Radiation Oncology


What to Expect During CyberKnife® Treatment

Patients who choose CyberKnife at Pennsylvania Hospital can expect an organized approach to their cancer treatment.

  • CyberKnife® is located within the radiation oncology department at Pennsylvania Hospital on the Ground Floor of the Widener Building.

  • Patients receiving CyberKnife® treatment wait in the newly constructed and furnished waiting room.

  • Medical physicists and dosimetrists (pictured) collaborate with the radiation oncologist during treatment planning to prepare the technical aspects of CyberKnife® treatment.

  • After a treatment plan is finalized by the radiation oncology team, a radiation therapist (pictured) administers the Cyberknife® treatment prescribed by the radiation oncologist.

  • One of the key elements of the CyberKnife® system, is a compact linear accelerator mounted on a multi-jointed robotic manipulator (pictured with James K. Kolker, MD). This dynamic device delivers high precision radiation therapy from virtually any angle.

  • The CyberKnife® suite is equipped with the RoboCouch® Patient Positioning System. The world's most advanced positioning system, RoboCouch automatically controls the precise positioning of the body to guarantee the exact dosage of radiation.

  • Diagnostic X-ray sources are mounted in the ceilings of the CyberKnife® suite. Throughout treatment, these low-energy x-ray sources create high resolution images to ensure real-time patient positioning and target location.

  • A collimator is a special device that controls the flow of particle beams. The Xchange® Robotic Collimator Changer exchanges collimators robotically to increase efficiency.

Patient Navigation

The CyberKnife program coordinator assists patients at every stage of their CyberKnife treatment, from consultation through post-treatment.

Consult Visit

Patients being considered for CyberKnife treatment meet with a physician within a week of making the initial call. During this meeting, the physician reviews the case and develops a care plan that addresses the best way to treat the cancer. The plan may include CyberKnife treatment alone, CyberKnife in conjunction with other techniques or a different treatment option. If CyberKnife therapy is chosen and approved, the doctors and physicists at Penn Radiation Oncology develop an individualized treatment plan for the patient.

CT Simulation

During the CT simulation, the radiation oncologist obtains a 3-D picture of the patient's tumor using CT, MRI or PET scanning. This information is used to reconstruct the tumor and the adjacent normal structures, allowing for accurate and precise dose targeting to the tumor and projection of normal tissues. In some cases, patients may require an outpatient procedure to place fiducial seeds (gold seeds) prior to CT simulation. These seeds help the CyberKnife track the actual movement of the target area.

Prior to starting radiation therapy, patients participate in a "dry run." The dry run usually takes place in the actual treatment room and all aspects of the patient's prescribed treatment are checked for accuracy.

CyberKnife treatments typically start five to ten days following treatment planning.

Treatment Sessions

CyberKnife treatments last an hour to two hours based on the type of tumor being treated. Because CyberKnife delivers precise radiation to the tumor, treatment can be completed in one to five days. The frequency of treatments depends on the type of tumor and where the tumor is located. Unlike some other types of radiation therapy, patients can receive multiple treatments or can have their cancer retreated with CyberKnife.


Cancer treatment can be both scary and confusing. Penn Radiation Oncology's social workers help make the process easier for patients and their families. Social workers serve as educators, navigators, coordinators and advocates for patients receiving radiation therapy. Social workers strive to help patients cope with these emotions in a variety of ways:

  • Providing information that leads to a better understanding of their diagnosis and treatments
  • Helping patients apply for programs that offer financial assistance
  • Referring patients to counseling and educational programs
  • Providing access to a wide range of support groups
Follow up

At the completion of their CyberKnife treatment, patients are scheduled for a follow-up visit with their radiation oncologist. During this appointment, they are encouraged to talk about any problems they are experiencing with pain or symptom management. Patients are also encouraged to discuss any other challenges they are experiencing (emotional, social, work/life) as a result of their diagnosis or treatment. The follow up typically takes place a month after treatment ends.

Most patients experience minimal or no short-term side effects from CyberKnife treatment and often recover quickly. Depending on the treatment site, some patient's may experience mild fatigue or nausea. The Penn radiation oncologist discusses all possible side effects prior to treatment.

The effects of radiosurgery vary and may occur gradually and over time, from days to years after treatment, depending on the medical condition. Some tumors may disappear slower than others or may simply stop growing and present no further cell activity. After treatment, patients receive a summary of their treatment and a follow-up care plan. This includes recommendations for screening for disease recurrence and so the physician can monitor the effectiveness of the treatment.