Cyberknife of Long Island Destroys Tumors Non-Invasively using Radiosurgery

Powerful new approach for the treatment of tumors without cutting or anesthesia

(Huntington, NY) – Cyberknife of Long Island has become the first cancer center in New York to treat tumors with the most advanced radiosurgery technology available to date.  The newest generation of the Cyberknife by Accuray offers unprecedented capabilities and renewed hope to cancer patients.  "Cyberknife of Long Island is proud to continue delivering on its promise to provide the highest quality, most advanced cancer treatment in the region with the addition of the CyberKnife System," said Jeffrey Musmacher, Chief Operating Officer at North Shore Radiation Therapy, the parent company of Cyberknife of Long Island.  "With this new image-guided robotic technology, we are able to treat those whose tumors were previously thought to be inoperable and untreatable."

North Shore Radiation Therapy has installed the most-advanced version of the system in their New York office located in Smithtown. 

"This technology will offer a new treatment option that revolutionizes cancer treatment in the region," said Richard Byrnes, MD, the center’s Medical Director.  "The advanced technology behind CyberKnife uses real time image guidance technology and computer controlled robotics to deliver an extremely precise dose of radiation to the tumor, avoiding the surrounding healthy tissue and adjusting for patient and tumor movement during treatment."

"The procedure requires no anesthesia, as the treatment is painless and non-invasive." said Maged Ghaly, MD, a Radiation Oncologist at Cyberknife of Long Island.  “The machine's robotic arm works continually with image guided technology and has the ability to move in three dimensions according to the treatment plan.”

The treatment has a higher rate of success with small tumors, and generally lasts between 30 to 90 minutes involving administration of 100-200 radiation beams delivered from different directions each lasting 10 to 15 seconds

"Other stereotactic systems, such as the Gamma Knife, treat only the brain and require that the patient be fitted with a rigid frame screwed into the skull.  The Cyberknife uses a frameless system, and can treat tumors throughout the body with a accuracy of less than 0.5 millimeters” said Heather Zinkin, MD, Radiation Oncologist.

This treatment can also successfully treat lung cancers and other cancers that are in areas that move involuntarily - like in the respiratory or digestive system.

"These treatments are out-patient procedures, ranging from five to as little as one visit, allowing patients to continue their normal activities," Ghaly said.

There are about 150 CyberKnife systems around the world, the one at Cyberknife of Long Island being the most advanced.

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North Shore Radiation Therapy in New York Performing 4-Dimensional CAT Scan Simulations

Powerful new approach for the accurate treatment of cancer using radiation therapy

(Huntington, NY) - With 4-Dimensional CAT scan treatment planning, physicians are able to obtain a CAT scan while the patient breathes and then analyze the movement of a tumor and/or normal tissue inside the body. According to Richard Byrnes, MD, Medical Director of North Shore Radiation Therapy, "We can no longer look at a regular CT image and believe that the tumor is totally static. Depending on the position of the tumor, it has been clearly demonstrated that breathing can impact its position, and we now have the technology to identify these movements which allows us greatly improved accuracy in our treatments.”

Diverse imaging technologies are necessary for optimum treatment of cancers. The first step in preparing a patient for radiation treatment is called the treatment simulation. This process is usually accomplished using fluoroscopy or CT scan (CAT scan), where a patient’s tumor is localized, and marks are placed on the body for daily treatment set up. After simulation, treatment-planning computers are used to map out the radiation dose in and around the tumor, using information acquired by the CAT scan and other imaging studies such as PET scans and MRI. Although significant accuracy has been achieved over the past five years, the images are only a snapshot in time, and do not account for normal internal organ motion.

Tumors in the chest and abdomen move with respiration and are good candidates for 4D CAT scan simulation. “Physicians have learned that a tumor in the abdomen or chest moves with respiration in all directions. The range could be as large as 2 cm-3 cm, which is very significant in terms of planning”, notes Heather Zinkin, MD, of North Shore Radiation Therapy in New York.

