Patient Education

Overview

Brain tumors form when cells grow abnormally, forming a mass. They may originate in the brain or spread from cancer originating in other parts of the body. Brain tumors can directly destroy or indirectly damage brain cells, causing temporary or permanent effects.

Benign brain tumors are not cancerous, but they may be life-threatening if they are located in a vital area of the brain and/or are large in size, impacting normal surrounding tissue.

Primary brain tumors are life-threatening, as they are generally fast growing and can spread to other parts of the body.

Metastatic brain tumors result from cancer that spreads from another part of the body to the brain, such as lung, breast, kidney, colon, and melanoma skin cancer.

Symptoms

Brain tumors may cause a variety of different symptoms based on their size and location. Some brain tumors may not have symptoms until they are very large. Symptoms may develop quickly or slowly. Common symptoms include headaches, seizures, changes in thinking, emotional changes, and changes in the way your body moves, such as weakness.

Other symptoms may include:

• You may have constant headaches that wake you from sleep.
• You may not be able to think as well as you did before.
• You may be confused.
• Your behavior, moods, and personality may change.
• Your ability to see, smell, breathe, swallow, hear, or talk may change.
• You may have problems moving your body, including poor coordination, clumsiness, tremors, or falling.
• You may lack sensation in parts of your body.
• You may feel tired or weak.
• You may gain weight or become obese.
• Females may stop menstruating.

Diagnosis

Diagnosis is determined by biopsy, CT scan, MRI scan, or PET scan. Your doctor will stage your tumor based on the results of all of your tests. Staging describes the tumor and its extension throughout the brain and body and is helpful for treatment planning and recovery prediction.

Treatment

Though the causes of brain tumors are widely unknown, traditional routes for treatment include surgery, radiation therapy, chemotherapy, biological therapies, or a combination of treatments.

Thanks to the groundbreaking advances of radiosurgery through the CyberKnife system, it is now possible to treat, and in some cases, completely eradicate brain tumors and lesions while maintaining a quality of life throughout the process.

Until recently, CyberKnife was used to treat only metastatic breast cancer (breast cancer that has spread to other parts of the body). Now doctors are having great success using CyberKnife to treat primary breast cancer, too.

The results are proving CyberKnife treatments are just as effective as standard radiation treatments for breast cancer. The benefits include improved cosmetic results, less radiation exposure to surrounding tissue, and a shorter treatment period.

Patient Success for Primary Breast Cancer

Dr. Kristin Wiginton was among the first in the country treated with CyberKnife therapy for primary breast cancer at UT Southwestern Medical Center. Her post-lumpectomy therapy lasted one-third the duration of a typical radiation session for a breast-cancer patient.

“If this had not worked for me, I would have gone with six and a half weeks of traditional radiation,” said Dr. Wiginton, 45, an associate professor of health studies. In less than two weeks her treatments were complete. She had only 5 treatments – one every two to three days.

Dr. Wiginton described her first CyberKnife session as painless and she spent most of the time listing to music on her iPod.

Instead of standard radiation therapy systems that require heavy equipment with limited maneuverability and beam direction, CyberKnife uses a miniature linear accelerator on a robotic arm to focus multiple beams of radiation with sub-millimeter precision, while leaving surrounding healthy tissue unharmed.

Because heart disease runs in Dr. Wiginton’s family, traditional radiation therapy wasn’t a good choice due to potential damage to surrounding tissues, including the heart. CyberKnife’s precision greatly lessened that risk.

“If they’re willing to use it on brain cancer, I think it’s a fairly safe bet to use in a breast,” Dr. Wiginton said.

Kidney cancer, also known as renal cell carcinoma, is highly metastatic, meaning that it usually spreads to other areas of the body, including the lung, liver, or brain. Unfortunately, renal cell carcinoma is highly resistant to traditional radiation therapy, so normal treatment options are not effective at eradicating the cancer. Rather, they simply slow it down.

CyberKnife radiosurgery is the ideal non-surgical option for people with renal cell carcinoma because it is a treatment that can completely ablate the lesion utilizing its missile-guided technology and precision.

Causes

Kidney cancers include renal cell carcinoma (cancer that forms in the lining of very small tubes in the kidney that filter the blood and remove waste products) and renal pelvis carcinoma (cancer that forms in the center of the kidney where urine collects). It also includes Wilms’ tumor, which is a type of kidney cancer that usually develops in children under the age of 5.

