CyberKnife Technology Gives New Hope to Patients With Chronic Pain and Tumors

By Wendi Hope Bishop, Editor

A woman sips iced tea at a café. She is nestled into a corner table draped with white and blue cloth. Her friends and her exchange stories and laughs, taking a break from their shopping adventures. A full day of walking, standing and talking is behind her, and she anxiously waits for what the rest of the late afternoon holds for them.

This may seem like a typical scene. However, for Wanda Thrasher this feels like a dream. After living for almost two decades with severe pain, the CyberKnife® team at the University of Tennessee Medical Center rescued Thrasher from her chronic pain that she could never fully endure.

Sixty-four year old Thrasher suffered severe injuries in a car accident caused by a drunk driver in 1986. The other car struck Thrasher’s vehicle, spinning it around in the road approximately three times. Her car was totaled. She suffered from a broken neck, broken jaw, head trauma from being struck in the back of the head, damage to a nerve in her brain and seven ruptured discs. The head trauma caused trigeminal neuralgia – pain of a nerve in the fifth cranial or trigeminus nerve. Trigeminal neuralgia is a disorder characterized by repeated episodes of severe facial pain. The pain can be localized over either side of the face and affects one or more of the divisions of the trigeminal nerve. The intense pain experienced by the patient is triggered by touching specific skin areas with cold air or activities such as chewing, talking, swallowing, etc.

This would disrupt Thrasher’s life until 2005.

Thrasher was swollen all over and forced to live with the pain for approximately 10 months before anyone was able to help her. She relied on many medications over the years, but these only slightly eased the pain. (Patients with trigeminal neuralgia often are treated with anti-seizure medications that sometimes have debilitating side effects.) The medications would allow her to be OK for a short while, but when the pain hit, she said it, “blew her away.” She was unable to perform everyday tasks and live her life once the pain began. “I couldn’t even go out in the cold,” Thrasher explains. “I used to have to hold a scarf or my hand or something over my mouth because the cold would hurt so badly. I couldn’t go outside, and sometimes inside was too bad as well. It was embarrassing to me.”

Thrasher was worried about her options. Doctors had suggested brain surgery, which scared her even more than the pain and medications. Eventually, a solution came together. Thrasher’s oldest son Jerry discussed the problem with his coworker, the wife of Reid Webb, department manager of radiation oncology at UT Medical Center, who suggested the CyberKnife treatment.

CyberKnife is a new state-of-the-art technology offered exclusively at UT Medical Center, the only one of its kind in the area. This non-invasive, image guided, high-energy radiation treatment often is used for tumors and is capable of treatment throughout the entire body.

CyberKnife brings many patients new hope. Its name stems from having the precision of an operating table. It delivers precise beams of radiation from many angles outside the body without requiring the use of a metal head frame. The accuracy is so precise, in fact, that radiation can be matched to the shape of small complex tumors – even those close to critical organs. This technology is able to treat many lesions, even those that are considered inoperable or untreatable with surgery or other options.

Terri McDonald, a nurse specialist in radiation therapy at UT Medical Center, was able to get Thrasher in quickly at the beginning of 2005 and begin her treatment with the CyberKnife team. The CyberKnife Center at UT Medical Center was the 23rd center established in the United States, and its team consists of highly skilled professionals including radiation oncologists, neurosurgeons, surgeons, physicists, radiation therapists and nurses to ensure the best patient-centered care.

Although the machine allows for patient movement, to limit the need to move around, Thrasher’s arms were wrapped to her body for her own comfort and a mask was placed over her face. Once she lay down and was comfortable, a lightweight radiation system, mounted on a flexible robotic arm, began taking images. The image-guidance system utilizes bony landmarks or implanted markers to track the exact location of the tumor during treatment. This system ensures precise, accurate radiation delivery. “Some patients cannot have other treatment or their only other option is surgery,” states McDonald.

The procedure took approximately one hour and 30 minutes, although Thrasher says it didn’t seem that long. “I felt relief right on the table,” she exclaims. The first question she was asked was, “Do you have any pain or numbness?” Astonished, she simply replied, “I have none.”

Without any incision, Thrasher’s treatment had been a success, and she actually could start thinking about a life with no more pain. “Before I went in, I was on several medications and still was in tremendous pain. No incisions and no blood. It’s a miracle in my life. God has blessed me,” she smiles while looking up.

Although the CyberKnife technology was not intended to be a quick cure, it has seen its share of success. As of May 2005, the UT Medical Center performed almost 40 CyberKnife processes since its installation in January. Typically, a patient will have some relief of his symptoms within two weeks but some people such as Thrasher feel relief faster. “It’s very gratifying to see such immediate pain relief in a patient who has had such debilitating pain for 20 years,” states Dr. Dan Green, physician of radiation oncology at UT Medical Center. An estimated 80 percent of Tennessee patients treated with CyberKnife is expected to experience substantial and long-term pain relief. Pain relief may be substantially faster than other forms of radiosurgery, according to the CyberKnife Society.

The CyberKnife system is unique in that it is a painless treatment, it corrects for patient movement, does not require a rigid metal head frame, can treat anywhere on the body and is an outpatient procedure, eliminating the risk of complications and lengthy recovery time associated with traditional surgery. “I was able to get up and go home,” Thrasher proudly states. “The whole CyberKnife team was just so awesome to me. Even now, Terri still continues to call to check up on me!”

Thrasher now enjoys every day to the fullest. She spends time with her two sons, two daughter in-laws and three granddaughters. Her extremely energetic Pomeranian dog, Pooh, also keeps her running around. She is very active in her church and speaks regularly at a women’s group as well as at other churches. “I had pain all of the time,” she says. “Now, my whole life has changed as well as my family’s life.”