The CyberKnife Challenge: Shrinking Hard-to-treat Tumors

Vol. 18, No. 1
Spring 2008

  • The CyberKnife Challenge: Shrinking Hard-to-treat Tumors

  • Cutting-Edge Procedure Saves Patient with Rare Heart Condition

  • Winthrop Receives Highest Praise From Prestigious Joint Commission

  • Long Islanders Breathe Easier

  • Friendly Sons of St. Patrick Support Winthrop

  • Carleigh McCormack Pediatric Cardiopulmonary Lab Opens at Winthrop

  • Winthrop & Healthtrax: Partners in Wellness

  • Winthrop Celebrates and Honors its Volunteers and Auxilians

  • Yuletide Ball Raises Nearly $170,000 in Support of Pediatric Services

  • Winthrop Volunteers Wrap Holiday Gifts to Raise Funds for Reach Out and Read Program

  • Evening of 'Tasting and Giving' Raises $55,000 for Winthrop's CCFK

  • Astoria Federal Funds Creation of Virtual Resource Center for Diabetes Education

  • Winthrop's New Serenity Chapel Lights the Way for Peace & Hope

  • Winthrop to Undergo Facelift

  • Toshiba Reps Travel from Tokyo to Tour CyberKnife Center

  • Pat Lyons Foundation Supports Survivors of Childhood Cancers

  • Citigroup Foundation Supports CCFK

  • Loads of Toys for Winthrop's Young Patients

  • NY Islanders Visit Pediatrics

  • Winthrop Gets the Gold for Excellence in Stroke Care

  • Winthrop Continues Flu Immunization Program for Seniors

  • Local Homemakers Create & Donate Surgical Dolls

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    CyberKnife� radiosurgery has become well-known for its success in treating tumors of the brain, spine, prostate and lung, but physicians and patients at Winthrop - the only CyberKnife Center in the New York Metro area - are also using the revolutionary technology to offer profound relief from other rare conditions as well.

    "When CyberKnife technology was first approved by the FDA in 1999, it was designed for use on tumors of the head, neck and upper spine," said Alan Katz, MD, Chief of the Division o f Radiation Oncology at Winthrop. "But by 2001, the new stereotactic radiation system was developed even further, and it received additional approval from the FDA for use on tumors anywhere in the body."

    Dr. Katz has used CyberKnife to treat a wide range of soft tissue tumors, and while prostate cancer treatment is still a front-runner in the application of the sophisticated radiotherapy, Dr. Katz and others are seeing an increasingly diverse assortment of other patients as well.

    Jonathan Haas, MD, Associate Director of Radiation Oncology and an attending radiation oncologist at Winthrop, has also used CyberKnife to deliver life-altering treatments to patients with recurrent and hard-to-treat cancers, thanks to doctors like Eva Chalas, MD, Chief of Gynecological Oncology at Winthrop, and Nancy Epstein, MD, Chief of Neurosurgical Spine and Education at the Hospital, who have both referred patients to the CyberKnife Center for evaluation and treatment.

    "When physicians encounter patients who are struggling with inoperable tumors, or who have already had the maximum allowable conventional radiation therapy, they more often turn to CyberKnife," said Dr. Haas. "And patients - when they are faced with the possibility of conventional radiation therapy, which can take many weeks and have unpleasant side effects - often seek out alternatives." Many of them are opting for CyberKnife, which can shrink tumors in less than one week of outpatient treatment with little or no side effects.

    Veronica Terrill, an 83-year-old resident of Long Beach, NY, is one of the beneficiaries of this modern equipment, which uses cruise-missile technology to delivery extraordinarily targeted radiation to tumors. Five years ago, while she was visiting New York for the bat mitzvah of one of her granddaughters, Mrs. Terrill suffered a stroke. Not long after that, she was diagnosed with endometrial cancer, for which she underwent a hysterectomy and radiation therapy. The lasting effects of her stroke, however, in combination with the side effects of radiation therapy, made life temporarily unbearable for Mrs. Terrill.

    With the stroke and hysterectomy behind her, Mrs. Terrill decided to remain on Long Island and now enjoys living in Long Beach, which enables her to be closer to her seven adult children and their families, including her 13 grandchildren.

    Recently, during a regular checkup with her gynecologic oncologist, Dr. Ann Buhl of Winthrop, a tumor was discovered in the vaginal wall. In light of her complicated medical history, the options for treatment were limited.

    "Mrs. Terrill had undergone a mastectomy many years ago, the stroke about five years ago, and a hysterectomy more recently. She was opposed to the idea of any more conventional surgery and the difficulties of recuperation, but we knew - based on her previous experience with radiation therapy and her current physical condition - that she would also be unable to tolerate traditional radiation therapy," says Dr. Buhl.

