrate conclusively in clinical trials that they are of proven benefit or greater efficacy than existing treatments.

    Some of these new machines can cost several million dollars and offer amazing franchise opportunities... providing enough procedures can be scheduled on the machines during their operating lifetimes to amortise the cost and produce a profit.

    --

    Da Blog
    1. Re:Jury Still Out On CyberKnife by hrvatska · · Score: 1

      Some of these new machines can cost several million dollars and offer amazing franchise opportunities... providing enough procedures can be scheduled on the machines during their operating lifetimes to amortise the cost and produce a profit.

      Several million would be cheap compared to some devices. According to this article, accelerators can exceed $100 million per machine.

    2. Re:Jury Still Out On CyberKnife by baron+von+d · · Score: 1

      most modern linear accelerators (photons and electrons, not protons) cost something in the neighborhood of $5 million.

    3. Re:Jury Still Out On CyberKnife by AlejoHausner · · Score: 1

      The cyberknife works by delivering multiple beams of high dose radiation from a wide variety of angles using a robotic arm.

      Hang on a sec! Doesn't radiation give you cancer? And doesn't cancer take a long time to develop?

      It seems likely to me that the damage done by such devices will not be detected right away. Hence if it kills the cancer cells in the tumor, but damages the DNA in neighboring tissue and gives you more cancer years later, you will likely blame the original cancer for having grown back, and not the machine for having given you a new cancer.

      C'mon, let's use a little physics and dose of common sense:

      • you shoot particles into someone's flesh
      • the particles slow down and stop somewhere in the flesh.
      • you set the particle energy "just right", causing them to end up exactly where the tumor is located.

      There is one big problem with this scenario:

      Particles will not stop exactly where you want them to. The energy loss follows a probabilistic distribution, so they will either damage tissue outside the tumor, or will not hit every tumor cell. Either way, you will get more cancer.

      Moral: don't believe the "wider impact" statements in a research grant application. Physicists developed particle accelerators to study physics, and argued in their grant proposals that those particle accelerators weren't just good for pure research, but could also be used for medicine. How would you feel if a gun manufacturer told you that shooting bullets into flesh "very carefully" could be used to destroy tumors?

      Alejo

    4. Re:Jury Still Out On CyberKnife by Anonymous Coward · · Score: 0

      Your last statement about the amortization and profit laid your finger on the real issue regarding the cost of healthcare in the US. Healthcare technology are still treated like plant and equipment as far as profit and loss are calculated for tax purposes. As a result, cost is assigned in a hap-hazzard fashion usually wildly to the top end. This creates an artificial restraint especially when cuopled with the insurance industry's habit of not covering new, high tech treatments which only insures that as few people as possible can have access to it. As a result the number of machine cycles during it's useful life (stupidly measured in years)is constrained and the cost per cycle is elevated.

      If the US government really wanted to affect health costs, healthcare items like these should be mandated to be amortized on an estimated duty-cycle basis. This would give healthcare providers an incentive to use the device as much as possible thereby spreading the cost over as many patients as possible which should reduce the individual patient cost. Granted this does nothing to reduce administrative costs which are the real problem with US healthcare, but it's a good start at making current treatments affordable.

  25. England, Awake! by meehawl · · Score: 1

    it's been approved for use in England.

    Ah, but what of Scotland, Wales, or Northern Ireland? Only one of the four national health insurance systems in the UK gave the go-ahead?

    --

    Da Blog
  26. Correction to the summary by djelovic · · Score: 2, Informative

    We used something similar to kill my daughter's (benign) brain tumor that was in an inoperable location, so unfortunately I know a lot about the subject.

    Devices like this have been used for decades to treat brain tumors. Search for Leksell gamma knife or medical uses of the linear accelerators. The basic principle is to use numerous focused radiation beams from different directions in order to deliver the maximum possible radiation dose to the tumor (place where the beams intersect) while delivering less than lethal dose to the surrounding tissue.

    These techniques have been limited mostly to brain tumors, because:

    a) getting to them surgically can cause significant damage, and
    b) the head can remain fixed during the procedure

    What's new about the Cyberknife is that it can be used on internal organs that move as the patient breathes and his heart beats, two things you can't make stand still using general anesthesia.

    Don't get your hopes up that this is something that will bring great improvements to tumor treatments. It won't. Surgery, followed by chemical therapy or radiation (to kill any malign cancer cells that have spread), is still considered the golden standard in most cases.

    Tumor treatment has been improving incrementally. Your chances of surviving if you have a malign tumor are much greater than they were fifty years ago. But they still suck. Don't expect anything revolutionary until somebody finds a way (tailor-made virus or a tweak to your immune system) to kill just the tumor cells without killing healthy tissue.

    Dejan

    1. Re:Correction to the summary by NotSoHeavyD3 · · Score: 1

      Cool, actually wikipedia has more info on the differences between this and GammaKnife http://en.wikipedia.org/wiki/Cyberknife#Gamma_Knife

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  27. Remember Therac? by Cyberax · · Score: 1

    I hope they learned their lessons from http://en.wikipedia.org/wiki/Therac-25 machines and installed hardware safety devices.

  28. An army of MacGyvers . . . by PolygamousRanchKid+ · · Score: 1

    . . . armed with CyberKnives.