Symptoms

Kidney cancer rarely causes signs or symptoms in its early stages. In the later stages, kidney cancer signs and symptoms may include blood in your urine, which may appear pink, red, or cola-colored; back pain just below the ribs that doesn’t go away; weight loss; fatigue; and an intermittent fever.

Diagnosis

You doctor may suggest any variety of tests to accurately diagnose and treat kidney cancer. Tests and procedures used to diagnose kidney cancer include blood and urine tests, imaging tests such as ultrasound, computerized tomography (CT) or magnetic resonance imaging (MRI), or a biopsy of kidney tissue.

Once your doctor diagnoses kidney cancer, the next step is to determine the extent or stage of the cancer. Staging tests for kidney cancer may include additional CT scans or other imaging tests your doctor feels are appropriate. Make sure you understand the staging technique your doctor uses to assign your cancer.

Treatment

The type of treatment that you receive depends on several factors, including the type of kidney cancer you have. Treatment may be used to reduce the size of a tumor, prevent the cancer from spreading, or for cure. If the cancer cannot be cured, treatments may be used to reduce the symptoms and prolong life.

CyberKnife radiosurgery is a highly effective tool in the treatment of primary and metastatic kidney cancer. The extremely high doses of radiation target only the tumor while sparing healthy normal tissues.

Primary liver cancer, also known as hepatocellular carcinoma, originates in the cells of the liver while metastatic liver cancer occurs when cancer from other locations in the body spreads to the liver.

Liver cancer that is identified and treated early is associated with the best outcomes. In some cases, surgery or a liver transplant is used to cure liver cancer.

If surgery is not an option, CyberKnife stereotactic radiosurgery may be the most effective tool in the treatment of primary and metastatic liver cancer, ensuring targeted treatment with little to no downtime and virtually no pain.

Causes

Primary liver cancer occurs when the cells in the liver grow abnormally and out of control. In the United States, a leading cause of primary liver cancer is cirrhosis. Cirrhosis is frequently caused by alcohol abuse.

Metastatic cancers from colorectal, kidney, breast, esophageal, lung, and melanoma can spread to the liver.

There are several different types of primary liver cancer. Hepatocellular carcinoma is the most common type, while cholangiocarcinomas, which originate in the bile ducts, are less common. Fibrolamellar liver cancer is rare, but it has the best prognosis for all liver cancer types.

Symptoms

Liver cancer does not always produce symptoms in the early stages. The symptoms of liver cancer may seem vague or similar to that of noncancerous diseases.

Symptoms may include:

• You may lose your appetite and lose weight without trying.
• You may feel very full, even after eating a small amount of food.
• You may have pain or tenderness in the right upper part of your abdomen or stomach area, and your abdomen may be enlarged or appear swollen.
• You may bruise or bleed easily.
• You may experience jaundice, which can cause your skin and eyes to have a yellow-green color.

Diagnosis

A doctor can begin to diagnose liver cancer by reviewing your medical history, completing a physical examination, and conducting some tests. Your doctor will carefully examine your abdomen and conduct blood tests to show how your liver is functioning. Imaging tests may be used to help identify the location of liver tumor. A biopsy is usually the only way to determine if cells are cancerous or not.

If you have liver cancer, your doctor will assign your cancer a classification stage based on the results of all of your tests. Staging describes the cancer and if it has metastasized. Staging is helpful for treatment planning and recovery prediction.

Treatment

Treatment of liver cancer depends on the stage and type of liver cancer and if there is liver cirrhosis. Surgery to remove the cancer or liver transplantation to replace the liver may be a cure for liver cancer.

For people who may not be candidates for surgery or don’t want surgery, the CyberKnife is a highly effective tool and treatment for both primary and metastatic forms of liver cancer. With stereotactic body radiation therapy (SBRT), a high-dose radiation treatment, healthy tissues are spared because the CyberKnife precisely targets the tumor. Sophisticated software controls the radiation treatment beams to match the exact shape of a tumor while sparing normal tissue. Our procedure is painless and performed on an outpatient basis.

Lung cancer is the leading cause of cancer-related death in the United States. Early diagnosis and effective treatments, such as CyberKnife radiosurgery, are paramount when considering your options.

