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Featuring Demian Dressler, DVM and Susan Ettinger, DVM, Dip. ACVIM (Oncology), authors of The Dog Cancer Survival Guide

CyberKnife RadioSurgery in Pets

Updated: December 18th, 2018

If you have been following me on Facebook at Dr. Sue Cancer Vet, you know that last week I was lecturing with what I call “ASC Team CyberKnife.” This team includes radiation oncologist Dr. Sarah Charney, neurologists Drs. Rick Joseph and Jason Berg, and me, the medical oncologist.  We manage all the CyberKnife patients that come to the Animal Specialty Center (ASC) in Yonkers NY.

So after work on two nights, we all traveled to Red Bank, NJ and then to Norwalk, CT to talk to veterinarians about CyberKnife RadioSurgery, what tumors it’s good for, and our experience over the last 4 years.

There is a lot of great information on radiation therapy in the Dog Cancer Survival Guide, but in case you haven’t read it yet, you should know that typically, radiation therapy is used for local disease control — to damage and ultimately kill the primary cancer, usually as a follow up treatment to surgery. For example, if a dog has an incomplete resection — which means that there are cancer cells detected in their surgical scar on the biopsy report (dirty margins) — we would follow the surgery with radiation treatments to “clean up” those microscopic cancer cells. This is pretty common when it comes to a mast cell tumor or a soft tissue sarcoma. These conventional radiation therapy treatments usually require fifteen to twenty treatments, which are also called fractions (see below). Each session requires a short anesthesia, and pets are usually treated daily Monday to Friday with the weekends off. That’s a lot of anesthesia.

Why SO many treatments? It’s all about the normal tissue in the radiation field.  To minimize damage to the normal cells, the dose is divided up into many small treatments. These “fractions” are helpful because normal cells can repair themselves more efficiently after smaller, multiple doses. For example, if your dog has a tumor in the nose, conventional radiation therapy will probably expose other nearby body parts to the harmful radiation: the mouth, eyes, and brain may get radiation because it is in the treatment field.

It’s this damage to otherwise healthy tissue that has motivated oncologists to look for a way to deliver radiation with more precision, fewer side effects, and fewer treatment sessions.  The new technique called radiosurgery aims at getting the radiation energy directly to the tumor – even inoperable tumors – while avoiding healthy body parts that might be damaged by the beam or by its scatter.

By the way, I personally think the radiosurgery name is silly because there is no surgery in radiosurgery. There is no actual cutting – the name is meant to imply that radiation is accomplishing what surgery would do if it could actually get to the tumor.

Radiosurgery is not good for every type of tumor (for example, mast cell tumors and soft tissue sarcomas are not good candidates). But it does offer hope to some patients whose tumors were once considered inoperable. Here’s why:

The new, modified linear accelerators (radiation therapy machines) can generate very controlled, narrow beams that deliver radiation very precisely. The machine has five “arms” and rotates around several axes. It can approach a tumor from almost any angle the radiation oncologist wants it to, and while a traditional linear accelerator has two to four ports (holes where the radiation exits), the CyberKnife has hundreds.

Planning the radiation is critical when you’re dealing with radiosurgery. First, a CT (computed tomography) scan is done to get a very detailed three-dimensional image of the tumor. (For brain tumors we need both a CT and MRI for planning.) Then, Dr. Charney, our radiation oncologist, uses a complex computer program to plan precise coordinates for the radiation beam.

The precision involved in radiosurgery is amazing, and it also makes radiation therapy more appealing to dog lovers. For example, a nasal tumor that requires fifteen to twenty conventional sessions and exposes the mouth, eyes, and brain to radiation can be treated in only three consecutive CyberKnife sessions. That’s five times less anesthesia, five times fewer trips to the hospital, and fewer side effects. And the results are comparable to traditional radiation therapy. Some brain tumors are treated in just one treatment. It is pretty amazing!

My practice was the first to offer CyberKnife Radiosurgery to animals, and we have been treating dogs and cats since March 2008. Currently, radiosurgery is only practiced at the University of Florida, Colorado State University, southern California, and my practice the Animal Specialty Center in New York.

In my next blog I will tell you what tumors we treat and our experience so far. Stay tuned – this is pretty exciting stuff!

Discover the Full Spectrum Approach to Dog Cancer

Leave a Comment

  1. Mike Calderon on May 29, 2019 at 7:45 am

    Any successful treatment of canine insulinoma in pancreas using cyberknife? Thanks.

  2. ann on May 16, 2019 at 7:42 am

    just curious re radiation and oral malignant melanoma. My dog is 13yr and second tumor has just had to be removed from inside lip (didn’t get clean margins)He had been on Oncept for just over a year after first tumor was removed successfully. From my research it looks like radiation would be hard on him for his age plus melanoma being so aggressive would probably show up elsewhere eventually. Please let me know what you think, am praying for right decision.

