Am I a candidate for Cyberknife?

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Had SCC in 2006,left tonsil, radiation only, had SCC again this year on opposite side of neck, radiation and chemo, now, lucky me, I have developed "pre-cancerous lesions" back on my 2006 side, if this develops into cancer, can I have it treated with Cyberknife even though I have been radiated on both sides of neck? Thanks Longtermsurvivor for walking me through the options, just thought there might be someone else out there who has had this done.....Anyone????

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  • Tim6003
    Tim6003 Member Posts: 1,514 Member
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    Sorry I can't help..
    ..only a short-termer on here so far ..

    Keep us posted.

    Tim
  • CivilMatt
    CivilMatt Member Posts: 4,723 Member
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    buellman91,
    Cyber knife

    buellman91,

    Cyber knife seems to be a pretty cool tool. I hope you find a procedure that really gives these lesions a one-way ticket out of your life.

    Best,

    Matt
  • longtermsurvivor
    longtermsurvivor Member Posts: 1,842 Member
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    this question cannot be answered by anyone
    who isnot a qualified radiotherapist, AND qhas reviewed your records. There is a limit to how much radiation normal tissues can tolerate, and if this area hasnalready been exposed to rads twice, the answer may be no. Your previous radiation, while dose-reduced to surrounding tissues, still gave them some rads. Cyberknife is not a magic treatment, it simply concentrates rads further, thereby sparing surrounding normal tissue even more than IMRT.


    There have only been a few people post here who have had cyberknife. One was for an isolated metastasis to the leg, perhaps. The other was a local recurrance in the throat, but was a second treatment, not a third treatment. It is not a universally available treatment yet, and we are still learning what its application is.


    Pat
  • buellman91
    buellman91 Member Posts: 32
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    this question cannot be answered by anyone
    who isnot a qualified radiotherapist, AND qhas reviewed your records. There is a limit to how much radiation normal tissues can tolerate, and if this area hasnalready been exposed to rads twice, the answer may be no. Your previous radiation, while dose-reduced to surrounding tissues, still gave them some rads. Cyberknife is not a magic treatment, it simply concentrates rads further, thereby sparing surrounding normal tissue even more than IMRT.


    There have only been a few people post here who have had cyberknife. One was for an isolated metastasis to the leg, perhaps. The other was a local recurrance in the throat, but was a second treatment, not a third treatment. It is not a universally available treatment yet, and we are still learning what its application is.


    Pat

    Tumor l;ocation????
    Pat, I live in Allentown Pa., 1 hour outside Phila.I am actually seeing the chair of the Otorinolaringology (?)Dept. at Univ. of Penna., Dr. B ert O'Malley although he is a surgeon. I am seeing a Dr. Alt at U of P on Wed. I had my rads and chemo, both in 2006 and 2012 at Lehigh Valley Hosp. in Allentown. My tumor that got IMRT in 2006 was on my left tonsil and now it is right below my jaw on the left side. O'Malley says there is definitely a surgical option but wants to see if Cyberknife might be an option. I am having alot of swelling and pain on the left side and the right side, where I got the rads this years, is fine. I can't imagine the complications I might have with additional rads again, but I still might opt for that over surgery. I don't know what ntype surgery I would get for a tumor below the left mandible. Any thoughts? Would it get this neck disection I hear so much about?
  • longtermsurvivor
    longtermsurvivor Member Posts: 1,842 Member
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    Tumor l;ocation????
    Pat, I live in Allentown Pa., 1 hour outside Phila.I am actually seeing the chair of the Otorinolaringology (?)Dept. at Univ. of Penna., Dr. B ert O'Malley although he is a surgeon. I am seeing a Dr. Alt at U of P on Wed. I had my rads and chemo, both in 2006 and 2012 at Lehigh Valley Hosp. in Allentown. My tumor that got IMRT in 2006 was on my left tonsil and now it is right below my jaw on the left side. O'Malley says there is definitely a surgical option but wants to see if Cyberknife might be an option. I am having alot of swelling and pain on the left side and the right side, where I got the rads this years, is fine. I can't imagine the complications I might have with additional rads again, but I still might opt for that over surgery. I don't know what ntype surgery I would get for a tumor below the left mandible. Any thoughts? Would it get this neck disection I hear so much about?

    so your swelling and pain
    are lymphedema related, not cancer related it sounds like. This area that has the precancer diagnosis, below the jae implies that this is an area unserneath the jae and under the skin? Is there a palpable lump there, and is the lump what was biopsied? What isnt making sense to me is this aspect of things. To be "precancerous" an area has to contain a normal skin covering that is undergoing change. Not an area of tissue deep to the surface, because there isnt skin in that location to begin with. If there is an area under the skin, that should be SCC already. So pardon my continued lack of complete comprehension.