With the CyberKnife, we are able to treat the most primary non-small cell lung cancers (NSCLC) such as squamous cell, large cell, and adenocarcinoma, as well as metastatic lung cancers resulting from renal cell, melanoma, colon cancer, and breast cancer.

Overview

Lung cancer occurs when cells in the lung grow abnormally out of control and form tumors. Smoking and environmental exposure are some of the main causes of lung cancer. Lung cancer can spread to other parts of the body, including the other lung, brain, bones, lymph nodes, and liver. Some types of lung cancer are aggressive and can spread quickly.

Early stages of lung cancer may not produce symptoms. However, early diagnosis and treatment is important to ensure the best outcome. Lung cancer is often successfully treated with surgery, radiation, and chemotherapy, but it can come back after it has been treated.

Causes

In addition to smoking, exposure to second-hand smoke, polluted air or water, and certain industrial chemicals increase the risk for lung cancer. However, people who have never smoked may also develop lung cancer.

Symptoms

Lung cancer may or may not cause symptoms or may just cause minimal symptoms in the early stages.

Symptoms of lung cancer may include:

• You may develop a new cough that will not go away or worsening of a chronic cough, such as a smoker’s cough.
• You may cough up blood and/or develop pneumonia and bronchitis repeatedly.
• You may experience changes in the way you breathe, such as wheezing and shortness of breath.
• You may have chest pain.
• You may lose your appetite and lose weight without trying.
• You may feel tired all of the time.

Less common signs include swallowing problems, a hoarse voice, back pain, joint pain, and weakness.

Diagnosis

Your doctor can begin to diagnose lung cancer by reviewing your medical history and conducting a physical examination along with some preliminary tests. You should tell your doctor if you smoke or if you have ever smoked.

Your doctor will listen to your lungs with a stethoscope while you breathe. He may perform breathing or pulmonary tests to assess how your lungs are functioning. Your sputum may be tested for infection.

Chest X-rays and computerized tomography (CT) scans are used to provide images of your lungs to help diagnose cancer. A biopsy can confirm the diagnosis and identify the type of lung cancer.

If you have lung cancer, your doctor will assign your cancer a classification stage based on the results of all of your tests. Staging describes the cancer and if it has metastasized. Staging is helpful for treatment planning and recovery prediction.

Treatment

The type of treatment you receive depends on several factors, including the type of lung cancer that you have. Treatment may be used to reduce the size of a tumor, prevent the cancer from spreading, or to cure the cancer. If the cancer cannot be cured, treatments may be used to reduce the symptoms and prolong life.

With CyberKnife, we can disrupt the growth of the tumor by eradicating it entirely. Stereotactic body radiation therapy (SBRT) is a method of delivering targeted radiation therapy to lung cancer tumors. SBRT may be used instead of/or along with surgery. SBRT is delivered in 3 to 5 treatments, sparing normal healthy tissues.

Because of CyberKnife’s sophisticated technology, we can control the radiation beams to match the exact shape of a tumor or lesion. The beams are directed at the cancer from many different angles. The state-of-the-art equipment is able to adjust for minor patient movements and tumor movement caused by breathing during treatment. This precise delivery method quickly allows the cancer to receive the full dose of radiation, while the surrounding healthy tissue only receives a small percentage of radiation.

Metastatic cancer is cancer that has spread from the place where it first started, the primary site, to another place in the body. Metastatic cancer has the same name and the same type of cancer cells as the primary cancer. For example, colon cancer that spreads to the liver and forms a metastatic tumor is metastatic colon cancer, not liver cancer.

Metastatic cancers can be difficult to manage because they can sometimes be asymptomatic, but with periodic PET/CT scans we can find areas of concern and treat them early before they damage surrounding tissue or become symptomatic.

When malignant tumors grow, individual cancer cells frequently break away to metastasize. They travel through the lymphatic vessels, blood vessels or, less commonly, along surfaces on the inside of the body cavity. The origin of a cancer can affect where it will spread. The bones, brain, liver, and lungs are the most common locations for tumors to metastasize.

Although most cancers have the ability to spread to many different parts of the body, they usually spread to one site more often than others. The following table from the National Cancer Institute shows the most common sites of metastasis, excluding lymph nodes.