GE Healthcare's Advantage 4D CT with Varian Medical Systems' respiratory gating system has significantly impacted radiation therapy planning. These new technologies allow the physician to directly visualize tumor motion. This information is used to construct a more precise treatment plan, avoid tumor misses and minimize the amount of normal tissue in the radiation field.

“Typically this type of technology has been introduced at larger university hospitals”, says Jeffrey Musmacher, Chief Operating Officer, “We are proud to offer this to our community and integration with other technologies such as Rapid Arc”.

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North Shore Radiation Therapy is First to Treat Breast Cancer on Long Island with the Contura Applicator

Powerful new approach for the treatment of breast cancer in only five days using radiation therapy

Huntington, New York -- 07/29/2008 -- North Shore Radiation Therapy has become the first cancer center on Long Island for breast cancer treatment with a revolutionary new technique using the Contura device from Senorx.

The Contura Brachytherapy procedure is a partial-breast radiation treatment that allows breast cancer patients requiring radiation therapy after a lumpectomy to be treated in five days, rather than six to seven weeks for whole-breast irradiation.

“Brachytherapy is from the Greek word meaning ‘close’ or ‘internal,’ referring to a way of delivering treatment from inside rather than outside,” explained Maged Ghaly, M.D., “By targeting treatment from inside the breast, we can complete radiation treatment for the breast cancer in 5 days, allowing patients to return more quickly to their day-to-day lives.”

Radiation therapy is given to most patients who have a lumpectomy for breast cancer, to kill cancer cells or prevent them from reproducing or spreading, reducing the risk of recurrence. Whole breast irradiation uses a radiation source outside the body to treat the cancer site, typically involving daily treatments for six days per week over a six- to seven-week period.

Many breast cancer patients may be appropriate candidates for alternatives to whole breast radiation treatment known as partial breast irradiation or breast brachytherapy, a technique for delivering internally targeted radiation. Breast brachytherapy delivers radiation to the breast tissue surrounding the lumpectomy cavity rather than to the entire breast.

The Contura is a small balloon-based device implanted into the breast to treat the tissue surrounding the cavity left by lumpectomy surgery. After being inserted, the balloon is inflated and filled with saline; vacuum is used to help the balloon fit closely within the often irregularly shaped lumpectomy cavity. Then a radiation seed is sent through five separate “lumens” or channels inside the balloon, allowing the radiation dose to be “contoured” to reach the targeted area.

“The dose is directed by where the seed sits in the balloon, allowing us to concentrate the radiation dose on the tumor area,” explained Heather Zinkin, M.D. “If the seed were too close to the skin in channel one, we might place the seed in channels three or four for a longer time than in channel one.”

Before the introduction of Contura in 2007, balloon brachytherapy was available with only a single channel for delivery of the radiation seed. Some breast cancer patients who were possible candidates for the therapy were excluded because the location of the lesion relative to their breast size did not allow appropriate placement of the radiation seed to minimize radiation dose to the skin, chest wall or ribs.

Contura Multi-Lumen Balloon Brachytherapy was developed to address this problem by using five separate channels to place the radiation seed. It also employs vacuum suction to help the balloon fit closely within the often irregularly shaped lumpectomy cavity, so the targeted areas receive the prescribed therapeutic dose. This innovative method of breast cancer treatment has improved the delivery of the radiation to the breast cancer.

“The multiple channels of the Contura and its vacuum feature help the physician to shape or contour the radiation dose to obtain a more optimal result,” said Richard Byrnes, M.D., “We are able to better target the radiation to the areas in most need of treatment.”

