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RFA vs. CYBERKNIFE

scadamini
Posts: 10
Joined: Feb 2008

I was wondering if anyone has had either procedure and why they chose one over the other. My father has two small liver mets, which occurred after his colon resection, and is thinking about cyberknife or rfa. He is currently on chemo (avastin, xeloda, and campostar) but is tired of feeling so awful and wants to explore other non-invasive options. Thank you in advance for your help.

lisa42's picture
lisa42
Posts: 3661
Joined: Jul 2008

Hi,

I haven't had either procedure done, just because I'm not a candidate for either due to the size of tumors and because I have so many subcentimeter nodules all over both lungs.
But... when I was exploring the possibility of those options, I did talk about both with two different oncologists. My liver surgeon was one and he said he had not done an RFA procedure in over a year, that RFA seemed to have more issues with patients and he was going the route of either recommending a surgical resection, cyberknife, or stereotactic radiation (which is basically the same as cyberknife, but without the gold fidducial beads the cyberknife uses. Without the beads drawing the radiation beam, the patient instead has to hold their breath during the beams & cyberknife the beads create a more exact "sure fire" radiation beam going only to the affected place.)
My oncologist also said he doesn't refer many patients for RFA anymore. I do know, however, that I've heard of other patients who go to fairly top knotch care centers who have had the RFA done.
Hopefully more people will chime in and give their experiences and thoughts about the two procedures.

Best wishes,
Lisa

PhillieG's picture
PhillieG
Posts: 4907
Joined: May 2005

I've had an RFA and will be having another one in a few weeks. It was an incredibly easy procedure. They just stuck a needle into the tumor while doing a CT scan, they heat it up and fry the tumor. It was successful when I had it done, I'm hoping for a similar result again. Also, it only required an overnight stay and there is the possibility of getting home the same day this time. I do not know anything about the cyberknife procedure.
Hope this helps.
-phil
PS: Sloan Kettering uses the RFA over any form of radiation due to less collateral damage with the RFA. RFA hits the target dead on where radiation requires them to hit a moving target, at least in my lungs, due to having to breathe.

lisa42's picture
lisa42
Posts: 3661
Joined: Jul 2008

I wonder why the Drs. I spoke to don't do the RFA anymore, based on what Phil just said. Maybe they did have more issues w/ the RFA at the hospital here and that's why they don't want to do it anymore- maybe Sloan Kettering or other places do a better job at it.
I guess the key would be to not insist on getting it done w/ a doctor who said there have been "issues" with it- find a Dr. who does it and has a good success rate at it.
Re. the cyberknife, I recall from talking to the radiologist at our San Diego Cyberknife center, that most patients have 3-5 radiation sessions, which is obviously a LOT less than the traditional radiation (which is usually 4-6 weeks, daily M-F). The cyberknife is supposedly very accurate because the gold bead draws the radiation beam directly to it, which accounts for moving, breathing, etc.

Best wishes!
Lisa

scadamini
Posts: 10
Joined: Feb 2008

Thank you for your input. My father, pursuant to our own research, is leaning toward Cyberknife because in his case it appears to be less invasive in that one of his liver mets is on the posterior of his liver and they may have to cut to get to it. Also, in reading information regarding RFA there is a small chance of developing an infection or abscess. After his colon resection he acquired two infections, separately, after an abcess burst in his abdomen. Therefore, he is a little shy of having any type of incision. However, if RFA has a better success rate he may go for that. His onc. is not really saying which procedure would be better for him so I have just been trying to gather some info. Thank you again for your input.

Sundanceh's picture
Sundanceh
Posts: 4408
Joined: Jun 2009

Hi there

I've done both the RFA and CyberKnife procedures - with excellent results.

RFA is still at the forefront of treatment - it's not a dead technology. It's still widely used as a treatment option - and the success rates are equal to or better than a liver resection.

My procedure they opened me with a liver resect incision because we thought we were going that way, but my liver was not eligible for a resection, so we switched quickly to RFA. The surgeon placed the marker seeds into my liver while he had me open. They burned a 9CM tumor out of my liver (about the size of a small orange). I had one of the pioneer surgeons here in Dallas (he teaches all over the world) who did my RFA and I can recommend him highly - he is at Baylor in Dallas - and yes Dallas has some of the best surgeons and cancer treatment this country can offer.

Due to the location of my liver tumor, the surgeon got most of it, but there was some outlying tumor still left - so we did CyberKnife with the seed markers he put in there. I took 3 treatments and we killed the tumor locally - did systemic chemo after that. I did all of the Avastin, Xeloda, and Folfox instead of Camptosar for about 9-months post-op.

Almost 2 years later (which is an indicator that your liver is clear of cancer), I've had no recurrence of Cancer in my liver, so I can tell you, that both of these procedures are WINNERS!

RFA and CyberKnife were the 1-2 Punch for me! I'm sure either or both of these would be good for your dad as well. If you don't find what you are looking for in your area, then remember DALLAS, - we are doing it here - and doing it RIGHT!

I hope this helps your decision making.

-Craig

johnsfo's picture
johnsfo
Posts: 47
Joined: Oct 2009

I had cyberknife treatments for met at the sacrum at the end of September. I had three sessions on consecutive days, each lasting about an hour. The three doses, I'm told, are the equivalent of 6 weeks of daily radiation treatments using traditional equipment (I had that in March and April). Cyberknife equipment can deliver such high doses because the focus is so precise that very little healthy tissue is exposed to the radiation. The procedure was pain free, and it seems to have reduced the severe pain I was having. My CEA dropped from 60 to 12 a few weeks after the treatments. All of that is info about a bone metastasis, but I hope it's still helpful.

John

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