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Cyberknife on the kidney
merles
Posted: Saturday, October 18, 2008 5:17 PM
Joined: 10/10/2008
Posts: 3


Have other patients had Cyberknife treatment on the kidney and what was the success rate.  Did the SRS completely destroy the tumor.  Approximately how long does it take to shrink a large 5 cm tumor.   Has the Cyberknife treatment caused reduced kidney function.


radsrus
Posted: Sunday, October 19, 2008 12:18 PM
Joined: 10/10/2008
Posts: 4377


WE have only treated a relatively small number of patients with tumor in the kidney, but have been very successful without any significant loss of kidney function. Unfortunately, there are not any good studies as yet. There is a dose escalation trial being run at Baylor and Beth Israel. Time course of tumor response is not readily predictable.

 

Clinton A. Medbery, III, M.D.
St. Anthony Hospital Cyberknife Center
(405) 272-7311
buddy@swrads.org


 

Mail to:
Clinton A. Medbery, III, M.D.
Southwest Radiation Oncology
1011 N. Dewey Ave. #101
Oklahoma City, OK 73102


Dr. J
Posted: Sunday, October 19, 2008 9:46 PM
Joined: 10/11/2008
Posts: 1070


We have treated several as well with success going out around 2 years or so.

 

Jerome J. Spunberg, M.D., FACR, FACRO
CyberKnife Center of Palm Beach
jspunberg@radiationoncologyinstitute.com
(561) 799-2828

 

Radiation Oncology Institute
10335 N. Military Trail, Suite C
Palm Beach Gardens, FL 33410
(561) 624-1717


rena sudak
Posted: Monday, November 24, 2008 10:48 AM
Joined: 11/24/2008
Posts: 1


How helpful would cyberknife be for a 77 year old male heart patient, with stage 4 kidney cancer in the left kidney?  The cancer was discovered only on one kidney, but was inoperable because it was wrapped around the aorta and vena cava. 


AER2A

 


Dr. J
Posted: Wednesday, November 26, 2008 10:47 PM
Joined: 10/11/2008
Posts: 1070


Might be of some help, but mainly with palliative intent.  Have the films reviewed by a CK facility near you or one of us for an infomred opinion.

 

Jerome J. Spunberg, M.D., FACR, FACRO
CyberKnife Center of Palm Beach
jspunberg@radiationoncologyinstitute.com
(561) 799-2828

 

Radiation Oncology Institute
10335 N. Military Trail, Suite C
Palm Beach Gardens, FL 33410
(561) 624-1717


ata0
Posted: Tuesday, December 23, 2008 7:10 AM
Joined: 10/10/2008
Posts: 1


Following Cyberknife treatment, what is the expectation on kidney tumors? I'm post 3 months and it appears to have halted continued growth, but still there. Is it expected to die, shrink, etc.?
A.T.A.
radsrus
Posted: Tuesday, December 23, 2008 7:27 AM
Joined: 10/10/2008
Posts: 4377


Usually there is little change for several months,  then gradual shrinkage.


 

Clinton A. Medbery, III, M.D.
St. Anthony Hospital Cyberknife Center
(405) 272-7311
buddy@swrads.org

Mail to:
Clinton A. Medbery, III, M.D.
Southwest Radiation Oncology
1011 N. Dewey Ave. #101
Oklahoma City, OK 73102

 


Dr. J
Posted: Thursday, December 25, 2008 7:07 AM
Joined: 10/11/2008
Posts: 1070


Often that can be the case, but stabilization (no growth) over an extended period of time is OK too, so long as there is no progression.  Just because it does not shrink on scans does not mean that it is metabolically active.



 

Jerome J. Spunberg, M.D., FACR, FACRO
CyberKnife Center of Palm Beach
jspunberg@radiationoncologyinstitute.com
(561) 799-2828

 

Radiation Oncology Institute
10335 N. Military Trail, Suite C
Palm Beach Gardens, FL 33410
(561) 624-1717


Jat
Posted: Monday, February 16, 2009 7:01 AM
Joined: 2/16/2009
Posts: 1


My name is Jim.

Can someone help me with information re 6cm upper polar renal mass/tumor.  Is Cyberknife an appropriate therapy for this type of mass.  Thanks.  Jim 


radsrus
Posted: Monday, February 16, 2009 7:17 AM
Joined: 10/10/2008
Posts: 4377


Possibly. We still recommend surgery for people who can have it, but CK has been used successfully for kidney tumors in patients who cannot tolerate surgery for some reason or who refuse surgery. A biopsy will be needed if surgery is not to be performed.


 

Clinton A. Medbery, III, M.D.
St. Anthony Hospital Cyberknife Center
(405) 272-7311
buddy@swrads.org

Mail to:
Clinton A. Medbery, III, M.D.
Southwest Radiation Oncology
1011 N. Dewey Ave. #101
Oklahoma City, OK 73102

 


Rosaleen
Posted: Friday, March 20, 2009 5:57 PM
Joined: 3/20/2009
Posts: 2


Hi, my question is a bit like Jim's from Feb. 16. 

