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Liver cancer consists of two types: primary liver cancer, and liver metastases. Primary liver cancer, known as hepatoma or hepatocellular carcinoma, is a malignant tumor which starts in the liver. Liver metastases are cancers which developed elsewhere in the body, and spread – or metastasized to the liver.
Surgical resection remains the treatment of choice for most liver cancers. However, many patients are unable to undergo surgery due to the location of the cancer, or other medical problems. Until recently, treatment options for these patients were quite limited. Chemotherapy is oftentimes used, but may not be sufficient to entirely eradicate the cancer.
Treating Liver Cancer with CyberKnife® Radiation
Stereotactic body radiation therapy (SBRT), performed by the CyberKnife has emerged as an excellent treatment option for those patients who are unable to undergo surgery. The CyberKnife, with its ability to constantly track and target a liver cancer as it moves with the patient’s breathing, can precisely deliver obliterating focused radiation in just 3 treatments over the course of one week. Many studies have demonstrated success rates of 70 to over 90% for CyberKnife and SBRT treatment of liver metastases and inoperable primary liver cancer.
CyberKnife avoids the problem of tumors moving with breathing, while effectively controlling or destroying liver cancer cells. With an advanced combination of computer and imaging technology, CyberKnife identifies the exact location of the liver tumor. It also coordinates with the Synchrony® Respiratory Tracking System, which follows the tumor’s movement as the patient breathes, to help the CyberKnife accurately focus radiation on the tumor itself without affecting any surrounding healthy tissue.
Preparing for CyberKnife Treatment
Your team of trained specialists at Saint Francis will help you understand every step of CyberKnife treatment.
Before you have CyberKnife treatment, you may need:
- Fiducials – Fiducials are tiny gold seeds that guide the CyberKnife tools to the exact location of your tumor. Three to five rice-sized fiducials will be implanted into your tumor during an outpatient procedure in preparation for your CyberKnife treatment.
- Three to five fiducials are placed using needles guided by CT scan.
- Patients should be able to return home within an hour or two following the procedure.
- Do not eat or drink 8 hours before the fiducial placement procedure. You may take your normal medications that morning with a small sip of water.
- Since patients may receive intravenous sedation, arrangements should be made to have someone drive you home that day.
- Custom body mold – This mold is formed to your body to lie on, and will help you feel more comfortable during any pre-treatment imaging procedures, as well as during the CyberKnife procedure itself. It also keeps your body from moving too much so that all procedures will be as precise as possible.
- Synchrony vest – This comfortable vest works along with the Synchrony Respiratory Tracking System. It contains light-emitting diodes which allow the CyberKnife technology to follow the position of your tumor even as you breathe. This helps make sure that only your tumor receives radiation beams, and not any surrounding healthy tissue.
- Imaging – You will need to have a computed tomography (CT) scan, which creates a detailed picture of your tumor using computers and x-rays. The CT scan will give the CyberKnife the information it needs to pinpoint the exact size, shape and location of your tumor. Some patients may also require MRI and/or PET scans to help accurately pinpoint the liver cancer.
During CyberKnife Treatment
- Before each treatment, our team will help you put on your custom body mold and Synchrony vest. During the treatment, all you will have to do is lie still on a table and breathe normally. The CyberKnife robot will move around your body delivering radiation beams to your tumor.
- You should not feel any discomfort, and nothing will touch you directly.
- During the treatment you can even watch a movie on the flat screen TV on the ceiling!
- Treatments typically take 1-2 hours.
- You are generally free to return to your regular schedule following the procedure.
After CyberKnife Treatment
- Most liver cancer patients will receive three CyberKnife treatments over the course of one week.
- After treatment, you should be able to return to your normal daily activities.
- Many patients experience no side effects. Nausea following each treatment is possible, but rare. During the first few weeks following CyberKnife treatment, some patients may experience fatigue. Less common side effects include heartburn, diarrhea, or decreased appetite.
- If you are concerned about any symptoms you may experience, contact your CyberKnife physician or nurse.
- Patients are seen in follow-up evaluation 4-6 weeks after treatment, then every 3-6 months afterwards. Oftentimes, CT or PET scans may be ordered to evaluate the response to the CyberKnife treatment. Many cancers will continue to show continued response for up to 3-6 months after treatment.