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North Shore Radiation Therapy Offers Prostate Cancer Patients The Latest Tool For Precise Treatment

Image Guided Radiation Therapy (IGRT) For Prostate Cancer Available in New York

Huntington, NY -- April 17, 2008 -- Technology to deliver high dose radiotherapy for cancer treatment has constantly been improving and physicians continue to be faced with the difficulty of treating a moving target. Sophisticated techniques such as intensity modulated radiation therapy (IMRT) have been developed to produce highly conformal beams to minimize dose to healthy tissues. However, without accounting for organ motion, the benefits of these technologies cannot be realized. Radiation Oncologists at North Shore Radiation Therapy in New York are able to account for this motion.

The introduction of image guided radiation therapy, or IGRT, has revolutionized the delivery of modern day radiotherapy for prostate cancer. IGRT combines imaging with treatment delivery to provide up to real-time of the patient's organs in the treatment position, at the time of treatment, optimizing accuracy and precision. Organs including, but not limited to the lung, prostate and bladder tend to move as much as centimeters during the course of treatment and image guidance allows the physician to target and track tumors with pinpoint precision.

There are several techniques used to achieve image guided radiation therapy for prostate cancer. For some tumors, gold markers can be placed in the tumor. The patient is imaged daily prior to each radiation treatment. This is called on board imaging, or OBI. Patients who prefer not to have markers placed can be treated with other image guided techniques such as cone beam CT scan or ultrasound. In cone beam CT, the imager is rotated around the patient to quickly acquire a high-quality, low dose 3-D image of the tumor and surrounding anatomy. These 3-D images are compared to reference images from the treatment plan. Through 3-D image matching, which can be accomplished manually or automatically, shifts are calculated and the patient is moved into position for treatment. This technique is particularly useful for treatment sites that are far away from bony landmarks.

With the third technique, an ultrasound is performed daily prior to each treatment. The images are compared with reference images and the patient is shifted accordingly.

“Image guided radiation therapy allows physicians to treat with pinpoint accuracy diseases including brain tumors, prostate cancer, esophageal cancer, gastric cancer and spine tumors, as well as many others” stated Dr. Heather Zinkin, a board certified Radiation Oncologist at North Shore Radiation Therapy.

Their facilities house state of the art technology and patients can be treated using on board imaging, cone beam CT and ultrasound for high precision therapy.

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North Shore Radiation Therapy Opens on Long Island, Offers Cancer Patients Access to New, Advanced Cancer Treatments

Long Island, New York -- March 14, 2008 -- North Shore Radiation Therapy, formally known as North Shore Medical Accelerator, announced the opening of its new facility located in Huntington, NY, where they will provide the most technologically advanced cancer treatment available on Long Island, New York. After eight years of planning, design and construction, this premier Radiation Oncology practice in Suffolk County is now accepting patients. This new facility features a Varian Linear Accelerator that will allow physicians the ability to target tumors more accurately and adjust patients’ positioning prior to treatment, thus improving the precision and effectiveness of cancer treatments.

This new center is entirely electronic. All records are available to the physicians from any location. All x-rays are digital. “All patient treatments are computer guided for accuracy. North Shore Radiation Therapy physicians are on staff at Huntington Hospital, part of the North Shore Health System, on Long Island. They participate in cancer conferences, cancer committees and community programs. New in-patient and out-patient consultations are seen immediately” said Richard Byrnes, M.D., Medical Director.

This center offers:
• 4D CT Simulation – Using sophisticated cameras to “see” respiratory motion.
• IMRT – Technology that can modify the radiation during treatment to spare adjoining normal tissue and increase the dose to the tumor.
• IGRT – Radiation treatment guided by diagnostic images such as CT Scan.
• Rapid Arc – A major advance that allows improved dose control while significantly reducing treatment times.
• Stereotactic Radiosurgery
• Prostate Brachytherapy
• Skin Brachytherapy
• Rectal Brachytherapy
• Breast MammoSite

“We have raised the quality of radiation oncology services so needed in the Huntington community”, stated Jeffrey Musmacher, Director of Operations. “The strategic location of our radiation therapy facility in close proximity to North Shore – Long Island Jewish at Huntington Hospital will be convenient for physicians and patients alike”.