Let me start with the statement that I have had several bad experiences with hospitals and procedures.  I've been told that I have adhesions from past surgeries, including a C-section, 33 years ago.  Adhesions can make further surgeries, especially laparoscopies, more difficult, if I understand correctly.

Now I have a "large 7 cm mass" on my left kidney.  The MRI report says some benign and some cancerous etiologies, also, that this mass seems to be adrenal in origin with clean margins between the mass and the kidney.  I will not consent to a laparotomy and really prefer to avoid a laparoscopy, if possible.  The Cyberknife is written up as appropriate for "surgeries" on hard to reach areas, including the kidney.  I would expect, by extension, that it is appropriate for adrenal surgery, as well.  Can the Cyberknife system work for me, and do I have a prayer of finding a Cyberknife surgeon who will treat me?  While the up-front literature touts this technique as suitable for non-cancerous tumors, I am not finding much encouragement in available information on any but the most difficult cases or ones considered otherwise inoperable.

Thanks, in advance,

Rosaleen



Rosaleen
radsrus
Posted: Friday, March 20, 2009 8:14 PM
Joined: 10/10/2008
Posts: 4377


We are not limited to the most difficult or inoperable cases, although we can often do things that can't be done otherwise. THe first order of business is to get a diagnosis. A needle biopsy should be possible. 7 cm is a large tumor. It could be treated with CK, but would not have nearly the chance of taking care of a primary tumor of that size compared with surgery. If this is a primary adrenal tumor that is malignant, then please consider surgery. I understand your reluctance fully, but you should not let fear cause your death from an uncontrolled cancer. If this is adrenal, then it might be approachable without even entering the peritoneal cavity, making adhesions unimportant. I don't know if that is possible with your tumor, but you might seek several surgical consultations, including a large center or two.

 

Clinton A. Medbery, III, M.D.
St. Anthony Hospital Cyberknife Center
(405) 272-7311
buddy@swrads.org

Mail to:
Clinton A. Medbery, III, M.D.
Southwest Radiation Oncology
1011 N. Dewey Ave. #101
Oklahoma City, OK 73102

 


Rosaleen
Posted: Saturday, March 21, 2009 1:20 AM
Joined: 3/20/2009
Posts: 2


Thanks for your input. I have not so much fear as total disgust with what I have seen and experienced, plus experiencing that the body is never the same once disturbed.  I have contacted two large, reputable centers in a nearby major city.  I am not willing to go to the local hospital where I have witnessed far too much incompetence and total disregard for personal dignity.  I anticipate return messages to my inquiries early next week from the offices of  both a surgeon experienced with CK and one who is experienced with robotic laparoscopy.  My insurance will cover me nationwide, so I am not unwilling to travel to someone who inspires my confidence.

Rosaleen



Rosaleen
Dr. J
Posted: Saturday, March 21, 2009 7:23 AM
Joined: 10/11/2008
Posts: 1070


Surgery will most likely prove to be the better option for a tumor of this size.  CK may be worth exploring but ultimately, for a suitable surgical candidate, that would be the better choice.

 

Jerome J. Spunberg, M.D., FACR, FACRO
CyberKnife Center of Palm Beach
jspunberg@radiationoncologyinstitute.com
(561) 799-2828

 

Radiation Oncology Institute
10335 N. Military Trail, Suite C
Palm Beach Gardens, FL 33410
(561) 624-1717


radsrus
Posted: Saturday, March 21, 2009 7:42 AM
Joined: 10/10/2008
Posts: 4377


Sounds like you have a good plan.

 

Clinton A. Medbery, III, M.D.
St. Anthony Hospital Cyberknife Center
(405) 272-7311
buddy@swrads.org

Mail to:
Clinton A. Medbery, III, M.D.
Southwest Radiation Oncology
1011 N. Dewey Ave. #101
Oklahoma City, OK 73102

 


kiran
Posted: Thursday, April 16, 2009 8:37 PM
Joined: 4/16/2009
Posts: 3


hi,i am here to put forward my aunt's case.i would like to know if cyberknife would be any helpful.
      My aunt,45 years old,was diagnosed with a large mass(14cm * 16cm* 18cm) found on upper right kidney.Tests revealed it was a primitive neuroectodermal tumor but still there was some doubt about it being a PNET or Ewing's sarcoma.They proceeded to remove the tumor surgically,but due to some complications during the procedure,they were only able to remove the 90% of the mass.
   It has been nearly two months after surgery,but still doctors are yet to begin treatment.latest ct scans reveal the left over mass to be of size of around 2cm *3cm *4cm.Recently we heard about cyberknife technology,can it be any useful?

radsrus
Posted: Friday, April 17, 2009 3:15 AM
Joined: 10/10/2008
Posts: 4377


Possibly, but the more urgent question is why have they not started any other treatment? Have there been complications? In most cases, depending on the details, this would be treated with chemotherapy and probably standard radiation to the entire resection area. CK could be used if that is not completely successful.

