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Michael E. DeBakey VA Medical Center - Houston, Texas

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VA Docs Zap Tumors in Hard to Reach Places Using New Technology

February 8, 2011

Cyber Knife

"The CyberKnife® technology ‘sees’ tumors in their natural three-dimensional state which allows radiation to be concentrated more tightly around the tumor," said Angela Zhu, M.D., acting Radiotherapy Section chief. “We can now offer patients with inoperable or surgically complex tumors new hope.”
PHOTO: Lewis Hodnett, Jr.

HOUSTON - Always on the forefront of innovative treatments and technologies, the Michael E. DeBakey VA Medical Center (MEDVAMC) now provides Veterans a targeted, painless alternative to open surgery and a medical option for certain inoperable tumors.

The CyberKnife®, an impressive-looking machine resembling a giant robot with a multi-jointed arm that pivots, twists, and turns, can treat tumors anywhere in the body with radiosurgery.

Poised above the patient, who is fully clothed and awake on a table, the device’s giant arm whirs above, beside, then under the tumor site, delivering hundreds of beams of radiation to the tumor with pinpoint accuracy.

"The flexible arm allows for precisely targeted radiation delivery and can reach areas of the body that are untreatable with other, more limited radiation-delivery systems," said Angela Zhu, M.D., acting Radiotherapy Section chief.

At the beginning of the procedure, images from the patient’s previous computed tomography (CT), magnetic resonance imaging (MRI), or positron emission tomography (PET) scan are loaded into the machine, allowing physicians to identify the exact size, shape, and location of the tumor to target, as well as surrounding areas to avoid.

As the device begins zapping the tumor with radiation, X-ray machines take computerized images, allowing the machine to correct for a patient’s small, involuntary movements, like those caused by breathing or a heartbeat. Such movements can cause the tumor to shift position ever so slightly.

"This new technology ‘sees’ tumors in their natural three-dimensional state which allows radiation to be concentrated more tightly around the tumor," said Zhu. “We can now offer patients with inoperable or surgically complex tumors new hope.”

As the machine zeros in on the tumor from all angles, it delivers multiple beams of high-dose radiation. Each individual beam is not strong enough to cause harm, but the cumulative effect of all the beams creates a very high dose of radiation aimed at the tumor with extreme accuracy. The pinpoint accuracy protects and preserves the healthy tissue surrounding the tumor.

"It is so precise that radiation can be sculpted to tumors near critical structures like hearing or vision nerves,” said Zhu. "Though ‘knife’ is part of its name, the machine does not actually cut anything. The body absorbs the tumor, much like a bruise eventually disappears.”

The technology is ideal for patients who have medical conditions like heart or lung problems that prohibit surgery. Depending on the complexity of the case, only one to five treatments lasting 30 to 90 minutes are needed, given one to two days apart. No anesthesia is required because the procedure is incision-less and pain-free. When the session’s done, patients return to normal activity immediately.
"This advanced technology is an excellent alternative to surgery and can be used on tumors anywhere in the body including the brain, lung, liver, prostate, spine, pancreas … anywhere,” said Meena Vij, M.D., Diagnostic and Therapeutic Care Line executive. “This device has shown remarkable results and will provide a life-saving alternative for our Veterans.”

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Awarded re-designation for Magnet Recognition for Excellence in Nursing Services in 2008, the Michael E. DeBakey VA Medical Center serves as the primary health care provider for more than 120,000 veterans in southeast Texas. Veterans from around the country are referred to the MEDVAMC for specialized diagnostic care, radiation therapy, surgery, and medical treatment including cardiovascular surgery, gastrointestinal endoscopy, nuclear medicine, ophthalmology, and treatment of spinal cord injury and diseases. The MEDVAMC is home to a Post Traumatic Stress Disorder Clinic; Network Polytrauma Center; an award-winning Cardiac and General Surgery Program; Liver Transplant Center; VA Epilepsy and Cancer Centers of Excellence; VA Substance Abuse Disorder Quality Enhancement Research Initiative; Health Services Research & Development Center of Excellence; VA Rehabilitation Research of Excellence focusing on mild to moderate traumatic brain injury; Mental Illness Research, Education and Clinical Center; and one of the VA’s six Parkinson’s Disease Research, Education, and Clinical Centers. Including the outpatient clinics in Beaumont, Conroe, Galveston, Houston, Lufkin, and Richmond, MEDVAMC outpatient clinics logged more than one million outpatient visits in fiscal year 2010. For the latest news releases and information about the MEDVAMC, visit