By William Magnuson, M.D.
Director, Stereotactic Ablative Body Radiotherapy (SABR)
Stereotactic Ablative Body Radiotherapy (SABR) delivered with CyberKnife is a form of treatment in which very high doses of radiotherapy can be delivered in a very precise, non-invasive and non-surgical fashion. The sub-millimeter accuracy of CyberKnife, which cannot be achieved with conventional radiotherapy, minimizes any damage that may occur to the surrounding lung tissues. Here are five things that you should know about early stage lung cancer detection, prognosis and treatment options:
1. Early detection is critical and possible with screening lung CT scans. The 5-year overall survival (odds of being alive 5 years after diagnosis) for early stage (stage I) lung cancer is as high as 80% in recent studies1. Unfortunately, 40% of patients diagnosed with lung cancer have metastatic disease (stage IV) when they first see a doctor and have a 5-year overall survival of less than 5%. The National Lung Cancer Screening Trial showed that patients at high risk for lung cancer who had screening lung CT scans (looking for lung cancer even if not having symptoms) had lower rates of death than patients who did not have screening lung CT scans. Please contact us immediately to schedule a screening lung CT scan if you or a loved one are age 55-74, have a history of smoking at least 30-pack years (number of packs per day x number of years smoked) and are still smoking or have quit smoking within the last 15 years. Early detection is crucial.
2. For many years, the standard of care treatment for early stage lung cancer was surgery. Before the invention of PET-CT scans and other non-invasive procedures to determine if there is involvement of the lymph nodes, surgery (lobectomy - where one of the lobes of the lung is removed) had the benefit of removing the tumor and determining whether or not the cancer had spread to the lymph nodes. However, due to the invasive nature of the surgery, a patient must undergo anesthesia and often must recover in the hospital for a week or more.
3. Clinical outcomes with SABR are similar to surgery, but with fewer side effects. While surgery has been the standard of care treatment, the technological advances seen with CyberKnife are quickly changing the paradigm. In a pooled analysis of randomized trials, the use of SABR had improved 3-year overall survival (95% vs. 79%) and a lower risk of major grade 3-4 side effects (44% vs. 10%).1
4. The CyberKnife is very convenient and more precise than other types of radiotherapy. Unlike surgery, which requires hospitalization and recovery time, the non-invasive nature of CyberKnife allows for outpatient treatments and an immediate return to your normal activities. Since the lung tumor will move while the patient breathes, a gold marker will be implanted into the tumor. During treatment, the CyberKnife tracks the movement of the marker to account for changes in the position of the tumor. The real-time tumor tracking and high degree of precision allows for a much smaller safety margin to be placed around the tumor, which results in less radiation to the surrounding healthy tissues compared to other treatment machines.
5. You will receive the level of expertise on par with major academic centers. As the only physician fellowship trained in Stereotactic Ablative Body Radiotherapy in the state of Alaska, I can provide you with the level of care and expertise that you would receive at major academic centers in the Lower 48. During my fellowship at Yale University, I completed over 350 cases of SRS and SABR while working with some of the world’s experts and learning the latest advances in Oncology. As a result of my extensive training, I can give a fair, objective recommendation backed by scientific data for the treatment that would be best for each individual patient.
1 Chang et al, Lancet Oncology, 2015.
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