Treatment

Stereotactic body radiation therapy (SBRT) performed by the CyberKnife has emerged as an excellent treatment option for those patients who are not surgical candidates, have failed chemotherapy treatment, or have run the course of treatments and been told there is nothing left to do.

The CyberKnife has the ability to constantly track and target tumors as they move with normal respiration and can precisely destroy cancer cells in just 1 to 5 treatments or a course of treatment.

The number of courses required to treat metastatic tumors depend on how many tumors are present and if they are in close proximity to each other. Research continues to demonstrate a 90% control rate for certain types of metastatic cancers treated with CyberKnife and SBRT.

CyberKnife Center of Miami treats metastases including those in the bone, brain, liver, lymph nodes, and lungs.

For more information on treating metastatic disease, visit our Metatstatic Cancer Page.

Ovarian cancer is a growth of abnormal malignant cells that begins in the ovaries (women’s reproductive glands that produce eggs). It accounts for approximately 3% of cancers in women. Ovarian cancer is more common in white women than African-American women, and about half of the women diagnosed with ovarian cancer are projected to be 63 years or older. A woman’s risk of getting invasive ovarian cancer in her lifetime is about 1 in 75.

Unfortunately, the cause of ovarian cancer is unknown and currently there are no reliable screening tests for the early detection of ovarian cancer. However, new studies indicate that ovarian cancer has recognizable symptoms, even in the early stages of disease. Knowing these symptoms can help save a woman’s life. If symptoms are detected early and the disease is confined to the ovary, it can be treated successfully.

Symptoms

Warning signs of ovarian cancer may include:

• Abdominal bloating
• Ongoing pain or cramps in the pelvis or back
• Abnormal vaginal bleeding
• Feeling full quickly after eating
• Unusual fatigue
• Frequent urination

By the time ovarian cancer is considered as a possible cause of these symptoms, it has usually already spread beyond the ovaries to the lymph nodes, abdomen, pelvis, or surrounding tissue. Prompt attention to symptoms may improve the odds of early diagnosis and successful treatment.

If you have symptoms similar to those of ovarian cancer almost daily for more than a few weeks and they can’t be explained by other more common conditions, report them to your health care professional, preferably a gynecologist, immediately.

Depending on the cancer stage, ovarian cancer treatment includes surgery, chemotherapy, and standard radiation.

Metastatic Ovarian Cancer

Metastatic ovarian cancer is cancer that has spread from the ovary where it first started, the primary site, to another place in the body. When cancer cells break away from a tumor, they can travel to other areas of the body through the bloodstream or the lymph system (which contains a collection of vessels that carry fluid and immune system cells).

Metastatic ovarian cancer has the same name and the same type of cancer cells as the primary cancer. For example, ovarian cancer that spreads to the abdomen and forms a metastatic tumor is metastatic ovarian cancer, not abdominal cancer.

Treatment

Chemotherapy, surgery, and standard radiation are often used to treat metastatic ovarian cancer. However, stereotactic body radiation therapy (SBRT) performed by the CyberKnife has emerged as an excellent treatment option for those patients who are not surgical candidates, have failed chemotherapy treatment, or have run the course of treatments and been told there is nothing left to do.

The CyberKnife has the ability to constantly track and target tumors as they move with normal breathing and can precisely destroy cancer cells in just 1 to 5 treatments or a course of treatment. The number of courses required to treat metastatic tumors depend on how many tumors are present and if they are in close proximity to each other. Research continues to demonstrate the efficacy and high success rates for treating metastatic cancers with CyberKnife and SBRT.

We are frequently able to treat metastatic ovarian cancer with CyberKnife as a single modality, or along with other modalities, to manage patients with this disease. While CyberKnife treatment is not curative in these situations, patients very frequently experience improvement in symptoms and can live more comfortably and functionally.

The benefits of SBRT with CyberKnife far outweigh any potential risks, which are minimal. CyberKnife treatment is:

• Completely non-invasive: Despite its name, there is no knife or cutting involved.
• Painless with few to no side effects: You can resume your normal activities immediately following treatment.
• Quick: Each treatment typically lasts only 30 to 90 minutes.
• Cost-effective: CyberKnife is performed on an outpatient basis and does not require hospitalization or anesthesia. Furthermore, patients typically require only 1 to 5 treatments instead of 10 to 45 treatments with conventional radiation therapy.
• Precise: The radiation is so targeted that it spares the normal healthy tissue surrounding the tumor or lesion.
• Highly successful: The radiation delivered is so precise that tumors dissolve, and if they come back, we can treat them again if necessary.
• Alternative treatment option for certain patients: Those who are not candidates for surgery, chemotherapy or who have been previously treated with radiation may be a candidate for CyberKnife.