    • Dog Cancer Vet Team on May 17, 2019 at 7:44 am

      Hey Ann,

      Thanks for writing. When you’re unsure of what route to take, you should have a look at the section on Treatment Plan Analysis. Especially the articles on How to Make Decisions About Dog Cancer Treatments and Why Your Personality Is So Important To Your Dog with Cancer 🙂

      There is no “one-size-fits-all” treatment plan when it comes to dog cancer as each dog and their health situation is unique. You have to decide on a treatment plan that is right for both you and your dog. Are you okay with handling the side-effects of conventional treatments? How important is life-quality to you? Do you think your boy can handle surgery? These are just some of the questions that you have to ask yourself.

      Radiation is definitely not a walk in the park, and this why knowing yourself, and your dog, is so important when making treatment plan decisions. You should also check out this article on Things You Need To Know About Radiation for Dog Cancer and Chapter 11 of the Dog Cancer Survival Guide, which covers conventional treatments like surgery, radiation, and chemo 🙂

      Also in the Dog Cancer Survival Guide, Dr. D writes that there are a number of things that you can do to help your dog with cancer– under your vet’s supervision– such as conventional treatments, nutraceuticals, immune boosters and anti-metastatics, mind-body strategies and diet. This is what he calls Full Spectrum Cancer Care and you may find it to be helpful 🙂

      When you know what your options are and what is most important to yourself and your dog, you will be able to make a more informed decision. Don’t forget to consult with your vet or oncologist, and ask questions! 🙂

  3. Tom Liskowski on April 7, 2019 at 10:20 am

    My dog Max has a nasal tumor and was treated in MedVet Chicago with Cyber knife.He had 3 consecutive days of radiation last week.How long does it take before the treatment begins to help.He seems about the same ,sneezing ,snoring.Does it take a couple weeks before the radiation starts to work?Thanks

    • Dog Cancer Vet Team on April 8, 2019 at 6:28 am

      Hey Tom,

      Thanks for writing, and we’re sorry to hear about Max. That’s a tough question, and one best left to your vet or oncologist. As we aren’t veterinarians here in customer support, we can’t offer you medical advice.

      However your vet can. You have to remember that your vet knows your dog, they know the treatment plan, and they are able to physically examine Max. They can provide you with information that is based off of your particular boy, and his treatment plan. So they are the best person to ask for a better-informed answer 🙂

  4. Ellen Schlegel on December 27, 2018 at 12:03 am

    Why is stereotactic radiation not goodFor treating soft tissue sarcoma???

  5. Jane on December 6, 2018 at 8:06 am

    Why is stereotactic radiation not good with mast cell tumors?

    • Molly Jacobson on December 10, 2018 at 3:04 pm

      Hi Jane, thanks for your question. I’m not a veterinarian, so I’m not sure I have the right answer for you, but as the book editor, my guess is that mast cell tumors change too often and are too “tricky” for such an expensive treatment that depends on knowing EXACTLY where a tumor is in the body. Mast cell tumors can grow overnight or shrink and seem to disappear in an hour — they are the “tricksters” of tumors. I suspect that these tumors are difficult to plan for in the way this type of radiosurgery requires. Remember, it’s not just radiation — it’s also “surgery.” Where you place that radiation beam really matters, and they better know for sure there is a tumor there!

  6. […] turned out to be a life saver! The one option that the teaching hospital could not offer was cyber knife treatment – targeted intense radiation – which was available through Hope Veterinary Specialists […]

  7. […] turned out to be a life saver! The one option that the teaching hospital could not offer was cyber knife treatment – targeted intense radiation – which was available through Hope Veterinary Specialists […]

  8. They want EFX on April 12, 2016 at 1:28 am

    What is the real cost of Cyberknife treatment? I have an 11 year old Scottie with Prostate and Bladder cancer. I was told 10k all in for about 8 months of life. The NC State study said 5.5k. I was just wondering… has anyone had 2-3 treatments with a CT scan and what was the cost?

