Phone: 651-326-3636

Learning that you or someone you care about has a tumor is never easy, especially if it is difficult to treat.

First in the Upper Midwest
St. Joseph's Hospital was the first in the Upper Midwest to offer the revolutionary technology of the CyberKnife® Stereotactic Radiosurgery System. Since opening the CyberKnife Center, we've treated more than 500 patients.

The CyberKnife gives patients new hope for the treatment of tumors and lesions that previously have been diagnosed as inoperable or untreatable with existing technology.

Painless treatments
Unlike conventional surgery, CyberKnife procedures don't require large incisions or blood loss. Most patients require one to five treatments, each lasting 45 to 90 minutes per tumor.

The CyberKnife procedure is usually painless and most patients go home the same day. Click here for more information about the treatment process.

What we treat
CyberKnife technology is approved by the U.S. Food and Drug Administration (FDA) to treat tumors and lesions throughout the body.

St. Joseph's Hospital uses CyberKnife to treat a variety of tumors including those in the head, neck and spine, as well as tumors of the lung, pancreas, liver, kidney and pelvis. When appropriate, we can also treat tumors in other areas of the body.

About the CyberKnife Center
The CyberKnife Center at St. Joseph's Hospital was developed in partnership between the HealthEast Neurovascular Institute (now the National Brain Aneurysm Center) and HealthEast Cancer Care. Our programs have developed a reputation for clinical excellence and compassionate care. The CyberKnife Center reaffirms our commitment to superior care for our patients.

The CyberKnife project is led by a physician team that includes co-directors Leslie Nussbaum, MD, neurosurgeon and Ross McBride, MD, radiation oncologist, in collaboration with neurosurgeons Eric Nussbaum, MD, and Terry Hood, MD, and surgeon Andrew Fink, MD.

Contact us
To contact the CyberKnife Center, call 651-326-3636 or 1-866-747-1123. Click here to request an information packet.

Additional Information

Request an information packet

Skull base surgery at
St. Joseph's Hospital

Accuray, Inc.

CyberKnife Society

CyberKnife Support

Acoustic Neuroma Assoc.

American Brain Tumor Assoc

American Cancer Society

International Radiosurgery

How the CyberKnife^® Works

With its high precision and accuracy, the CyberKnife^® system can achieve a surgical-like outcome, without surgery. It's a painless outpatient procedure without the risk and complications associated with conventional surgery.

Treating tumors with technology
Stereotactic radiosurgery is a medical procedure that utilizes very accurately targeted, large doses of radiation to treat tumors, lesions and a few other select medical disorders.

CyberKnife is an entirely new approach to stereotactic radiosurgery because it can deliver radiation to tumors anywhere in the body, while standard radiosurgery techniques can only treat brain tumors.

Cruise missiles and computers
Using x-ray image cameras and computer technology similar to that used for cruise missile guidance, the CyberKnife system locates the tumor in the body.

A computer program evaluates the unique shape and location of the tumor to determine the orientation of each of the 1,200 or more beams of radiation that will target the tumor.

An x-ray source located on the CyberKnife's robotic arm delivers concentrated beams of radiation to the tumor from multiple positions and angles, without damaging healthy surrounding tissue. The range of motion offered by the robotic arm allows for maximum flexibility to reach tumors not accessible by other means.

The CyberKnife continually checks and corrects for any patient movement during the treatment, ensuring superior accuracy. Thanks to this accuracy, the CyberKnife can use higher doses of radiation to attack tumors.

A frameless alternative
Standard stereotactic techniques, such as the Gamma Knife, require the use of a metal frame that is bolted to the patient's skull during the procedure. This head frame remains attached to the patient during the entire process - while initial imaging scans are taken, while doctors develop a treatment plan and during radiation treatment. This process can take a day or longer and is extremely uncomfortable for many patients.

CyberKnife offers all of the advantages of radiosurgery, but without the need for a metal head frame. Instead, patients are fitted with a a more comfortable flexible mesh mask for tumors in the head, or a body cradle for spinal tumors or other tumors outside the head.

Additional Information

Request an information packet

Accuray, Inc.
www.accuray.com

CyberKnife Society www.cksociety.org

CyberKnife Support www.cyberknifesupport.org

Acoustic Neuroma Assoc
www.anausa.org

American Brain Tumor Assoc
www.abta.org

American Cancer Society
www.cancer.org

International Radiosurgery
www.irsa.org

The Treatment Process

Once you and your doctor have decided the CyberKnife® is the best option for your condition, there are six basic steps involved in the treatment process:

• Intake process
• Consultation
• Treatment setup
• Treatment planning
• Treatment delivery
• Follow-up

These steps can be performed on the same day or separate days, depending on your schedule and the schedules of the CyberKnife team.

