"You have 5 minutes to go, you're doing great, you're almost done."
The first reaction was, “Wow, this looks like something from Star Wars”
Very quickly, it became apparent that this could change the way we treat patients.
Now we could actually treat formerly untreatable conditions.
It’s the idea that one should do surgery in the least destructive way possible.
CyberKnife in itself represents one of the major advances in medicine over the last 50 years.
The CyberKnife was invented at Stanford by John Adler. John studied with Lars Leksell
in Sweden who introduced the invention of the Gamma Knife to Neurosurgery.
I was in Stockholm and caught up under the spell of Lars Leksell, and it seemed to me
that Leksell was describing the future of much of neurosurgery, and I just couldn't
get it out of my head.
This drawing was actually made in 1988 - it tried to depict my ideas for the core technologies
that would eventually become the CyberKnife.
The challenges of bringing a team together and finding the money to make it real was
just a huge, huge challenge. Perhaps most lucky of all was the ready proximity of people
who knew how to make linear accelerators.
The linear accelerator industry is based here in Silicon Valley, and it's an example of
Stanford's seminal role in creating modern radiotherapy.
This drawing was done in 1990. At this point, I decided that I had a small little linear
accelerator that I could detach to the robot, and it was clear that this was going to be
the final solution in terms of aiming the linear accelerator.
So this device right here is the heart of a linear accelerator. Electrons are injected
at one end, and at the other end, they can achieve the speed of light before hitting
a tungsten target, and this basic concept was created at Stanford.
At that point in time, we had been doing radiosurgery using a stereotactic head frame system, similar
to the Gamma Knife system in that it required rigid fixation
and a frame placement on our patients.
Instead of the frame which anchored to the patient's skull, I realized that with modern
technology, we would be able to target tissue anywhere in the body with computerized core
image correlation.
One of the advantages that the CyberKnife has over conventional radiation is that it’s
very precise. It has accuracy of less than a millimeter of error when delivering radiation.
We can also see the tumor better with improved imaging study and we can also be able to track
the tumor better. And because of that, we spare more of the normal tissue, and that
give us ability to give more intense radiation treatment over a shorter period of time. Which
really has revolutionized the way we treat the patient.
The standard radiation oncology treatment is six, seven, eight weeks of treatment. Now,
the CyberKnife showed that you could reduce these big, long radiation treatments to literally
a matter of a day or a few days.
It has the versatility of being able to treat structures outside the brain. And so, you
can treat the spine and also outside the central nervous system, you can treat prostate, lung,
abdominal and even cardiac problems.
The limits of the CyberKnife, I don’t think have been really, fully pushed.
The most cutting edge treatments on the horizon are treatments of things such as depression,
back pain, obsessive compulsive disorders,
and then certainly you can make the leap even beyond the realm of neurosciences.
The risk to innovate, the risk to think outside of the box - it's these sorts of thought processes
to think beyond really what is currently available, that really change the world.
I think the CyberKnife has shown us that it isn't just the magical nature of radiation
itself. It's the precision with which that radiation is administered. So what we've done
is we've taken Marie Curie's magical energy source, and we've made it precise for
the modern world and in doing so, I think, made something very, very special and almost
magical in its own way.