    Dr. Buhl referred Mrs. Terrill to Winthrop's CyberKnife Radiosurgery Center for an evaluation and Dr. Haas, Mrs. Terrill and her family agreed - CyberKnife was the way to go.

    "I was willing to try anything new, and I was thrilled to hear that there was a new treatment that didn't have the side effects of radiation therapy or the long recovery time of conventional surgery," said Mrs. Terrill. "I was so excited to hear that there was another option," she exclaimed after recently completing treatment with CyberKnife at Winthrop. Her radiotherapy consisted of five daily treatments of 45-minutes each over the course of just one week.
    The Gynecological Oncology program at Winthrop has earned an excellent reputation for its quality care and above-average outcomes, as evidenced by data collected by the Hospital Tumor Registry of the American College of Surgeons. Winthrop's GYN Oncology program provides comprehensive interdisciplinary care that can only be achieved in the complex, technologicallysophisticated setting of a major medical center, but with the personal attention usually associated with a smaller hospital.

    An MRI reveals two tumors in Mrs. O'Neill's spinal canal.
    Fifty-three-year-old Roseanne O'Neill of Bayside had a similar experience with CyberKnife. She had already endured 20 surgeries before she came to Winthrop-University Hospital with two benign (non-cancerous) tumors which had developed in her lumbar spine (lower back). Imagine her delight when worldrenowned neurosurgeon Dr. Nancy Epstein offered her two choices - open lumbar surgery with fusion for stabilization or non-invasive CyberKnife radiosurgery to shrink the tumors.

    Dr. Epstein is an advocate of helping patients to explore all options, and she recently published a scholarly article about the use of CyberKnife for spinal lesions in the prestigious Official Journal of the Japanese Society of Spinal Surgery. In the article, Dr. Epstein describes the growing role of the sophisticated stereotactic radiosurgery in the global treatment of spinal tumors.

    "I was ecstatic to find out that I didn't have to have invasive spinal surgery," explained Mrs. O'Neill.

    "Compared to everything else that I've been through over the years, to me, CyberKnife radiosurgery was as easy as going for a hair cut!"

    Mrs. O'Neill's history with surgery and the development of multiple benign tumors throughout her body is a long one. In 1973, she developed a neurofibroma - a growth along a nerve or nervous system tissue - that extended from her chest to her back.

    The surgery required a 20-inch incision. When the tumor recurred 12 years later, the entire 20-inch incision had to be reopened, resulting in a very painful three-month recovery. "The surgery was unbelievably debilitating," Mrs. O'Neill recalled. "The pain was so bad that I would cry every day."

    Nine years later, Mrs. O'Neill was diagnosed with Schwannomatosis - a disease characterized by the development of multiple benign tumors (schwannomas) that originate from cells that cover the nerves of the peripheral nervous system called Schwann cells. A recently recognized form of neurofibromatosis, Schwannomatosis is considered a rare genetic disease.

    Between 1985 and 2007, Mrs. O'Neill endured 17 operations to treat various schwannomas that had developed throughout her body. It wasn't until recently, upon experiencing numbness and tingling in both legs that resulted in her having trouble walking, that Mrs. O'Neill was referred to Winthrop-University Hospital, where she met with Dr. Epstein.

    An MRI of her lower back showed two tumors in her spinal canal. This discovery explained what Dr. Epstein had observed during an in-depth neurosurgical examination to determine the cause of the significant neurological deficits that Mrs. O'Neill was experiencing.

    "After a thorough assessment of Mrs. O'Neill's condition, I offered her two options - CyberKnife or conventional surgery," said Dr. Epstein. "We discussed the benefits of each option and Mrs. O'Neill expressed that she "absolutely wanted to try CyberKnife."

    After undergoing three consecutive CyberKnife treatments of less than two hours each day, Mrs. O'Neill's therapy regimen was complete. A recent MRI revealed a dramatic reduction in the size of the tumors that were treated by CyberKnife - and no current need for surgery.

    "Mrs. O'Neill's symptoms have largely resolved - the numbness in her legs has disappeared and the two tumors that were treated with CyberKnife have shrunk," said Dr. Epstein.

    "I am so grateful that I was sent to all the right people at Winthrop," said Mrs. O'Neill. "CyberKnife was the best thing that could've ever happened to me."

    According to Dr. Katz, additional conditions amenable to CyberKnife treatment include lung, kidney, liver and pancreatic tumors; acoustic neuromas; recurrent and residual tumors; arteriovenous malformations (AVMs); and functional disorders such as trigeminal neuralgia.

    For more information about CyberKnife Radiotherapy at Winthrop, please call 1-866-WINTHROP.

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