    • Ellen Schlegel on December 11, 2018 at 6:21 pm

      For us it is $13 K in California( Cyberknife alone that includes placing the markers under a CT scan for the actual treatment, and it doesn’t include all the diagnostics prior. )

  9. […] State University, southern California, and my practice the Animal Specialty Center in New York. CyberKnife RadioSurgery in Pets – Dog Cancer Blog […]

  10. […] on the dog, there are fewer side affects, the treatment is more targeted and a lot less expensive. CyberKnife RadioSurgery in Pets – Dog Cancer Blog […]

  11. […] the prostate tumor pressing on his colon. His owners had come to me to consider a procedure called CyberKnife, a precise radiation of the […]

  12. Maggie Faces Osteosarcoma – Part 2 | SlimDoggy on August 11, 2015 at 4:45 pm

    […] Radiation Therapy (SRT) for Treatment of Limb Osteosarcoma CyberKnife RadioSurgery in Pets New Cancer Therapy Options for Animals: CyberKnife Radiation Treatment targets canine cancer […]

  13. Maggie Faces Osteosarcoma Part 1 | SlimDoggy on August 5, 2015 at 7:30 am

    […] The Stereotactic Radiosurgery is a fairly new procedure. It has been used in humans for many years, but only in the last 5-6 […]

  14. Susan Kazara Harper on November 16, 2014 at 9:13 pm

    Kim, What did the MRI show? It’s not productive to pull stats out of the internet, as your dog is his own, beautiful, individual being. If you have any more info, do let us know and we’ll be glad to help untangle things, but of course your vet is right there with the results and the offer of treatment. An on site expert. Make sure your boy’s nutrition is a clean and natural as you can get it to support him.

  15. Kim on November 8, 2014 at 12:46 pm

    My 6 year old Rhodesian Ridgeback had cyberknife surgery on a femoral nerve root tumor last Oct. he is now showing the same symptoms again? I am having a MRI on him on Monday. What are the percentages than it could possibly reappeared? Also does scar tissue occur after Cyberknife? It just seemed like one day he was fine then he turned in my SUV and let out a loud yelp and since then hasn’t put his leg down, holding it up to walk? We had a X-ray and his legs and hips are great! Is is at all possible he could have torn scar tissue??? I know I’m pulling at straws! Thank you any insight would greatly appreciated. Thanks Kim from Anchorage AK.

  16. robert lahser on June 6, 2013 at 2:32 pm

    Hello- can you please please please give me a ball park price for Cyber Knife to treat a 1/4 marble sized mostly exposed Mast Cancer tumor on our 12 -year-old dog Murphy’s right flank. It’s a third re-curring MCT ,Murphy has had three surgeries over the past 28 months and is currently on Kinavet,a new MCT lump popped up a week ago and the Kinavet is not working. We are seeing an Onco in Matthews,NC and the best option for survival that we were given is 16 radiation treatments at $5k plus surgery. All three recurring MCT’s have popped in the same spot. Today 6/6/13 I called Vet Speciality Clinic in Yonkers and was told I would have to pay the $175 consult fee to get a cost on the Cyber Knife treatments. We are spending more than we can afford now on Murphy’s treatments. Can you please let me know a ball park price on Cyber Knife,you can email me privately. Many thanks,Robert in N.C.

  17. Jerry Markham on June 2, 2013 at 3:46 pm

    I made a typo it was a 20 minute swim not 20 hours! Before the event. (i.e. He was not preparing to swin the English Channel)

