Not long ago Alan Bowley was a dying man. Diagnosed with an inoperable tumor on his pancreas, Alan’s only option was palliative radiotherapy to buy him a few more months of life.
“I was in a dreadful state. The type I had was called a peripheral nerve tumor, which meant it affected the sheath of the nerves in the area where it was located. These sort of tumors are extremely painful and I suffered quite badly.”
“I was taking the maximum dose of oral morphine allowed each day, but even that just took the edge off the pain and left me feeling nauseous and drowsy.”
“I struggled to force down even the smallest amount of food. I am 6 feet tall and usually weigh around 141 pounds, but I was down to 80 pounds, feeling weak and drained, and it was hard to do anything but lie in bed or on the sofa. I felt close to giving up hope.”
Just 39, married to Janet, a midwife, and with three children under the age of ten, Alan had everything to live for. But his surgeon in the United Kingdom where he lives, had already successfully removed a similar tumor on the wall of his duodenum in 2002, and was adamant that this time there would be no similar miracle.
“This new tumor was wrapped around an artery which supplies the lower stomach,’ explains Alan. This meant there was a high chance that peeling it away from the artery would cause massive damage and I could bleed to death on the operating table. The surgeon wasn’t prepared to take the risk. I was told that with radiotherapy I might survive another two years.”
But Alan’s wife Janet, by chance, stumbled across a treatment on the internet called CyberKnife that had a 90% survival rate. Just a few weeks after his fateful diagnosis, Alan went to America and was having CyberKnife therapy at Georgetown University Hospital.
CyberKnife is a highly accurate form of radiotherapy that is pinpoint accurate and can deliver a high dose to within a 1 millimeter accuracy range. It uses an advanced linear accelerator which can produce high-energy beams, and a robot which can deliver the radiotherapy beams from several angles using robotic arms.
Vitally, several X-ray cameras constantly monitor the position of the patient as they breathe or make tiny movements, then feeds the 3D readings back to the robot which adjusts the beam accordingly.
This accuracy is a huge advance compared to conventional radiotherapy which can often damage the area around the tumor.
As a result, CyberKnife can be used on areas which were previously considered too dangerous to be treated by conventional radiotherapy, and use much higher doses.
The machine can treat, for example, early-stage non-small cell lung cancer, pan coast tumors, brain and spinal tumors. Basically tumors any where in the body and even areas which have already undergone radiation treatment.
Dr. Gregory Gagnon, of the Department of Radiation Medicine at Georgetown University Hospital, who treated Alan, says: “This has opened up a whole new wave of cancers for treatment which were previously considered inoperable. For example, we have been collating data on treatment of early stage non-small cell lung cancer over the past three years. Usually this condition has a survival rate of 30-percent over three years. Patients who have undergone CyberKnife have a survival rate of around 90-percent over the same period. We have treated spinal cancers without damaging the spinal cord and the vital nerves that surround the spine, and can even use it to treat multiple secondary tumors.”
In other aggressive cancers, such as pancreatic, Dr. Gagnon claims it has a 100 percent success rate of holding the treated tumor at the same size.
“Unfortunately, pancreatic cancer will almost always appear elsewhere and it is too early to say whether CyberKnife prolongs survival in these cases,” he adds. “But even then Cyberknife is an extremely good palliative treatment because the side-effects are minimal and the increase in quality of life significant.”
There are CyberKnife centers world wide and dozens in major U.S. cities. There are even several CyberKnife centers for pets in America.
“Janet came across the American website run by people who had used CyberKnife while we were still waiting to see if my surgeon here in the U.K. could remove the tumor,” says Alan.
“Although my doctor had never heard of CyberKnife, he sent my CT scans to America. Within a few days we got an email back saying they felt they could irradiate the tumor without damaging the artery.”
But first Alan had to raise 37,000 dollars needed for flights and treatment.
“Because I was deteriorating so fast, there was no time to apply for primary care trust (PCT) funding in the UK. We managed to get a bank loan, and my colleagues in the police force were marvelous, pledging to raise money to cover it. Both sets of parents were also very supportive.”
Alan and Janet flew to Washington, D.C. and met Dr. Gagnon. “He felt that there was a very good chance of being able to kill off the tumor completely,’ says Alan. I can’t explain how ecstatic I felt to hear that after all the bad news of the previous few months.”
The following day Alan underwent an operation to have ‘fiducial’ markers inserted into his tumor using keyhole surgery. These are tiny seeds that allow the CyberKnife system to track the tumor while the radiotherapy takes place. A week later a CT scan pinpointed the position of the markers which were fed into the CyberKnife computer along with 3D images of the tumor.
“I had three days of treatment with each lasting 40 minutes,” says Alan. ‘It was completely painless. I lay there listening to my jazz music as the cameras moved around me.”
After the second dose Alan’s pain worsened, probably because the nerve-dependent tumor was inflamed by the treatment. But after a night’s sleep he woke up pain-free for the first time in months.
A year later Alan’s CT scan has shown that the tumor growth has been halted, meaning the treatment has successfully stopped the cancer cells from replicating. According to Dr. Gagnon, Alan’s tumor may stay the same size for ever, or decrease as it is slowly absorbed into the body.
Meanwhile, Alan’s life is slowly returning to normal. “I’ve gone back to work three days a week, and in June walked halfway up Scafell Pike Mountain carrying my three-year-old on my back.”
The CyberKnife machine costs around 2 million dollars but there is also the cost of building the facilities which include the radiotherapy proof bunker and training which can easily double the costs.
The NHS baulked at introducing this facility, but in January 2009 the private Harley Street Clinic opened its 15 million dollar CyberKnife center, the first in the UK. It estimates that the cost of treatment will be upwards of 12,000 dollars, although those with private health insurance should be covered.
Headed up by Dr. Nick Plowman, who is also director of clinical oncology at St. Bartholomew’s Hospital in London, it will be available via the private sector but also, he hopes, in partnership with the NHS.
Alan is currently fighting to get some of the cost of his treatment back from his PCT.
He says: “This treatment is a lifesaver and we found out about it by chance. Even our consultant had never heard of it. There must be hundreds of people in the UK who could benefit, and it seems shocking that it is not easily available to them. What cost a human life?”
Story Written By: Isla Whitcroft for Daily Mail On Line
At the CyberKnife Center of Miami we have treated thousands of patients from all over the world and in the United States. We were among the first CyberKnife centers to open in America and have the most experienced team, which is also why we get some of the most difficult cases, and gladly take on because we believe doing something is better than doing nothing and most often we can help people cure or control their cancer, buying them the precious gifts of time and life.
You can reach us 305-279-2900. Our team can answer all your questions and review your scans to determine if we and CyberKnife can help you.