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Hollywood Radiation Oncology
6030 Hollywood Boulevard
Hollywood, Florida 33024

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CyberKnife® Frequently Asked Questions

What is stereotactic radiosurgery?
Stereotactic radiosurgery is as non-invasive (non-surgical) treatment in which high doses of focused radiation beams are delivered from multiple locations outside of the body to destroy a tumor or lesion within the body. The procedure has been used for more than 30 years, and over 200,000 patients have been treated worldwide. Radiosurgery does not remove the tumor or lesions. The radiation destroys tumor cells and stops the growth of active cells.

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What is image-guided stereotactic radiosurgery?
The CyberKnife system uses a distinctive radiosurgery device with a linear accelerator (Linac), which produces the radiation mounted on a robotic arm. Through the use of image guided cameras, the CyberKnife locates the position of the tumor. The Linac attached to the robotic arm is then used to deliver multiple beams of radiation while minimizing exposure to surrounding normal tissue. With sub-millimeter accuracy, the CyberKnife is used to treat vascular abnormalities, tumors, functional disorders, and cancers of the body.

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Is the CyberKnife safe?
The CyberKnife, because it is not really surgery, does not present the same problems as traditional surgery. Mainly, there is no anesthesia or anesthesia after effects. And the risk of infection and hemorrhaging are minimized. The CyberKnife offers accurate precision within sub-millimeter distances and spares healthy tissue surrounding the targeted area. Over 6,000 people have received CyberKnife treatments around the world. No mortality or morbidity data has been reported as a direct result of a CyberKnife procedure.

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How is the CyberKnife system different from other stereotactic radiosurgery
systems?

The CyberKnife uses the combination of a robotic arm and Linac image guidance. 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. Second, unlike other stereotactic radiosurgery treatments, the CyberKnife is able to locate the position of the tumor within the body without the use of an invasive stereotactic head frame. This means no pin screws on your forehead or blood. Third, the CyberKnife system compensates for patient movement during treatment, constantly ensuring accurate targeting.

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What can I expect during a CyberKnife treatment?
All CyberKnife cases are unique. Factors like the patient’s medical condition, ambulatory status, pre-existing conditions, and present treatments are considered during the planning phase and help the doctors formulate an individualized treatment plan. For example, some patients receive a single session of CyberKnife. Others staged (over time) treatments. Patients at the CyberKnife Center receive one-on-one education pre and post treatment so that they know what to expect during the process.

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What types of conditions are considered for CyberKnife treatment?
The CyberKnife treats intracranial (skull base) benign and malignant tumors, as well as spine tumors and lesions of the cervical, thoracic and lumbar regions. Additionally, the CyberKnife is capable of full-body targeting for: Thoracic surgery (lung); General Surgery (liver, pancreas and breast); Head and Neck Surgery (laryngeal, nasopharyngeal, glossal); and Urological Surgery. Over 6,000 cases have been treated worldwide. Research is ongoing at major medical centers as more specific indications for treatment are explored.

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What are the benefits of the CyberKnife?
There are many benefits to a CyberKnife procedure. It is non-invasive, does not require a headframe or painful immobilization device and it is able to reach areas of the body previously thought untreatable. It is ideally suited for those who are unable to undergo traditional surgery or who do not wish to risk surgery.

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How much does a Cyberknife procedure cost?
The CyberKnife Center receives many patients from abroad who do not have health insurance coverage in the United States. Uninsured patients are offered a global discount which includes the treatment phases and the professional fees for the treating physicians. All treatment plans are customized to meet the needs of a patient and his or her condition. Some patients can be treated in one session, while others may require multiple sessions. Some conditions require a Cat-Scan for planning, others require different or multiple images. Some conditions require fiducial placements, while others do not. Consequently, until a CyberKnife trained physician evaluates a particular case the price cannot be determined. Customarily a CyberKnife procedure can cost between $30,000 and $55,000. Self-paying patients are extended a discount provided payment is made on or before the day of treatment.

