Dr. Sinclair was first introduced to the CyberKnife when he did a fellowship at Stanford Medical Center in California. CyberKnife was invented at Stanford, so the neurosurgeon was one of the first to see the benefits of this frameless radiosurgery treatment.
When Dr. Sinclair was recruited to The Ottawa Hospital in 2005, he had hoped to bring this novel technology to patients here. At the time, it was a technology that wasn’t approved by Health Canada. So, Dr. Sinclair and his team made a case for robotic radiosurgery, presenting scientific data that validated its success.
The Ottawa Hospital was eventually one of two health research centres in Ontario allowed to test the CyberKnife. However, there was no government funding available to purchase the machine. The hospital appealed to the community, which pulled together and generously raised the entire $4 million to purchase it. CyberKnife began treating patients at The Ottawa Hospital in September 2010.
“Because it’s delivering a high dose, it’s considered similar to surgery without using a scalpel, so patients experience no blood loss, no pain, no ICU stay, or recovery time,” said Dr. Vimoj Nair, one of the radiation oncologists trained to prescribe CyberKnife treatment. “So CyberKnife radiosurgery does provide an option where people can be treated with outpatient techniques.”
With regular radiation, the daily doses were lower and patients had to come to the clinic for more radiation treatments overall. Regular radiation treatment could range from five to six weeks. With CyberKnife, radiation is focused precisely on the tumour, allowing larger doses to be given daily, therefore giving the total treatment in one to six days. The hospital’s CyberKnife has gained a reputation for improving treatment of various tumours. Dr. Nair said that because it is one of only three in Canada, patients from British Columbia to the Maritimes are occasionally referred to The Ottawa Hospital for treatment.
“At first, we would treat one tumour,” said Dr. Sinclair. “Now, we treat five or six individual tumours at a time and spare the rest of the brain. We’re sending radiation only to those metastatic tumours. There is a proportion of patients who develop cognitive problems a few months after whole-brain radiation. But with radiosurgery, because we give a higher dose of radiation only to the actual tumours, patients have improved outcomes, and so their quality of life is better.”
This has meant an increase in the number of patients having multiple tumours treated in the same session.
“Treating several tumours at once helps keep the patient’s clinic visits to a minimum,” said Radiation Therapist Julie Gratton, who has worked with CyberKnife since it was installed at The Ottawa Hospital. “Targeting individual tumours rather than treating the whole organ helps spare healthy tissues and reduce side effects.”