CyberKnife represents the next frontier of medicine … and private/public partnerships

Dr. Shaio Woo with CyberKnife.

The high-tech race between hospital groups just got more aggressive with the arrival of CyberKnife, a non-invasive radial surgery system advocates say is the most precise in this market.

Beyond technology, though, CyberKnife also may represent a new model for health care. The $6 million project is a partnership between CyberKnife of Louisville private investors, Nashville, Tenn.-based U.S. Radiosurgery, which operates 15 other CyberKnife units, local investors and the University of Louisville.

And the arrival of CyberKnife here definitely represents the victory of resoluteness over skepticism, with it taking years to get the project done.

A project that started back in 2008, CyberKnife is finally going live, scheduled to treat its first patients tomorrow, Wed., Oct. 24, said Dr. Shaio Woo, chairman of the Deparment of Radiation Oncology at the University of Louisville’s James Graham Brown Cancer Center.

Those patients will walk into a room at Brown Cancer Center and see a large, Jetsons-like white device with calming blue accents.

CyberKnife looks like a giant assembly-line robot, not unlike the robots that assemble cars at high-tech auto manufacturers.

Which is exactly the case, said Woo. CyberKnife is part precision German robotic technology adapted from the auto industry, and part American radiation technology.

Robotics, lasers and conventional cameras “synchronize with the movement of the person” as the patient breaths or squirms a bit, Woo said.

In addition, this latest version of the 22-year-old technology has lens-like devices that tightly focus the radiation beam only on a tumor or cancer without affecting healthy tissue.

The combination of the lens and the synchronization creates a giant gun that Woo says doesn’t miss.

“This is no shotgun” Woo said. “This is more like a rifle.”

Smiling, he added, “It’s cool!”

Insider Louisville and every other media outlet has made much of the fact CyberKnife has come to Louisville, though Lexington, Ky. already has one.

And Woo makes clear that CyberKnife is one of several physician options at Brown Cancer Center.

CyberKnife overlaps with other therapies and equipment at Brown Cancer Center, including TrueBeam radiotherapy system. The TrueBeam system uses imaging and motion-management technology to compensate for movement, as well.

All have their particular advantages, “and sometimes, it comes down to patient preference,” Woo said.

Lens-like devices focus radiation.

But Woo and others say CyberKnife technology has a big advantage in only requiring a limited number of treatments, at most five. Because stereotactic radiosurgery focuses radiation on a tiny area, higher doses of radiation can be delivered, with fewer individual treatments required, he said.

(Insider Louisville has calls into other area cancer centers for comment.)

Overlooked by the conventional media is that CyberKnife also is a victory for the entrepreneurial vision of health care – public/private partnerships putting expensive equipment into facilities that might not otherwise be able to budget for such a large investment.

(Just renovating the space in the basement of the Brown Cancer Center, then installing the CyberKnife gadgetry cost about $1 million, Woo said.)

Investor Steve Bass and oncologist Dr. Bobby Baker, a Louisville native who practices in Hawaii, have spent five years trying to persuade investors and hospital administrators of the merits of CyberKnife.

Initially, they got a lot of push back.

A 2008 story in Business First quoted a doctor at, ironically, Brown Cancer Center calling CyberKnife “a very clever machine. But it just doesn’t do anything that isn’t already capable of being done with what we currently have on the marketplace.”

Baker and Bass persisted, going through years of steps to get a state certificate of need during a time of changing Kentucky medical certification rules, then a false start with a plan to build a building on Dutchmans Lane before finding a hospital system with which to collaborate.

“It was a three-year march,” Bass said.

Ultimately, they were able to convince the skeptics and enter an actual partnership with U of L. The turning point, according to Bass, was the arrival at U of L of the Stanford University Medical Center-educated Woo, who embraced the CyberKnife technology.

“To be honest I think (the partnership) is quite unusual due to the fact the hospitals are so protective,” Bass said. “But we all feel having this new technology offered exclusively at Brown Cancer is a very exciting partnership.”

“I believe U of L Healthcare felt that this particular model just made good sense in their continuing efforts to offer the very best in cancer treatment in the metro area.

“Is this the right project at the right hospital?” Bass added.

“There’s not a doubt in my mind.”