    Listing your center and attending, I am certain they will do well for you, and I didnt mean to imply you should jump ship. It will be interesting to see what rhey say about cyberknife. Exterpative surgery is always an option in this area, as they apparently said. A number of us have had surgery in the general area you are describing, including me. I rmembered who it was that went through cyberknife awhile back. He posted as Marty36. I dont think he has posted for a few months.

    By the way, your center probably has as much cyberknife experience as any place in the country.
    best
  • buellman91
    buellman91 Member Posts: 32
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    so your swelling and pain
    are lymphedema related, not cancer related it sounds like. This area that has the precancer diagnosis, below the jae implies that this is an area unserneath the jae and under the skin? Is there a palpable lump there, and is the lump what was biopsied? What isnt making sense to me is this aspect of things. To be "precancerous" an area has to contain a normal skin covering that is undergoing change. Not an area of tissue deep to the surface, because there isnt skin in that location to begin with. If there is an area under the skin, that should be SCC already. So pardon my continued lack of complete comprehension.

    Listing your center and attending, I am certain they will do well for you, and I didnt mean to imply you should jump ship. It will be interesting to see what rhey say about cyberknife. Exterpative surgery is always an option in this area, as they apparently said. A number of us have had surgery in the general area you are describing, including me. I rmembered who it was that went through cyberknife awhile back. He posted as Marty36. I dont think he has posted for a few months.

    By the way, your center probably has as much cyberknife experience as any place in the country.
    best

    Hot spot was at "lower left mandible"
    I think was how the PT described it and they went in through my mouth to do the biopsy which was not very painful, beyond the daily pain. Remember, rads on left side of neck in 2006. I developed a lump under my chin slightly to the left about three months ago and in that time there has been no apparent change or improvement. It is very painful and previously none of my tumors had any pain associated with them.
    Pain doc has me on Gabapentin, fentanyl patch and SUBSYS,again fentanyl all to treat cancer specic nerve pain associated with radiation side effects I experience shooting pain in chin, ears, jaw. My biggets question is with the realization that I had IMRT on left side in 2006 can I get Cyberknife on that side now?
  • longtermsurvivor
    longtermsurvivor Member Posts: 1,842 Member
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    Hot spot was at "lower left mandible"
    I think was how the PT described it and they went in through my mouth to do the biopsy which was not very painful, beyond the daily pain. Remember, rads on left side of neck in 2006. I developed a lump under my chin slightly to the left about three months ago and in that time there has been no apparent change or improvement. It is very painful and previously none of my tumors had any pain associated with them.
    Pain doc has me on Gabapentin, fentanyl patch and SUBSYS,again fentanyl all to treat cancer specic nerve pain associated with radiation side effects I experience shooting pain in chin, ears, jaw. My biggets question is with the realization that I had IMRT on left side in 2006 can I get Cyberknife on that side now?

    well, it will be interesting to see what the experts say
    when you have rads on one side, it is not as though the surrounding tissues dont get any rads. They do, although at a reduced dose. The exact dose is only known tomthe guy who designed that particular treatment. There exists a computer generated "map" of the entire area, which sort of looks like a topographical map, showing your dosimetry. All will depend on how much has actually been delivered to this area previously. And again, surgery is an option.

    Pat
  • buellman91
    buellman91 Member Posts: 32
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    well, it will be interesting to see what the experts say
    when you have rads on one side, it is not as though the surrounding tissues dont get any rads. They do, although at a reduced dose. The exact dose is only known tomthe guy who designed that particular treatment. There exists a computer generated "map" of the entire area, which sort of looks like a topographical map, showing your dosimetry. All will depend on how much has actually been delivered to this area previously. And again, surgery is an option.

    Pat

    My Radiation Graduation present....
    was a diploma (not kidding) and that map which I kept as a souvenir since 2006. Little did I know I would need it again.Regardless of what option the "experts" recommend will I wait until the pre-cancerous cells becomes "official" cancer or can they treat me now? Thanks for providing so m uch information Pat. I genuinely appreciate it.
    Bill