CyberKnife...done.

     As planned, I had a CyberKnife treatment about ten days ago.  The build up before the treatment turned out to be more intense than the treatment itself.  In the time it was decided that I had a brain tumor until I actually had CyberKnife, I had a fourth brain MRI, a CT scan of my head, met with two radiation oncologists, and a neurosurgeon.  There's a lot of medical personnel coordination and an incredible amount of technology that goes into a treatment, but for me as the patient, I was pleasantly surprised with how easy this all turned out to be.  

     A couple days before my treatment, I was scheduled for a 5-hour appointment which included meeting with a nurse and then a radiation oncologist, followed by the additional imaging studies...CT and brain MRI, and finally, a mask fitting, needed to keep my head still during the CyberKnife treatment.  

     Meeting with the nurse was really helpful.  She outlined how my long day was going to go. She warned me that the CT scan that I was going to have that day uses very thin slices, so it was possible that additional small tumors could be detected.  Depending upon the specifics of any newly detected tumors, if possible, they would zap them, too.  The radiation oncologist discussed more details about the treatment, including side effects and risks, both common and rare.  She was as reassuring as she could be that I would not be different following my treatment.  

     Here's my mask.  For the fitting, the techs placed a warm, pliable mesh over my face and manipulated it to contour my face. Their goal was to make the mask fit tightly against my skin without being too uncomfortable.  The mask is attached to a frame that is secured to the treatment table so that I cannot move my head during the treatment.  I had to lay still until the mesh cooled and hardened.  

The upper right and bottom pictures show my tumor, the white blob.

     The CT scan of my head and brain MRI are used to create a 3-D grid of my head and the coordinates of my tumor were precisely calculated.  A physicist is part of the team, and along with the radiation oncologist, a treatment plan was created that included the radiation dosage and number of beams that would be targeted to my tumor.  This is my treatment plan, (upper left picture).  Each thin blue line is a highly focused beam of X-ray radiation sent directly toward my tumor.  Each beam is a low dose of radiation which will travel through normal brain tissue and will not affected it.  However, the point where the beams converge is, cumulatively, a high dose of radiation...enough to stop cancerous cells from living and growing.  

     It takes a few days for the physicist to calculate the treatment plan, which is then reviewed by the radiation oncologist and neurosurgeon.  So, two days after my "prep" day, I returned for the zapping treatment.  I was told that no additional tumors were detected.  (Whew.) 

     I laid on the treatment table and my head was secured down with my mask.  I made sure that I was comfortable because I knew that I shouldn't move.  The  techs told me to do my best, but in my case, the CyberKnife robot was calibrated to sense any movements greater than 0.5 mm and would make adjustments. If I made any large movements, the robot would stop, re-image, re-calculate, and start up again. Amazing, don't you think? 

 

     The treatment lasted 40 minutes.  It's longer for patients with more than one and/or larger tumors.  It was totally painless.  I slept through some of it.  

     Afterwards we got ice cream with friends, Seth and Ben, who had come to sit with Wynn while I was being zapped.  The next day I had a mild headache and some weird mental fogginess.  I took a couple Tylenol and jumped on my stationary bike.  The Tylenol worked for the headache and getting my blood flowing made the fogginess go away.  I rested for the weekend and went to work on Monday, as usual.  Overall, aside from the hassles of going to many appointments and managing some pre-procedure anxiety, the actual CyberKnife treatment was totally underwhelming. 

     I'll have a follow-up brain MRI in two months.  Hopefully, the tumor will be gone and no new ones will be seen.  

Wish me luck!