Dr. John Adler CyberKnife
The cutting edge of surgical technology.
by Lauren Paul dated August 20, 1997
The scene: An ordinary medical treatment room, with a bed in the center. On the bed lay Mike Murray of Princeton, NJ, the first patient in the world to receive a brand-new type of high tech brain surgery. There were a few things that were strange about the setting. Murray was in street clothes, and conscious. And he was alone in the room-- except for a large, robotic machine that looked like it would be more at home on the set of Star Wars.
Behind a wall the team of doctors murmured excitedly. One sat at a computer console in front of a 3D image of the patient's head. The tumor-- the enemy-- was highlighted in red. A click of the mouse, and extremely high-powered X-rays were delivered through the snout of the machine, passing through the Murray's skin and skull into the tumor. Controlled by the same technology that guided Gulf War missiles, the CyberKnife system targeted the tumor, delivering precise doses of killing radiation.
After an hour, Murray got up, shook a few hands and left. Within 15 minutes, he was sitting outside at a restaurant, eating a cheeseburger and fries. "It felt like going to the moon and back," says Murray, 42, who had brain tumors related to von Hippel-Lindau Disease when he went under the CyberKnife last year. VHL is a rare inherited disorder characterized by the appearance of tumors in the cerebellum, eyes, kidneys and spine. Today the tumor is smaller. Murray's doctor has proclaimed the procedure an unqualified success.
Murray had been through it all before-- literally. In 1995 he was the first person ever to receive this type of treatment for a tumor lodged at the T-1 junction of his spine, a notoriously difficult place from which to remove a tumor. The chances for impairment, ranging from partial to total paralysis, resulting from removing the tumor were very high.
Murray was not willing to take that chance. Rendered blind by a series of surgeries to remove eye tumors from age 15 to age 25, he was unwilling to give up any more of his quality of life. Because the tumor was not malignant, there was time to consider other options.
Accustomed to taking charge of his own health, he did some research and found Dr. John Adler, an associate professor at Stanford University Medical Center, who was developing a noninvasive way to kill tumors with X-rays. Murray then put Dr. Adler in touch with an expert in military "vision" technology, Dr. Jim Berger of the David Sarnoff Research Center in Princeton.
Out of that collaboration, the CyberKnife was born. Technology that had helped missiles search and destroy was now being used to search and destroy tumors unreachable by a physical knife. Today, the CyberKnife is still classified by the Federal Drug Administration as an "investigational device," meaning it can only be used under strict protocols at designated beta sites. To date, approximately 30 patients have received the new-wave treatment, in most cases receiving hope where there was none. Because CyberKnife technology builds on a proven medical concept (i.e., that powerful X-rays kill tumors), it is likely to be approved for wider medical use within two-and-a-half years.
According to the statements above, CyberKnife was built on a proven medical concept that powerful X-rays kill tumors. Please note the words, "proven medical concept;" I think that the terms medically acceptable and proven medical concept are probably synonymous. I would like to point out that the proven medical concepts to which this statement refers are FSR and IMRT, the very treatments you say are experimental. The only explanation I can see for your continued delay in approving my treatment is that you believe my group coverage expires soon. If you can stall long enough, then the cost of my treatment will be someone else's responsibility. Totally disabled persons get 29 months of employer group insurance under COBRA, and I'm going to take advantage of every last month. I think it is unethical and probably discriminatory what you are doing to me, especially since many people have e-mailed me that BlueShield paid for their FSR or IMRT with no problem. What's wrong with your Review Board?
The CyberKnife may soon become the desired way to treat all tumors, not just those in the brain. "This is a flexible surgical tool to be used anywhere in the body," says Adler, who invented the CyberKnife concept. Certainly, the benefits over existing methods of brain surgery are clear. Previously, even in gamma knife, the most advanced form of brain surgery, the patient's head would have to be steadied by literally screwing a metal frame into the patient's skull. Needless to say, patients are thrilled by anything that lets them avoid that process.
Because there is no anesthesia and no surgical openings to heal, patients are out of the hospital the same day, eliminating the cost of a stay in the hospital. As for Mike Murray, the CyberKnife saved him from being robbed of his quality of life. And that's the kindest cut of all.
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