Our CyberKnife team is there to help you through each step of the treatment process. Depending on your needs, you will be cared for by nurses, radiation oncologists, surgeons, neurosurgeons, physicists and technicians. Our knowledgeable, professional staff are experts in their fields and work as a team to give you the best possible care. All patients work with a radiation oncologist (a doctor who specializes in treating cancer with radiation), as well as a neurosurgeon (for head and spine tumors) or surgeon (for tumors in other areas of the body).

1) Intake Process
Prior to scheduling an appointment at the CyberKnife Center, our doctors and nurses need to review your medical record. This information helps us determine if your condition can be treated with CyberKnife. Your help in gathering the information from your doctors will speed up the entire process. Important parts of the medical record include past CT or MRI films and previous radiation therapy records. During this process you will work closely with a CyberKnife nurse and clinic assistant.

2) Consultation
During your first visit to the CyberKnife Center you will meet with a nurse, radiation oncologist and surgeon. You and your family will be able to get your questions answered in a comfortable, non-threatening environment. Our team of doctors and nurses will educate you on the pros and cons of treatment and give a thorough explanation of what you can expect as you go through the treatment process.

3) Treatment setup
Setup is the initial process that allows your doctor to plan the delivery of your CyberKnife treatment. At this appointment, you will be cared for by a CyberKnife therapist, radiation oncologist and CT/MRI therapist.

Making a mask or body mold
During this appointment, a custom-fit, flexible mesh mask (for head/neck treatments) or body mold is formed. It will be used to help minimize movement during the treatment and ensure your comfort. Creating the mask/ body mold is a simple and painless process.

Fiducial placement
Treatment for spine or other tumors outside the head may also require placement of fiducials near the tumor. Fiducials are small metal markers that track the tumor's position during treatment. It is a procedure similar to a biopsy.

Imaging
A CT scan is then taken to create computerized images of the tumor. Your doctors use the scan to see the exact size, shape and location of the tumor.

You do not need to wait in the hospital while the treatment plan is being developed. You can go home after setup and return on a different day for treatment delivery.

4) Treatment planning
During treatment planning, your doctor and a physicist review your CT scan. They then put the information into a specialized computer and use advanced software to determine the number, intensity and direction of radiation beams for your treatment. During this step, the CyberKnife completes millions of calculations to develop a radiation delivery plan created specifically for you.

You do not need to be present during the treatment planning process.

5) Treatment delivery
On the day of your appointment, wear comfortable clothing and no jewelry. You will need to have someone drive you to and from your treatment because you will be given a mild sedative thirty minutes before the treatment. Try to relax knowing this is a painless procedure. We encourage you to bring relaxing music to listen to during treatment.

Feel free to bring a list of questions to ask the CyberKnife team. They are there to ensure your comfort and safety.

During treatment, you will be cared for by a nurse, CyberKnife therapist or physicist, radiation oncologist and your neurosurgeon or surgeon.

Positioning
You will be asked to lie on the treatment table and will then be fitted with the custom mask or body mold that was made during the set-up process. Because the treatment is usually painless, only mild sedation may be required to keep you comfortable.

Painless treatment
During the treatment, you will need to lie still. You will be awake throughout the entire procedure, which typically lasts 30 to 90 minutes, depending on the complexity of your tumor. The image guidance system periodically takes x-ray images and compares them to data from the CT scan to ensure the radiation is targeted accurately to the tumor.

Completion
If you are undergoing a single session radiosurgery treatment, your treatment is complete and you can usually leave the hospital immediately. If your physician prescribes a "hypo-fractionated" or staged treatment, you will need to return for additional treatments. Many patients will require an additional two to five treatments. Either way, the outpatient CyberKnife procedure allows you to undergo your treatment and immediately resume your normal activities.

6) Follow-Up
After your CyberKnife treatments, follow-up imaging and doctor's visits will be required to monitor your progress. This will be discussed with you at the time of treatment.

Additional Information

Request an information packet

Accuray, Inc.

Frequently Asked Questions

What is stereotactic radiosurgery?
What is CyberKnife^® Stereotactic Radiosurgery?
How does the CyberKnife^® system work?
How is CyberKnife^® different from other stereotactic radiosurgery systems like Gamma Knife?
What can the CyberKnife^® treat?
What are the benefits for patients?
What can I expect during CyberKnife^® treatment?
Is CyberKnife^® covered by insurance?
How can I find out more about the CyberKnife^® at St. Joseph's Hospital?
Where else is CyberKnife^® available?
Who makes the CyberKnife^® system?