To understand how pancreatic cancer occurs, you first have to understand what the function of the pancreas is. The pancreas is an organ that has two major functions in the body: it makes digestive enzymes that help the intestines break down food and it produces hormones – in particular, insulin, the hormone that regulates the body’s use of sugars and starches.

The pancreas is about 15 centimeters in length and is located in your abdomen and lies horizontally between the lower part of your stomach and the spine.

Pancreatic cancers spread rapidly (unfortunately). It starts when a malignant tumor forms in the pancreas. As the tumor grows and spreads, pain develops in the upper abdomen and can spread around to the back. The pain may become exacerbated when the person eats or lies down.

Overview

Metastatic pancreatic cancer is when cancer spreads from the pancreas and invades and damages surrounding tissue, sneaking into the bloodstream and lymphatic system from the tumor to other cells, involving another part of the body, such as the liver. The new tumor has the same kind of abnormal cells and the disease is then called metastatic pancreatic cancer, not liver cancer. It is treated as pancreatic cancer, not liver cancer.

Pancreatic cancer is also presented as part of a hereditary tumor spectrum, in association with colon and breast cancer that are also hereditary tumors. Cancer specialists are unable to explain the exact cause of pancreatic cancer origin.

Often this type of cancer is referred to as a silent disease. The symptoms usually are nonspecific so most patients are unfortunately diagnosed at an advanced stage (there are 4 stages of pancreatic cancer).

Some possible symptoms may be:

• Nausea
• Vomiting
• Abdominal pain
• Fever
• Weight loss
• Development of diabetes without previous family history
• Palpable abdominal mass
• Flatulence

Risk factors include:

• Smoking (doubles the risk)
• Aging (approximately 80% of cases develop between the ages of 60 and 80)
• African-American race
• Excess body weight
• Chronic inflammation of the pancreas (pancreatitis)
• Diabetes
• Family history of genetic syndromes that can increase cancer risk, including a BRCA2 gene mutation, Lynch syndrome, and familial atypical mole-malignant
• Melanoma (FAMMM)
• Personal or family history of pancreatic cancer
• Diets high in meats, cholesterol, fried foods, and nitrosamines

Stages

Staging shows how far advanced the cancer is (whether it has spread). The tests for pancreatic cancer not only diagnose the cancer, but also help doctors determine the stage of the cancer and the best treatment for you. Even though you have a diagnosis, always obtain a second opinion to be certain that your diagnosis is accurate. Second opinions save lives.

• Stage 0: No spread. Pancreatic cancer is limited to a single layer of cells in the pancreas. The pancreatic cancer is not visible on imaging tests or even to the naked eye.
• Stage I: Local growth. Pancreatic cancer is limited to the pancreas, but has grown to less than 2 centimeters across (Stage IA) or greater than 2 centimeters (Stage IB).
• Stage II: Local spread. Pancreatic cancer has grown outside the pancreas, or has spread to nearby lymph nodes.
• Stage III: Wider spread. The tumor has expanded into nearby major blood vessels or nerves but has not metastasized.
• Stage IV: Confirmed spread. Pancreatic cancer has spread to distant organs.

Treatment

The types of treatment for pancreatic cancer will depend on the stage of the disease. If the tumor is inoperable then chemotherapy and /or radiation therapy is used. CyberKnife radiotherapy or standard radiation treatments can also be combined with chemo (commonly referred to as chemoradiotherapy or chemoradiation).

Patients with pancreatic cancer whose tumor cannot be completely removed with surgery, but who have biliary obstruction, have to be treated. This is a good role for CyberKnife radiotherapy. It allows for treatment of the tumor without damaging normal tissues, including bowels, kidneys, and liver. Management of pain and other symptoms is an important part of the treating pancreatic cancer.

Overview of Prostate Cancer

Prostate cancer generally occurs when cells in the prostate gland grow abnormally or out of control. It is one of the most prevalent cancers in men.