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Will my insurance pay for CyberKnife treatments?
Cyberknife treatments are not experimental and are covered by most insurance carriers. A CyberKnife procedure at the CyberKnife Center is cost effective as it is performed on an outpatient basis and does not require hospitalization, anesthesia or rehabilitation. Because CyberKnife technology is new to our region some insurance companies may not be familiar with our services. We ask all of our patients to share with us their information early enough prior to their treatment so we can assist with obtaining pre-authorization and meet coverage requirements. Our Office Manager is available to assist patients with any question they may have concerning their coverage and out of pocket requirement

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Who determines if CyberKnife is an appropriate treatment?
Medical necessity can be determined by your physician or specialist after evaluating your condition. The CyberKnife is a unique modality and as such only a CyberKnife trained physician can best determine if it is appropriate treatment for a particular condition. An experienced CyberKnife physician can offer the best advice and discuss other treatment options with you and your family. It is not uncommon for cases to be discussed with various physicians, including the patient’s primary doctor, before determining candidacy for CyberKnife treatment.

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Can the elderly and children be treated with the CyberKnife?
Because the CyberKnife is less risky than traditional surgery it can be a suitable option for the elderly or for pediatric cases. Age is not a crucial factor in excluding patients from CyberKnife treatments. In the case of small children, a pediatrician, anesthesiologist and nurse anesthesiologist may be consulted to ensure the safety and comfort of the child during treatment.

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After treatment, when will my tumor or lesion disappear?
The effects of radiosurgery occur gradually and over a period of time. The timeframe can range from days, months or years depending on the medical condition targeted. Some tumors dissolve slower than others and eventually disappear. Others simply stop growing and present no further cell activity. After treatments patients typically are asked to get periodic images (CAT Scan or MRI) of their tumor(s) so that their physician can monitor the effectiveness of the radiation.

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What are the complications or side effects of CyberKnife radiosurgery?
Complications with the CyberKnife are less prevalent than those found in other radiosurgery modalities or radiation treatments. After treatment sometimes patients experience headaches or feel nauseas or very tired. These symptoms are temporary and rarely the result of radiation, but simple nerves or fatigue due to lack of sleep. Uncommon complications may include skin reddening due to the face mesh or vomiting. Delayed symptoms may include local brain swelling in the treatment site, which can be addressed with steroids and other appropriate medications by the doctor. Rare complications may include vision loss or hearing loss depending on the diagnosis and condition being treated.

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Will my hair fall out or burn my skin after CyberKnife treatment?
The radiation being delivered by the CyberKnife is so focused on a specific target that it is highly unlikely that hair loss or skin burn will occur. Typically, the radiation dose administered is not sufficient to cause permanent damage to the skin or hair follicles. In the event that an intracranial lesion being treated is close to the scalp a patch of hair may be effected. The hair will grow back. Patients receive instruction before and after treatment and have an opportunity to dialogue with members of the medical team so that they are aware of possible events specific to their case.

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How many times can you receive a CyberKnife treatment?
The frequency of treatments depend on where the tumor is located and what type of tumor is being treated. Most cases can receive multi-treatments or be re-treated with the CyberKnife.

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Are all CyberKnife Centers alike?
The CyberKnife is solely manufactured by Accuray®, Inc. and is patented for its unique image-guided system and robotic-arm delivery. CyberKnife Centers have their own medical director(s) and can be found in different medical environments, such as Universities, for-profit and non-profit medical centers as well as private medical practices around the United States. Some CyberKnife programs only treat specific conditions, while others are opened to treating both whole-body and intracranial conditions.

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Are there CyberKnife patient organizations I can contact for more information?
There are numerous patient organizations that can offer support and education to patients seeking more information on radiosurgery treatment. Specific to the CyberKnife is The CyberKnife Patient Support Group, a non-profit organization established in July of 2001. The CyberKnife Patient Support Group is dedicated to helping others by sharing the personal experiences of patients who have undergone a CyberKnife procedure. www.cyberknifesupport.org

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