 

Clinton A. Medbery, III, M.D.
St. Anthony Hospital Cyberknife Center
(405) 272-7311
buddy@swrads.org

Mail to:
Clinton A. Medbery, III, M.D.
Southwest Radiation Oncology
1011 N. Dewey Ave. #101
Oklahoma City, OK 73102

 


kiran
Posted: Friday, April 17, 2009 10:22 AM
Joined: 4/16/2009
Posts: 3


Thank you for replying.
I am not sure if the complications that occurred during the surgery was due to some biological reason or due to incompetence of the doctor.As far as I know,during the procedure there was lots of blood loss and this was the reason why they were not able to completely remove the tumor.
I would like to ask a question.Is PNET a malignant tumor?What would you suggest for the treatment?
latest ct scans reveal that it has not spread anywhere else.Does removing the left over mass alone solve the problem once and for all?

radsrus
Posted: Friday, April 17, 2009 10:46 AM
Joined: 10/10/2008
Posts: 4377


It is always difficult to remove a tumor that large. PNET is malignant. Both PNET and Ewings' sarcoma require chemotherapy and local radiation in most cases. How old is she? Surgery will not be sufficient.

 

Clinton A. Medbery, III, M.D.
St. Anthony Hospital Cyberknife Center
(405) 272-7311
buddy@swrads.org

Mail to:
Clinton A. Medbery, III, M.D.
Southwest Radiation Oncology
1011 N. Dewey Ave. #101
Oklahoma City, OK 73102

 


kiran
Posted: Monday, July 06, 2009 5:46 PM
Joined: 4/16/2009
Posts: 3


thank you for your reply....
  as you suggested, she underwent chemo and had three rounds of chemotherapy. But latest scans reveal that the chemo has not affected the tumor that well.a very small portion of the tumor has been shrunk. doctors are now gearing up for the cyberknife treatment.what would your suggestion be at the moment?you think cyberknife will be helpful?

radsrus
Posted: Tuesday, July 07, 2009 4:01 AM
Joined: 10/10/2008
Posts: 4377


Likely it will be, but it is difficult to predict without having seen the scans. It certainly sounds like a very reasonable approach.

 

Clinton A. Medbery, III, M.D.
St. Anthony Hospital Cyberknife Center
(405) 272-7311
buddy@swrads.org

Mail to:
Clinton A. Medbery, III, M.D.
Southwest Radiation Oncology
1011 N. Dewey Ave. #101
Oklahoma City, OK 73102

 


Sanjeev
Posted: Friday, February 15, 2013 4:00 AM
Joined: 2/15/2013
Posts: 1


My Brother in law  (Male 36)  is suffering from VHL Disease & have been recently operated for Brain Tumor of left cerebellar SOL ? hemangoblastoma, He also have multiple hyper vascular lesions in both kidneys,  The right kidney had two lesions measuring 3 X 2.6 X 3cm & 3 X 3 X 3.3cm while left kidney had one lesions measuring 4 X 3 X 3cm. The same was diagnosis during Brain tumor operation.

 Doctor have planned Target Therapy to shrink the tumors and make it opera table  by way of Chemo (Sorafenib - Oral take) 800mg daily and after 2 cycle the size had reduces.
Overall size of both the tumors in kidney is reduced by 30%. Old size of Right kidney was 3 X 2.6 X 3cm & 3 X 3 X 3.3cm., respectively, After the post target therapy the size has shrink to 2.2 X 3.2cm & 2.1 X 1.5cm respectively. While left kidney, the size has reduced to 1.6 X 2.3cm from 4 x 3 x 3cm. (2 months drug trial) The panel of doctors have decided  to continue with drugs for 2 months (2 more cycles), bcoz they are not satisfied with the results and are expecting more results to save maximum nephrons and i know they are trying their best. Since drugs have more side effects on his body we have no option left and to continue the same. He is tired of taking drugs.

Doctors have planned Nephrons Sparing Surgery for Left Kidney and if it is successful then they will go for Radical Nephrectomy for Right Kidney after evaluating of 2 cycles of chemo through MRI by 15 March  2013. Will  CK can  benefit him ? 
EDUARDO J
Posted: Thursday, June 19, 2014 6:08 AM
Joined: 2/19/2014
Posts: 3


Hi, my father has a 7cm mass in his right kidney close to the vein and collection ducts. He is 85 years and surgery is not an option because of his health. Is Cyberknife a good alternative for him? Thanks for your help. EDUARDO J

EDUARDO J
radsrus
Posted: Friday, June 20, 2014 6:41 PM
Joined: 10/10/2008
Posts: 4377


Possibly, although that is pretty large. Get a CK center to take a look

 

Clinton A. Medbery, III, M.D.
St. Anthony Hospital Cyberknife Center
(405) 272-7311
buddy@swrads.org

Mail to:
Clinton A. Medbery, III, M.D.
Southwest Radiation Oncology
1011 N. Dewey Ave. #101
Oklahoma City, OK 73102

 


Vincy Mol
Posted: Monday, July 24, 2017 3:42 AM
Joined: 7/24/2017
Posts: 1


A tumor in or near the kidneys can move as you breathe, making it difficult to accurately target with standard radiation. As a result, the tumor may not receive enough radiation and healthy tissue near the tumor may be damaged. Assignment help
 

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