Prostate cancer is typically a slow-growing cancer. Screening tests can identify most prostate cancers before symptoms develop and many forms of prostate cancer can be treated if detected early.

According to the American Cancer Society, prostate cancer is the second leading cause of cancer-related deaths among American men, but the numbers are decreasing thanks to improved detection methods and treatments, such as CyberKnife radiosurgery at the CyberKnife Center of Miami. With the CyberKnife, we can safely and effectively target the cancerous growth with precision and minimal side effects.

Causes

Unfortunately, the exact cause of prostate cancer is not always known. Some recent discoveries have linked prostate cancer to changes in DNA and also to high levels of certain male hormones.

Prostate cancer is not, however, linked to an enlarged prostate gland, a condition also called benign prostatic hyperplasia (BPH) or benign prostatic hypertrophy. An enlarged prostate gland is not cancer and does not cause cancer.

Symptoms

The symptoms of prostate cancer are also the same type of symptoms shared by many non-cancerous conditions. Therefore, it is very important to have a doctor determine the source of the problem for men who experience changes in their urinary functions. It is also possible to have prostate cancer and not have symptoms.

Symptoms may include:

• Problems with urination (most common)
• Blood in your urine
• Frequent or recurring bladder and kidney infections
• Low back pain
• Abdominal pain
• Bone pain and tenderness
• Chronic fatigue
• Weight loss
• Anemia

Diagnosis

Your doctor can diagnose prostate cancer after reviewing your medical history and conducting a physical examination. You should tell your doctor about your symptoms and risk factors. The doctor will rule out other conditions with similar symptoms, such as an enlarged prostate gland or infection and will also conduct a few tests to help diagnose if you have prostate cancer.

Your doctor will perform a digital rectal examination to check the size and condition of your prostate gland. The vast majority of prostate cancers originate in the outer sections of the gland, which makes the digital rectal examination an excellent screening tool. A digital rectal examination can also help determine if the cancer has spread beyond the prostate gland.

If your doctor suspects that you have prostate cancer, more tests may be ordered such as blood tests, prostate biopsies, or imaging studies.

If you have prostate cancer, your doctor will assign your cancer a classification stage based on the results of all of your tests. Staging describes the size of the tumor, characteristics of its cells, and if it has grown or metastasized. Staging is helpful to your doctor for treatment planning and recovery prediction. Always make sure you understand the staging system that your doctor is using.

Treatment

Treatment for prostate cancer depends on the stage of the cancer, your age, and overall health. In select cases, men with very slow growing prostate cancer who are older or have other major health problems may forgo treatment initially. Instead, doctors closely monitor their cancer growth and symptoms.

For men who are at higher risk, traditional treatment routes include surgery, radiation therapy, cryosurgery, hormone therapy, and, in some cases, chemotherapy.

Unfortunately, the side effects from these methods can be harsh and emotionally difficult for some men. The type of side effects that you experience may depend on the type of treatment or combination of treatments that you receive. Side effects may include impotence, sterility, incontinence, diarrhea, loss of appetite, fatigue, low blood counts, an increased risk for infection, and bleeding.

That’s why CyberKnife is the treatment of choice for prostate cancer. Non-invasive with minimal side effects, the CyberKnife saves time and your quality of life throughout the process.

At CyberKnife Center of Miami, we offer patients a non-invasive option for spine cancer treatment. Unlike conventional radiation therapy, during which low doses of radiation are delivered over several weeks, the CyberKnife system can treat a tumor in one to five days by delivering a high dose of radiation with extreme pinpoint accuracy.

CyberKnife has been used successfully to treat lesions in people who are otherwise not candidates for surgery or for lesions that are not amenable to open surgical techniques. Spinal tumors present a treatment challenge because the spinal cord can receive only limited amounts of radiation before being damaged and is often in the treatment field.

The CyberKnife system allows us to custom-shape the beam and can limit or completely avoid the spinal cord at risk, as well as other healthy surrounding tissues. At CyberKnife Center of Miami we are able to achieve a high level of accuracy to pinpoint a tumor’s exact location throughout the treatment, resulting in successful outcomes.

Overview

A spinal tumor is an abnormal mass of tissue within or surrounding the spinal cord and/or bones of the spine. Spinal tumors can be benign (non-cancerous) or malignant (cancerous). Primary tumors originate in the spine or spinal cord, and metastatic or secondary tumors result from cancer spreading from another site to the spine.

