CyberKnife Patient Guide

 

CyberKnife radiosurgery is a high-energy radiation treatment that delivers very precise beams of radiation from many angles outside the body. The accuracy of CyberKnife is so precise that radiation can be “matched” to the shape of small complex tumors, even those located near critical organs or those unreachable by conventional treatments such as surgery or external beam radiation methods.

As a CyberKnife patient, you benefit from

• No Incisions
• Ability to Return to Normal Activity Quickly
• No Stereotactic Head- Frame
• No recovery time
• Outpatient service
• Minimal side effects (if any)

Compared to other radiosurgical treatments, the CyberKnife offers several advantages to patients, including the ability to treat tumors anywhere in the body as well as using special techniques for treatment delivery. These advanced techniques allow treatments to be more accurate and less damaging to healthy tissue.

The number of treatments vary depending on the tumor size, location and shape but typically require one to five daily sessions. The CyberKnife allows patients to lie comfortably on the procedure table while the robotic arm moves, without touching them, to treat the entire targeted area with sub-millimeter accuracy. Treatments are performed on an outpatient basis, with each treatment lasting between 45 and 120 minutes.

CyberKnife treatment utilizes a team approach where medical experts collaborate with you to determine the plan of care. Team members may include a surgeon, radiation oncologist, medical oncologist, medical physicist, nurse, radiation therapist, and other team members. Your case may be reviewed at one of the Cancer Institute’s multidisciplinary conferences to determine the best treatment plan.

A very informative patient education video can be viewed online at www.cksociety.org. This video, found under the “CyberKnife Information” link, provides an overview of the technology, and the patient treatment process for all listed indications.

What happens after it is determined to proceed with CyberKnife treatment?
The CyberKnife nurse coordinator will make arrangements for the planning studies/services and verify your insurance coverage. (See section on Financial information). They will keep you informed regarding appointments and specific instructions regarding diet, medications, blood work or need for a driver. Let us know if you have concerns regarding pain, anxiety or other issues.

Studies/Services Needed Prior to CyberKnife Treatment(s)
Depending upon each patient’s case (area of treatment) the physician will need to order various studies/services prior to treatment. These will include imaging scans (CT, MRI, cisternogram/myelogram and/or PET) or possibly the placement of fiducial markers (3 to 4 small gold seeds).

The CyberKnife Experience in Review

• Initial consultation with CyberKnife trained physician(s).
• Confirmation of insurance coverage.
• Fiducial placement for body treatments if necessary.
• Setup involves creation of either a face mask or body mold by trained radiation therapists prior to CT imaging. On the day of setup come prepared to spend one to two hours.
• Radiology studies–CT imaging is the main planning tool; other studies may be required to give the highest quality of treatment planning.
• Treatment planning–This phase involves the physicians and medical physicists. Treatment planning can be simple or very complex depending on area of treatment, size, etc. and can take one or more weeks. The nurse coordinator will keep you informed and schedule the day(s) of actual treatment. We will do our best to work with you regarding dates and time for treatment(s).
• CyberKnife treatment(s)–May range from one to five daily sessions. Patients are invited to bring their favorite music on CD to listen to while undergoing treatment. Due to the unique image-guidance system patients may take breaks during treatment without interfering with treatment outcome.
• Follow-up–On the day of your last treatment, you will be given written post-CyberKnife instructions specific to your needs which will include physician visits and imaging studies.

Billing and Insurance
Insurance verification and approval will be obtained prior to scheduling all CyberKnife treatments. This process could take up to 30 business days depending upon your insurance. CyberKnife patients will receive separate billing statements for their course of treatment from the University of Tennessee Medical Center and from the physicians (radiation oncologist, neurosurgeon, radiologists). The hospital statements are for the technical and facility services and the physician statements are for the professional component of services. Patient’s financial responsibility will depend upon your individual insurance policy/plan. For example: If your insurance policy covers 90% you will be billed for remaining 10%. Please note this amount will vary case to case depending on the number of imaging studies ordered and number of treatments delivered.

For any billing questions please call

1. The University of Tennessee Medical Center Patient Accounts at 865.251.4400 for questions regarding your hospital statement.
2. Radiation Medicine Specialists – Contact Audrey Winters, 865.603.9554.
3. Surgeon or neurosurgeon – Please call the physician’s office with billing questions.
4. University Radiologists – Contact the business office at 865.584.7376.

For questions please contact the Nurse Coordinator at 305.6889.

Additional information on CyberKnife can be found at     
CyberKnife Society, www.cksociety.org
CyberKnife Patient Education Group, www.cyberknifesupport.org
Accuray Incorporated, www.accuray.com