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It’s not a real knife, but it can cut away tumors


A relatively unknown treatment for tumors could be a boon for many African American cancer patients. The treatment—a radiation procedure for both benign and malignant tumors called CyberKnife—is painless and can be done on an outpatient basis requiring little or no down time or recovery time.

“We call it radiosurgery in the sense that a large dose of radiation is delivered to the tumor in one to five days,” said Albert C. Mak, M.D., director of the Pasadena CyberKnife Center. “This is in contrast to the standard conventional radiation, in which you get treatment for six to eight weeks. In order to deliver the surgery the treatment has to be very precise.”

Mak describes the CyberKnife procedure as “basically a radiation machine controlled by a robot. We also call that robotic radiosurgery. What the robot does is manipulate the machine from different 300 to 400 possible angles. That allows us to have a lot of flexibility to target the tumor.

“Also, because it’s a robot, the machine actually moves and corrects for any movement of the tumor in the body. The robot can track the tumor movement, and correct for any movement. It’s actually a perfect treatment for any tumor in the body and for any movement in the body,” said the doctor.

“Because we can follow the tumor, we can reduce the volume of normal tissue exposed to the radiation. In that case, we can reduce the short-term and long-term side effects of the treatment,” said Mak. “At that same time, we can improve the cure rate because we can deliver a higher dose of radiation to the targeted tumor.”

For prostate cancer, Mak said the treatment consists of four to five days of radiation.

“It’s non-invasive,” he said. “It’s not a surgery. There is no knife. It’s outpatient treatment. There is no anesthesia. The treatment is totally painless. It takes half an hour to an hour and a half, depending on the size and location of the tumor, but it’s totally painless. No recovery time.”

Willis Jordan, an African American patient who underwent the procedure for prostate cancer a year ago, agreed that his treatment “went very smoothly” and was painless.

“I went for five days straight, and each session was about one hour,” he said. “There was no pain. The only thing that was uncomfortable to me was—and I don’t know if you could really consider it a discomfort—I had to take a strong laxative each night and an enema each morning before treatment.”

Also, Jordan said, during the five days it made his appetite a little irregular. Although he had the operation during his summer vacation, Jordan said he could have worked, even though he had some trouble urinating. To treat that, he said, he was put on a prescription drug that helped alleviate the problem.

CyberKnife, a linear accelerator-based therapy, is just one form of radiosurgery; there are at least two other types.

Mak pointed out that there are some restrictions to CyberKnife surgery. “The tumor has to be relatively well defined,” he said. “If the tumor is too extensive, we cannot do it. It has to be well-defined and confined to an area.”

In general, Mak said, the tumor cannot be larger than about 5 centimeters.

He called the radiosurgery comparatively less expensive than conventional radiation and less expensive than open surgery, because it is totally outpatient.

While comparatively unknown, the CyberKnife treatment, is not new. Mak credits a Stanford neurosurgeon with its invention about 15 to 20 years ago. It was first used in brain treatment, but has since been adapted to the whole body. The technology, imaging and targeting has improved, he said.

Prior to establishing the CyberKnife Center, Mak used traditional surgical methods to treat cancer patients. Now, he said, he only uses traditional surgery for those patients who are not good candidates for the CyberKnife surgery because their tumors are too large or not well-defined.

“We started Cyberknife about three and half years ago,” he said. “It’s a better machine, delivers good results, and allows for patient comfort.”

The radiosurgery process could be a real boon to men with prostate cancer, which is much more prevalent among African Americans than males in other ethnic groups.

The Pasadena Cyberknife Center at 630 S. Raymond Ave., Suite 104, in Pasadena, has four radiation oncologists on staff. The phone number is (626) 768-1021 or go online at