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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."
It's lo and behold, not "low".
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
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?
www.tomotherapy.com
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