Advanced system offers ray of hope

PUBLISHED : Monday, 17 December, 2007, 12:00am
UPDATED : Monday, 17 December, 2007, 12:00am

CyberKnife allows patients to have painless and highly effective treatment on tumours that might otherwise be inoperable

When a young mother, who was dying of cancer, came to the Hong Kong Adventist Hospital even the most advanced anti-cancer weapon couldn't offer her the gift of life - but it was able to give her something almost as precious.

'She was in her 30s and she had advanced lung cancer,' said Victor Tsang Hing-yeung, the hospital's assistant clinical director, CyberKnife Centre. 'She had tried everything and she knew she was dying, but now she was losing her vision as well. It was a very sad case. The cancer had spread to the area around her eyes. She told us, 'My only hope now is that I don't want to die blind. I want to see my husband and I want to see my young daughter'.'

To save her sight, she was treated with the hospital's US$5million CyberKnife, a frameless robotic radiosurgery system able to non-invasively treat tumours anywhere in the body with sub-millimetre accuracy.

'She was able to retain her vision up to her death. She passed away still able to see her family,' said Dr Tsang, who has treated most of the 130 patients who have used the CyberKnife since it was installed at a total cost of HK$78million in September last year. 'It was a very touching experience.'

Dr Tsang explained that CyberKnife was a remarkable advance in radiosurgery, allowing patients to have painless and highly effective treatment on tumours that might otherwise be inoperable.

The treatment does not require anaesthesia and patients can return home or go back to work within two hours. Most patients are treated in one to five sessions. Using X-ray image cameras and computer technology, the treatment locates the tumour and a computer program determines the exact radiation strength required. A robotic arm delivers concentrated beams of radiation from multiple angles to the tumour, without damaging healthy surrounding tissue.

What it is not, however, is a wonder cure.

'This is not a machine from heaven. It is not a magic machine that will turn a dying patient into a picture of health. But it is equipment that can help many patients when there are no other options.'

The CyberKnife, combined with other recent advances in cancer treatment, means that doctors at the Adventist Hospital can now offer help to about 50 per cent of cancer patients who cannot be cured either because the cancer is too advanced or too severe.

'Ten years ago, when we were faced with that group of patients we basically had nothing to offer,' Dr Tsang said. 'But now, with newer technology and advances in chemotherapy and CyberKnife, although we cannot cure patients we can make them live longer - and live longer with a good quality of life.

'I had a middle-aged woman patient who had lung cancer. The disease had spread to the bones and the liver. Before, a patient in her condition would only live for three months. With chemotherapy she was rendered almost disease-free after six months of treatment.

'The only disease left was inside the lung, where the primary lesion was, and inside the bone area. Before, all we could have done was sit and wait for the cancer to come back. But this patient was then treated with CyberKnife and today, she is still disease free after 11/2 years.'

CyberKnife also helped an elderly patient, dying from lung cancer, who was in such severe pain that she needed high doses of morphine which left her semi-conscious and unable to speak.

'She was just lying there unable to communicate with her family who wanted to talk to their beloved mother,' Dr Tsang said. 'We treated her with CyberKnife for just three days. After that she was able to sit up and talk to her family and required no further pain medication for the remaining six or seven months that she lived.'

The Adventist Hospital's CyberKnife centre was established in 2006, and was the first of its kind in Hong Kong. There are already two existing centres and two more being set up in the mainland.

Tests in the US suggest CyberKnife could become a primary weapon in treating early prostate cancer - now the number four cancer among Hong Kong men - and that it may also be used increasingly to treat breast cancer.

Like all new medical technologies, CyberKnife is not inexpensive - a five-treatment session can cost around HK$170,000 - but Dr Tsang said: 'When patients reach a critical moment, they are at a point where money doesn't come into the equation at all.'