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Cyberknife offers cutting edge cancer treatment

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By Barbara IsaacsHERALD-LEADER STAFF WRITERSome 240 separate intense beams of focused radiation targeted the cancer nestled next to Merle Clemons' spinal cord this morning.

The 78-year-old retired business and economics professor from Lexington spent an hour, motionless, as the latest in cancer radiation therapy worked to potentially destroy her tumor.

"It's a miracle -- a great innovation in medicine, I think," Clemons said, just moments after her second treatment using the CyberKnife Robotic Radiosurgery System. She'll get one more treatment Monday.

Clemons is the first person to receive the treatment in Kentucky. On Wednesday, Clemons was the first person to get the treatment at Central Baptist Hospital, but since then four other patients have been treated with the system.

Cancer radiation experts at Central Baptist expect to use it on between 100 and 200 patients during the next year.

Clemons said the the treatment was completely painless and she had noburning sensation either during the treatment or after. All she noticed was some fatigue, a common side effect of radiation therapy.

Clemons has a cancerous tumor about an inch wide next to her spinal cord -- a risky place to try to surgically remove it, said Dr. Alan Beckman, a radiation oncologist at Central Baptist Hospital.

Clemons was diagnosed with breast cancer in 1996, which was treated by removing the cancerous lump, followed by traditional radiation therapy. In December 2004, doctors found a cancerous lesion next to her spine.

But she soon reached her lifetime maximum of conventional radiation.

"There's only so much radiation that can be delivered that way," Beckman said. "There were no other good treatment options. It allowed us to safely re-treat her and give her the best chance or eradicating it entirely." In two to three months, doctors will evaluate how well the treatment worked for Clemons, but they feel there's a good chance the cancer will be gone and the area where it was turned to scar tissue.

This is definitely cutting edge -- and costly. Central Baptist paid $3.5 million for the CyberKnife machine and another $1 million for construction costs and infrastructure to install it, said Ruth Ann Childers, spokeswoman for Central Baptist Hospital.

So far, Central Baptist is the first in Kentucky to get the system. They are one of 39 U.S. medical centers currently using the system.

CyberKnife can be used on tumors anywhere in the body where radiation can be used. It's not just used for cancerous tumors, but also inoperable benign growths.

A key feature is its "real-time image guidance system," said Henrik Bacho, senior product manager for Accuray, the company that makes the CyberKnife system.

Before each of the 240 radiation beams that treated Clemons today were fired, an X-ray provided an instant image. The CyberKnife's robotic arm could adjust exactly -- to the fraction of a millimeter -- so radiation would strike the tumor directly.

A similar type of targeted radiosurgery, Gamma Knife surgery, is used at the University of Kentucky. But

Gamma Knife can only be used on the head and requires a metal frame that must be bolted to the skull. Other targeted radiation systems also exist, but they use images taken before the radiation sessions start, not images taken while the radiation is under way.

Real-time guidance is important, because no living person can lay perfectly motionless, Bacho said. It's also possible to treat lung tumors as they move while the person breathes.

"It uses tiny beams and lots of them, instead of the broad stroke with conventional radiation," Beckman said.

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