Symptoms

Many patients will present with back pain as the primary symptom. The pain can occur at rest, be worse at night, and may or may not be related to activity. Other symptoms may include:

• Loss of sensation or muscle weakness in the legs, arms or chest
• Difficulty walking, which may cause falls
• Decreased sensitivity to pain, heat and cold
• Loss of bowel or bladder function
• Paralysis that may occur in varying degrees and in different parts of the body, depending on which nerves are compressed

Metastatic Spinal Tumors

The spinal column is the most common site for bone metastasis. Statistics indicate that at least 30 percent and as high as 70 percent of patients with cancer will experience spread of cancer to their spine.

Common primary cancers that spread to the spine are lung, breast, and prostate. Lung cancer is the most common cancer to metastasize to the bone in men, and breast cancer is the most common in women. Other cancers that spread to the spine include lymphoma, melanoma, multiple myeloma, and sarcoma, as well as colorectal, kidney, and thyroid cancers.

Diagnosis

A thorough medical examination with emphasis on back pain and neurological deficits is the first step to diagnosing a spinal tumor. Radiological tests are required for an accurate and positive diagnosis.

• X-ray: Application of radiation to produce a film or picture of a part of the body can show the structure of the vertebrae and the outline of the joints.
• Computed Axial Tomography (CAT scan or CT scan): A diagnostic test that produces 3-dimensional images of the body using radiation. The CAT scan can show the shape and size of the spinal canal, its contents, and the structures around it. It also is very good at visualizing bony structures.
• Magnetic Resonance Imaging (MRI): A diagnostic test that produces 3-dimensional images of body structures using powerful magnets and computer technology. An MRI can show the spinal cord, nerve roots, and surrounding areas, as well as enlargement, degeneration, and tumors.

After radiological confirmation of the tumor, the characteristics of the tumor can help to identify whether the tumor is benign or malignant. The only way to be sure if the tumor is benign or malignant is to examine a small tissue sample (extracted through a biopsy procedure or surgery) under a microscope.

If the tumor is malignant, the biopsy also helps determine the cancer’s type, which subsequently helps determine treatment options.

Treatment

The CyberKnife system’s sophisticated software can pinpoint a spinal tumor’s exact location in real time using X-ray images taken during treatment. This allows us to precisely deliver radiation to the tumor while minimizing damage to the surrounding sensitive spinal cord tissue and other critical structures.

The CyberKnife system’s continual image guidance software allows us to deliver high radiation doses with pinpoint accuracy, while automatically correcting for tumor movement and adjust in real-time to the patient’s slight movements caused by breathing, allowing for less damage to surrounding healthy tissue.

CyberKnife Center of Miami – The Beam of Life – can successfully treat persistent throat cancer using CyberKnife stereotactic radiosurgery.

Overview

Throat cancer develops in the pharynx (throat), tongue, hard or soft pallet, tonsil, or the larynx, more commonly known as our “voice box.” The term “throat cancer” encompasses several different types of cancer, such as nasopharyngeal cancer, oropharyngeal cancer, hypopharyngeal cancer, and glottic cancers that can develop within the throat.

Causes

While we don’t know exactly what causes throat cancer, researchers have identified several risk factors including:

• Smoking
• Alcohol consumption
• Human papilloma virus (HPV)
• Asbestos
• Dietary exposures
• Genetics

Symptoms

While symptoms may vary, keep an eye out for:

• Persistent cough
• Difficulty swallowing
• Persistent hoarseness or frequency of clearing the throat
• Sore throat
• Lump in the throat
• Change in the sound of your voice
• Abnormal breathing sounds

If you experience symptoms for two weeks or longer, see your doctor for an exam. Do not wait for symptoms to go away on their own. A delay could potentially be the difference between early or late detection of cancer, which may affect treatment outcome.

Diagnosis

The doctor will first perform a routine physical exam to feel the throat area for any lumps or other abnormalities.

To get a better view of the inside of the throat, the doctor may recommend having a laryngoscope exam. During this procedure, a thin, fiber optic scope is fed down the throat, allowing the doctor to see the back of the throat, larynx, and vocal chords. A sample of tissue may be taken if any suspicious areas are discovered. This is called a biopsy, and it either confirms or rules out cancer.