What is stereotactic radiosurgery?

Stereotactic radiosurgery is a non-invasive (non-surgical) treatment in which high doses of focused radiation beams are delivered from multiple locations outside the body to destroy a tumor or lesion within the body. This procedure does not remove the tumor or lesion. Instead, it destroys tumor cells or stops the growth of active tissue.

Traditional methods relied on a metal frame that was bolted to the skull in order to target the treatment. Because of the need for the metal frame, radiosurgery was not possible for tumors located outside of the head.

The procedure has been used for more than 30 years, and over 100,000 patients have been treated worldwide.

What is CyberKnife^® Stereotactic Radiosurgery?

CyberKnife^® is an entirely new approach to stereotactic radiosurgery because it can deliver targeted radiation to anywhere in the body, while minimizing exposure to surrounding normal tissue. It offers all of the advantages of radiosurgery, but without the need for a metal head frame.

With sub-millimeter accuracy, CyberKnife can be used to treat tumors, cancers, vascular abnormalities and functional disorders. Best of all, it achieves surgical-like outcomes without surgery or incisions.

How does the CyberKnife^® system work?

Using x-ray image cameras and computer technology similar to that used for cruise missile guidance, the CyberKnife^® locates the tumor in the body. A computer program then evaluates the unique shape and location of the tumor to determine exactly how each of 1200 or more beams of radiation will target the tumor.

An x-ray source located on the CyberKnife's robotic arm delivers concentrated beams of radiation to the tumor from multiple positions and angles without damaging healthy surrounding tissue. The range of motion offered by the robotic arm gives it maximum flexibility to reach tumor sites not accessible by other means.

The CyberKnife continually checks and compensates for any patient movement during treatment to ensure accuracy. Because the CyberKnife has pinpoint accuracy, it can deliver higher doses of radiation to treat tumors.

How is CyberKnife^® different from other stereotactic radiosurgery systems like Gamma Knife?

First, the CyberKnife^® system uses the combination of a robotic arm, Linac, and image guidance technology. Because of the flexibility of the robotic arm, the system is able to reach areas of the body that are unreachable by other radiosurgery systems. CyberKnife can be used anywhere in the body, while existing systems can only offer treatments to the head and neck area.

Second, the CyberKnife is able to locate the position of the tumor within the body without the use of an invasive head frame.

Third, the CyberKnife monitors and compensates for patient movement during treatment, constantly ensuring accurate targeting.

What can the CyberKnife^® treat?

CyberKnife^® technology is approved by the U.S. Food and Drug Administration (FDA) to treat tumors and lesions throughout the body. St. Joseph's Hospital uses CyberKnife to treat benign tumors, malignant tumors, vascular malformations and functional disorders.

We use CyberKnife to treat tumors of the:

• Head
• Neck
• Spine
• Lung
• Pancreas
• Liver
• Kidney
• Pelvis
• Other sites as appropriate

What are the benefits for patients?

• Better quality of life during and after treatment:
  - no need for an invasive head frame
  - typically no hospital stays
  - few visits to hospital
  - short or no recovery periods
• Treatment is available for tumors previously considered inoperable. -Reduces the risk of complications that are sometimes associated with conventional surgery
• Dosage distributions adjusted to minimize radiation exposure to surrounding healthy tissue
• Less pain
• No blood loss
• No scalpel
• Mild sedation during treatment
• Usually performed as an outpatient procedure
• Lesions that have previously undergone the maximum allowed dose of radiation can be treated

What can I expect during CyberKnife^® treatment?

Treatment follows six steps that can be performed on the same day or on separate days:

• Intake process
• Consultation
• Treatment setup
• Treatment planning
• Treatment delivery
• Follow-up

Click here for information on each of the steps.

CyberKnife^® staff is always present to ensure your comfort and to make sure that the treatment provides maximum results.

Treatment is generally completed in one to five 60 to 90 minutes sessions. Most patients feel no pain during the treatment and are able to go home immediately afterward.

Is CyberKnife^® covered by insurance?

Similar to surgical treatment, stereotactic radiosurgery treatments, including CyberKnife^® , are usually covered by Medicare and most private insurances.

How can I find out more about the CyberKnife^® at St. Joseph's Hospital?

For more information, call 651/326-3636 or 1-866-747-1123 or click here to request information by mail.

Where else is CyberKnife^® available?

For a listing of sites that are currently treating patients using the CyberKnife^® system, visit www.cksociety.org.

