STANFORD, Calif.—When Lori Brownell's first tumor appeared on her left carotid artery−it was surgically removed, leaving an inches-long incision to heal. It was eight years before the feeling returned to that side of her neck, and for a time, she couldn't drive because she couldn't turn her head far enough.
On September 15, at the Stanford Cancer Center, a tumor on Brownell's right vagus nerve was the target, not of a scalpel, but of narrow, finely-focused beams of radiation. Instead of risking incisional surgery that might have affected Brownell's ability to swallow and speak, Stanford physicians decided to use a radiation machine called the CyberKnife.
And Brownell became Stanford's 5,000th CyberKnife patient−that's 5 percent of all treatments conducted since 1994, when Stanford Hospital became the first to buy and use the groundbreaking device, the brainchild of a Stanford physician.
Now, 206 health care centers worldwide have a CyberKnife, but Stanford is one of just four facilities to own two.
Once it was called Adler's Folly, a name that reflected the audacity of its inventor, Stanford neurosurgeon John Adler. Adler had imagined something that would send radiation into the body in a way that no other could do, combining computer imaging and robotic motion to treat the most difficult cancers in the brain, lung and spine, where there is no leeway for error.
A decade of development later, the folly was recognized as a treatment powerhouse, its use expanding rapidly. Brownell's tumors are benign, but genetics seem to be contributing to their occurrence. She had a second tumor, on her left jugular vein, treated with a five week course of fractionated radiotherapy two years ago. When the third appeared, her hometown neurosurgeon in Florida recommended Stanford's Griff Harsh, MD, who worked with radiation oncologist Scott Soltys, MD, to complete Brownell's treatment with the CyberKnife.
The CyberKnife, Harsh said, "not only vastly improved the safety and efficacy of irradiating many brain tumors, but also revolutionized much of radiation oncology. Our 5,000 patients, and almost 100,000 worldwide, have truly benefitted from this kind of innovative patient care."
This use of radiation has come to be known as stereotactic radiosurgery and radiotherapy.
The CyberKnife's special quality is that it tracks tumor movement whether from breathing or other patient motion. Its beam delivery arm reacts with minute precision to real-time images of the tumor.No radiation is sent out when the tumor moves out of the beam, protecting healthy tissue that can sometimes be damaged as it might be in traditional wide field beam delivery. With lung cancer, treatment is particularly challenging because tumors move with each and every 12 breaths a minute. The CyberKnife's tracking system adjusts delivery to react to that normal, active breathing pattern.