    Against the Sharks with Lasers.

    Coming soon to a theater near you.

    --
    Schroedinger's Brexit: The UK is both in and out of the EU at the same time!
  29. SAVE A LIFE, BIN YOUR KNIFE by Anonymous Coward · · Score: 0

    I can only imagine the problems that this is going to run into with the insane anti-knife propaganda that the UK is currently trying to push. You cannot even buy silverware without showing an ID!

  30. It's also a time machine... by Rashdot · · Score: 1

    permitted to treat 50,000 patients in the first semester of last year.

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  31. Well there's alot of problems with conspiracy theo by NotSoHeavyD3 · · Score: 1

    The first off is the the problem is that in order to do that is that they have to be "Just-so Evil". By that I mean that they have to be evil enough to screw regular people over. However when it comes to screwing each other over all of a sudden they become honest for no real reason.(Since they could either try to take over the whole market for themselves or even collude at first and milk out some extra money by selling more than their quota when no one is looking.) Also there's the problem that if a cure existed cancer rates would probably go up since nobody is going to bother avoiding cancer if they can take a pill and be cure. (So big deal if you make less money on a single regiment to cure a patient. You'll make it up on the repeat business anyway. So go ahead, lay out in the sun all day or whatever. In the end it'll get fixed no matter how many times you get cancer.) The final problem I see with the "conspiracy" idea is that of the suppliment. (Which is weird that they could "forget" that given how common they are the US.) The idea is pretty simple, if you had a safe and effective cure for cancer that was resonably priced one way to make alot of money would be to just make it part of a vitamin pill and charge a little more for the pill. (I mean suppose there was a vitamin on the market that cost a $1 a day to take. One effect of this is that as long as you take it you can never get cancer. Anybody want to take a guess how many people in the Western world would be willing to pay for that? Hell, I would just knowing how one can die in a matter of days after the discovery of some cancers.)

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  32. I think that they mean 1st one in Enlgand... by Anonymous Coward · · Score: 0

    ...as I seem to recall hearing advertisements for some medical centers touting cyberknife for some time now in the US. It's also not the only highly focused application of radiation device to combat cancer either as I have heard other adverts from medical centers with other devices prior to the cyberknife ones, but they didn't have a trendy catchy name.

  33. House, anyone? by quadripedman · · Score: 1
    Excelent. This is a great step towards doctors doing whatever doctors do (like saving peoples lives...)

    methinks this would make a good house episode....

  34. I for one... by Anonymous Coward · · Score: 0

    I for one welcome our new cancer-fighting robot overlords.

  35. 10 years to get the knife; then 10 year use wait by peter303 · · Score: 1

    The wonders of single-payer medicine.

  36. family experience by on+the+8ball · · Score: 1
    My mother-in-law (88 years old) has pancreatic cancer, first diagnosed in January 2008. The Mayo Clinic (in Rochester Minnesota) would not operate because they determined that the cancer had already begun to spread outside the pancreas.

    After some research we found the CyberKnife Center in Saint Paul Minnesota and she was treated in early April. The treatment was effective in killing the original tumor and had neglible side effects other than some fatigue and very mild nausea, easily treated with medication.

    She was totally pain and symptom free for over six months following the treatment, which gave her a considerable extension of her life with excellent quality of life, compared to the alternatives. Unfortunately the cancer did continue to spread and is now showing up in other parts of her body, and she has only 3-6 months to live. But she (and we her family) are very happy that we did the CyberKnife treatments because of the extra good months that we have had with her.

    So, I would recommend this medical technology highly from our experience. While expensive, it is effective, the treatments are not hard on the patient, and the side effects are minimal compared to any other cancer treatment modalities.

    --
    Do not dwell in the past, do not dream of the future, concentrate the mind on the present moment â" Buddha
  37. Description could be better. by Anonymous Coward · · Score: 0

    "Moves around the patient when he breathes."

    So if he holds his breath, it stops?

    Because I've seen other descriptions of such systems, I see what they're trying to say. Basically, they can circumzap a small volume of tissue with a lot of radiation with great enough accuracy (because the aim of the encircling beam source is adjusted for body motion in real time) that it can be done in fewer sessions than the old way.

  38. Please stop saying "cyber". by Anonymous Coward · · Score: 0

    The use of this word is prima facie evidence for being-a-journaiist-caught-in-the-act-of-not-knowing-anything-about-technology

  39. The first Cyberknife? by scottv67 · · Score: 1

    The *first* Cyberknife? No, it's the first Cyberknife in the *UK*. We've had a Cyberknife for more than a year and ours was not the first in Southeast Wisconsin.

    For more details:

    http://www.prohealthcare.org/services/cyberknife/index.aspx

  40. Yawn..... by Anonymous Coward · · Score: 0

    This story is soooooooo yesterday ...

  41. One step closer to robotic cybermuggings by komode0 · · Score: 1

    Damn you, science!

  42. Never take a robotic cyberknife by agitationist · · Score: 1

    ...to a robotic cybergunfight.

  43. Re:OT: Greasemonkey fix for new /. user page by Anonymous Coward · · Score: 0

    When robots masturbate they whack out a Greasemonkey.