Who makes the CyberKnife^® system?

Accuray, Inc. designs, manufactures, and distributes the CyberKnife^® Stereotactic Radiosurgery System worldwide. Accuray is based in Sunnyvale, California.

Additional Information

Request an information packet

Accuray, Inc.

The CyberKnife^® Care Team

The CyberKnife^® team at St. Joseph's Hospital is committed to providing you with personalized treatment for your exact condition. Our group of doctors, nurses, therapists, physicist and assistants all work together to provide you the best radiosurgery treatment available - and compassionate care.

June Kim, MD, is a board-certified radiation oncologist. She attended William Paterson University in Wayne, New Jersey and New Jersey Medical School. She went on to complete her residency at Eastern Virginia Graduate School of Medicine in Norfolk, Virginia and a fellowship in radiation oncology at Harvard Medical School in Boston.

Dr. Kim most recently practiced at a cancer center in LaCrosse, Wisconsin. She has also served as medical director of radiation oncology at a medical center in Portsmouth, Virginia and as an assistant professor of radiation oncology at Eastern Virginia Medical School.

Dr. Kim has performed and presented her clinical research in a variety of areas for many years. She is a member of the American Society for Therapeutic Radiation and Oncology.

Ross McBride, MD, is co-medical director for the CyberKnife Center. A board-certified radiation oncologist, he studied business finance at Brigham Young University and medicine at the University of Texas. He completed his residency at Henry Ford Hospital.

Prior to joining HealthEast, Dr. McBride practiced in Springfield, Missouri, where he served as a co-medical director of stereotactic radio surgery, and in Redding, California, where he developed an Intensity Modulated Radiation Therapy (IMRT) program. He is an active member of the American Brachytherapy Society.

Terry Hood, MD, FACS , is a board-certified neurological surgeon. He is a graduate of Northwestern University and the University of Virginia. He received his medical degree from Washington University in St. Louis and completed his neurosurgical residency at the University of Minnesota . He gained additional experience in neurosurgery as a clinical fellow at the University Hospital in Zurich, Switzerland.

Eric Nussbaum, MD, FACS, is a board-certified neurological surgeon and the medical director of vascular neurosurgery at the HealthEast Neurovascular Institute. He is a graduate of Johns Hopkins University. He received his medical degree from the University of Maryland School of Medicine and completed his surgical internship and neurosurgical residency at the University of Minnesota. He gained additional experience in neurovascular and epilepsy surgery while a clinical fellow at the University Hospital in London, Ontario.

Dr. Eric Nussbaum has written a guide for patients and families on brain aneurysms and vascular malformations. He's also published many journal articles and book chapters on the subject and is invited regularly to speak at national conferences.

Leslie Nussbaum, MD, PhD, FACS, is co-medical director for the CyberKnife Center at St. Joseph 's Hospital. A board-certified neurological surgeon, she received her BS, PhD and medical degrees from the University of Arizona . She completed her surgical internship at the University of Maryland and neurosurgical residency at the University of Minnesota. She gained additional experience in spine surgery while a clinical fellow at the Medical College of Wisconsin in Milwaukee.

Dr. Leslie Nussbaum has published multiple articles and book chapters.

Andrew Fink, MD, FACS is the medical director of surgery for HealthEast hospitals. A graduate of the University of Minnesota Medical School, he trained in general surgery at Hennepin County Medical Center.  He is a board-certified general surgeon and is a fellow in the American College of Surgeons.  He has been Chief of Surgery at HealthEast and is now devoting his practice to radiosurgery with the CyberKnife Center.

Guy Sherwood, DABR, is senior medical physicist for the department of Radiation Oncology at St. Joseph's and is the lead medical physicist for the CyberKnife Center. He received his bachelor's degree in physics and mathematics from the University of Dubuque and is board-certified in therapeutic radiological physics by the American College of Radiology. He also received advanced certification in CyberKnife stereotactic radiosurgery at the University of Pittsburgh Medical Center. Guy has more than 30 years of clinical experience in radiation oncology and has published several papers on medical physics.

Lori Copsey, CMD, BS, is a junior medical physicist involved with the CyberKnife team. She has been active in the field of radiation oncology for 20 years and has worked in physics for the last 15. She obtained her BS degree and dosimetrist training from the University of New Mexico. Lori attended CyberKnife training at Stanford University in November 2003.

Dawn Wilson, RT(R)(T) is certified in radiology and radiation therapy and has been part of the HealthEast family for more than 25 years. She is excited to be part of the CyberKnife team and attended training at Stanford University in November 2003.