If cancer is found, it is then necessary to determine the extent of the cancer. This process is called staging. The doctor will want to see if the cancer has spread to nearby tissues or organs. The stage of throat cancer will affect which treatment method will be recommended for you.

Treatment

Several factors are taken into consideration when a treatment plan is developed for someone with throat cancer. Their age and overall general health are important, as well as the type, stage, and location of the cancer. Whether or not the cancer has spread plays a large role in determining what treatment method is best.

Surgery and radiation are standard methods of treatment for throat cancer. Surgery is very common in all stages of throat cancer and can have a curative effect in the early stages. Surgery can be as simple as using laser therapy to remove cancerous tissue, to more aggressive surgical approaches.

Radiation therapy is given as a primary treatment, as well as sometimes after surgery to eliminate any remaining cancer cells or to remove cancerous tissue that could not be removed during surgery.

Some people with throat cancer may undergo chemotherapy to treat the disease. It is normally prescribed in conjunction with other treatment methods.

If there is a persistent tumor in an area already treated with radiation and surgery, or chemotherapy is no longer an option, CyberKnife radiosurgery may be an option. The CyberKnife uses highly focused and precisely aimed radiation beams that destroy the tumor while sparing surrounding healthy tissue. It is much more accurate than any other type of radiation.

CyberKnife treatments are painless. There is no bleeding because there is no cutting involved. It is a 100% non-surgical treatment.

A new clinical trial is underway to assess the use of CyberKnife in treatment of primary vocal cord (larynx) tumors. This revolutionary treatment will allow patients the option of having five treatments rather than several weeks of conventional radiation or surgery to remove the larynx.

Trigeminal neuralgia is a chronic pain condition that affects the trigeminal nerve that carries sensation from your face to your brain. If you have trigeminal neuralgia, even mild stimulation of your face — such as brushing your teeth or putting on makeup — may trigger a jolt of excruciating pain.

You may initially experience short, mild attacks, but trigeminal neuralgia can progress, causing longer and more frequent bouts of searing pain. Trigeminal neuralgia affects women more often than men and is more likely to occur in people who are older than 50.

A life with pain from trigeminal neuralgia is no longer necessary because of the numerous treatment options available. CyberKnife radiosurgery (SRS) can effectively manage the pain when surgery or medications are not effective.

Causes and Symptoms

In trigeminal neuralgia, also called tic douloureux, the trigeminal nerve’s function is disrupted. Usually, the problem is contact between a blood vessel and the trigeminal nerve at the base of your brain. This contact puts pressure on the nerve and causes it to malfunction.

Trigeminal neuralgia can occur as a result of aging, or it can be related to multiple sclerosis or a similar disorder that damages the myelin sheath protecting certain nerves. Less commonly, trigeminal neuralgia can be caused by a tumor compressing the trigeminal nerve. In some cases, a cause can’t be found.

A variety of triggers may set off the pain of trigeminal neuralgia, including shaving, stroking your face, eating, drinking, brushing your teeth, talking, putting on makeup, encountering a breeze, or something as simple as smiling.

For those living with trigeminal neuralgia, the day-to-day symptoms and pain can be debilitating and often leaves patients without hope. Thankfully, treatments with the CyberKnife system have provided pain relief and management for those experiencing the symptoms of trigeminal neuralgia.

Diagnosis

Your doctor will diagnose trigeminal neuralgia based on your description of the pain taking into account the type, location, and triggers of your pain. To further validate the diagnosis, your doctor may conduct several other tests that will also help determine the underlying causes for your condition.

Your doctor also may conduct reflex tests to determine if your symptoms are caused by a compressed nerve or if another condition is causing your symptoms. He may order an MRI scan of your head to determine if multiple sclerosis or a tumor is causing the trigeminal neuralgia.

It’s important to note that your facial pain may be caused by many different conditions so an accurate diagnosis is important. Your doctor may order additional tests to rule out other conditions.

Treatment

Trigeminal neuralgia is often treated with medication. When medications are no longer effective, surgery or stereotactic radiosurgery can be effective.

CyberKnife radiosurgery is non-invasive and does not require the rigid head frame bolted to the skull, as is used with Gamma Knife radiosurgery. Patients require no anesthesia and can return to their normal routines after their treatment. Treatment is an outpatient procedure lasting about one hour.