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Frequently Asked Questions About Knife-Less Surgery

What is radiotherapy?

Radiation therapy, or radiotherapy, is the use of high-energy radiation from X-rays, gamma rays, neutrons and other sources to destroy cancer cells and shrink tumors. Radiation may come from a machine outside the body (external-beam radiation therapy), or it may come from radioactive material placed in the body near cancer cells (internal radiation therapy, implant radiation or brachytherapy). Systemic radiation therapy uses a radioactive substance, such as a radiolabeled monoclonal antibody, that circulates throughout the body. Fractionated radiotherapy is administered in a series of treatment sessions over a specified period of time.

What is radiosurgery?

Radiosurgery is a radiation therapy procedure that uses a special system to precisely deliver a large radiation dose to a tumor over one to five treatment sessions. The goal of this non-invasive procedure is to destroy the target without surgery or harming nearby healthy tissue. It is used to treat various types of cancer, such as tumors in the brain, spine, lung, liver and prostate, as well as some other non-cancerous disorders. It also is called radiation surgery, stereotactic external-beam radiation, stereotactic radiation therapy, stereotactic radiosurgery and stereotaxic radiosurgery.

What is the difference between stereotactic radiosurgery and fractionated stereotactic radiotherapy?

Radiation treatment of a tumor can either be applied in a single session with a high dose of radiation, also known as stereotactic radiosurgery, or in a series of treatments over a period of time, known as fractionated stereotactic radiotherapy. Fractionated radiotherapy involves similar total doses of radiation as radiosurgery, but the radiation is delivered in smaller amounts. Fractionated stereotactic radiotherapy allows the healthy tissue to recover from the impact of the radiation before the next treatment session.

What is Novalis TxTM?

The Novalis TxTM platform for image-guided radiosurgery offers patients fast, accurate non-surgical treatments for cancer and other conditions in the brain, head, neck and body. Novalis Tx incorporates advanced imaging, treatment planning and treatment delivery technologies, enabling doctors to carry out highly precise, non-invasive image-guided radiosurgery procedures quickly and with great precision.

Image-guided radiosurgery involves quickly delivering precisely focused, high-energy radiation to a localized area to destroy tumors or to make other medical repairs that often cannot be addressed by conventional surgery, including some malignant and benign lesions, brain metastases, arteriovenous malformations and functional lesions.

Novalis Tx combines a powerful linear accelerator, which rotates around the patient to deliver treatment beams from virtually any angle with a set of advanced image guidance and motion management tools that guide patient set up, positioning and monitor motion during treatment. 

The system can deliver both stereotactic radiosurgery and fractionated stereotactic radiotherapy treatments. Unlike some systems, Novalis Tx can provide a very high number of fractions, which, studies have shown, are necessary for the best treatment of some tumors, protecting more healthy tissue. This is particularly true for tumors near auditory nerves, and the ability to spread the treatment over enough fractions can provide better treatment outcomes and preserve the patient's hearing.

What types of conditions can be treated with Novalis Tx?

Novalis Tx can be used to treat non-cancerous and cancerous conditions such as:

  • Arteriovenous malformations
  • Cavernous angiomas 
  • Trigeminal neuralgia 
  • Intractable seizures 
  • Parkinson's disease 
  • Brain metastases 
  • Low -and high-grade gliomas 
  • Vestibular schwanomas 
  • Uveal melanomas 
  • Neurofibromas  
  • Spinal tumors 
  • Lung tumors 
  • Liver tumors 
  • Prostate tumors

What are the benefits of treatment with Novalis Tx?

There are several benefits to this system:

  • It is extremely precise, minimizing radiation damage to normal tissue 
  • It ensures that the tumor or lesion receives even distribution of the prescribed radiation dose by shaping the beam to accurately match the outline of the tumor or lesion 
  • It is optimized to deliver radiosurgery in the shortest possible time, averaging 15 minutes, preventing errors due to minor movements during long treatments 
  • It is one of the most advanced technologies for radiation treatment available today 
  • It is non-invasive, with only minor incisions for cranial halo procedures 
  • It is painless, and treatment is usually performed on an outpatient basis

Why is fast treatment important?

There are two reasons why short treatment times can be important: treatment accuracy and patient comfort. The length of treatments with some devices can be extreme, lasting an hour or more, during which the patient must lie as still as possible. Prolonged treatment times can make the entire process even more stressful, and some physicians recommend practicing meditation during the procedure or even prescribe a sedative. Reducing the treatment time also minimizes the time where the patient may make small movements that can affect the overall accuracy of the treatment.

Novalis Tx is optimized for the fastest treatment delivery, improving both patient comfort and treatment accuracy.

What is the advantage of shaped beam radiosurgery?

Traditionally, circular beams are used for radiosurgery. The resulting dose of such an approach is a spherical dose volume. As most lesions are very irregular in shape, several of those spherical dose volumes have to be composed together to cover the complex tumor shape. This can result in lower than desired irradiation to parts of the tumor and higher than desired irradiation to healthy tissue. The Novalis Tx has the most precise beam-shaping technology available to avoid unneccessarily treating normal tissue.

What should I expect at my treatment session?

Your doctors will recommend the technique most appropriate for you depending on the size and location of your tumor. You do not need to bring special clothing or equipment to The Steeplechase Cancer Center for treatment.Patients receiving fractionated treatments will be asked to wear a face mask that contours to the exact shape of the patient's head. All patients will want to dress comfortably and bring a book or something else to keep you busy during any waiting periods that may be required. You also may bring a friend or a relative with you to stay with you during the day. However, during the actual treatment procedure, your companion will have to leave the treatment room. Please make sure to arrange for transportation home as you might feel tired after the treatment and driving is not recommended.

What effect is the radiation likely to have on my disease?

With radiosurgery and radiotherapy, high-energy radiation beams aim to destroy tumor cells by damaging the cells and causing them to die. Visible results, as seen on a follow-up scan, might include shrinkage of the tumor or the cessation of further tumor growth. Because cell destruction and the absorption of the cells within your system is a lengthy process, it can take up to six months before the effect of the treatment is visible on a follow-up image.

Will there be any side effects?

The procedure itself is not painful. Side effects that you might experience immediately following treatment include headache and dizziness. Your doctor will discuss with you specific side effects that may occur depending on your overall treatment plan.