  18. Jerry Markham on June 2, 2013 at 2:38 pm

    Our 12 year old mixed breed short haired terrier who weights about 40Lbs was diagnosed with a 1CM X .5 CM left side trigeminal nerve sheath tumor by MRI that had not traveled into the brain. He was then put on 10 Mg.of Prednezone in anticipation of Cyberknife at UC Davis Veterinary Medical Center under the direction of its chief of that Department Dr Theon which he had on October 23, 2012. He tolerated the procedure well and we drove him home to Seattle a weak later and was then slowly weened off the Prednezone gradually over the next few months until he was down to 2.5 Mg every 3 days. in February. We were advised by Dr. Theon it would be safe for him to fly to our winter home in Arizona in January while he was still on that dose, but we waited until February when he’d had his last dose. He seemed fine after the flight and he’d been off Prednezone totally for about 5 days. However shortly after (after one brief 20 hour swim in the pool — he’s usually good for an hour or more), he developed a marked weakness in his right side became disoriented and could barely keep his feet from sliding out when standing on tile floors, and could only walk with the assistance of leaning on a wall and began running into open door on the right. All this happened over the course of an afternoon. We rushed him to the Arizona Veterinary Hospital in Tucson where under Dr. Theon’s telephonic direction he was administered 15 Mg. Prednezone and that was continued for the next month. For the better part of that month he could hardly get out of bed to toilet (but he generally could he had only a couple of urine incidents when we weren’t paying attention — although he’d never done that before). His bowl movements were generally OK though and he was always hungry. Slowly he got so where he could walk again without use of walls but pulling to the right and finally in a straight line if he had the edge of the sidewalk to follow and walking over a mile. But on that heavy dose of Prednezone he had significant muscle wasting (and was ravenous all the time). Finally Dr. Theon decided the Prednezone was doing more harm than good and he reduced it to 10 and began weening him off again. He is now down to 2.5 daily and starting to gain a little muscle. He has however lost vision in his right eye (we are told permannetly) , it doesn’t tear properly and he has little sensation on the right side of his face and drops food when he eats from that side. But otherwise he’s walking, eating and toileting OK. He also has water therapy every day on an underwater treadmill. There was much speculation between his Oncologist in Tuscon, his Neurologist in Seattle and Dr. Theon at UC Davis as to just what occurred and in the absence of another MRI they can’t tell (and all say they might not treat differently if they did). The opinions ranged from a bleed caused by the void created by the Cyber knife that got into the brain, or an inflamation occasioned by his body attacking the dead cancer cells (and cutting off the Prednezone too soon), an unrelated stroke, or and everyone says this is highly remote a return of the cancer? Now Dr. Theon and the Neurologist say they would like to do another MRI to determine what the cause was although they say we might trying increasing the Prednezone first and seeing if he improves on that? The Oncologist in Tucson said that the University of Colorado has some sort of study that supports keeping them on Prednezone for 6-12 months is necessary to prevent dead cancer cell inflamation (she studied at U of Colorado but frankly seemed the least knowledgeable due to her youth). we only kept him on for four before his “stoke” or what ever you want to call it? There is a risk of loosing him in the anesthesia if we re-image him. But despite his muscle loss from the Prednezone his neurologist thinks he’s strong enough to survive it. WE’d like to get him off the prednezone as high doses really alter his personality and all doses even the 2.5 daily now do some and causes muscle wasting and we are concerned about permanent damage to his stomach (although he takes it with a pill to coat his stomach before hand). Is there a Colorado Study? How long do your keep dogs with this type of cancer on Prednezone after cyber knife? Should we re-image and what would that tell? And what could we do different depending on what they found? Dr. Theon said he’s not a good candidate for another Cyber knife treatment if the cancer returned. We are very worried? But he is much better than he was in February. But not what he was. If his personality returned when he got of Prednezone that would be a beautiful thing. But we are prepared to “go slow” and prolong his life. He was a very loving dog before but the heavy does of Prednezone makes him very hyper, fearful and a little mean less at 2.5 but still not the same dog. His name is Phinney!

    • Maryann on January 7, 2019 at 9:15 am

      My girl “Mushi” has a 2cm right brain stem, possible Trigeminal Nerve Sheath Tumor and had Cyberknife 4 1/2 months ago.
      Within the past few weeks, we are seeing the same signs return that she had prior to CyberKnife treatments…. feet slipping when walking, difficulty getting up and down and the inseccent circling to the right(the side of the tumor).
      She seemed to have improvement signs following the first CyberKnife treatment, but unfortunately was not able to be weaned off the prednisone (5mg 2x/day).
      She has experienced a couple episodes of post-therapy swelling that can occur that requires a five days course of increased prednisone to 5mg/AM and 10mg/PM) to resolve the swelling/pressure.
      Your experience and timeframe of symptoms seems to coincide with ours.
      We have not undergone a post CyberKnife MRI to check to tumor size/status.

      I would appreciate any details you could provide as to your experience after this post.
      Did you have a follow up MRI? If so, what did it reveal?
      Did they offer another course of CyberKnife treatments? We were advised by our radiation oncologist that it could be repeated in January( if needed). Her original treatment ended 8/23/2018.
      I hope that your pup did well after this episode.
      Thank you for your time and info. It’s greatly appreciated and desperately needed.

  19. wendy finch on June 1, 2013 at 10:45 pm

    Dr. Ettinger

    Our 8 yr old Boston Terrier is presently with a pituitary macroadanoma approx
    8mm. one week ago we took her to the Emergency Hospital with excessive panting of sudden onset. The staff performed a comprehensive work up.
    (Several chest & neck xrays, scope of throat, us of abdomen, several CT’s of
    neck and head and blood work) Cushings Disease and C6 vertebral herniation were diagnosed. We decided to have decompression of the disk per the recommendation of the surgeon. Her panting was not relieved so a second surgery was performed. The Surgeon was not able to remove all of the disc material on the first and second surgery. She remained to pant excessively. It was then decided to perform a contrast CT and it revealed the macroadanoma. Seven days later we are at home. She was prescribed a fentanyl patch, tramadol, gabapentin & pednisone. She does very well with anesthesia, going under 5 times in seven days (she had her palate resected two years ago). She only has subtle neurochanges – nothing dramatic except for the excessive panting.

    We are interested in Cyberknife radiation, but cost is a concern because of
    recent treatment amounts. Could you provide an approximate cost range? Also, how many treatments are typical for a Pituitary Macroadenoma? – speculatively. We live in Texas. We plan to see a general vet on Monday to address the Cushing medication needs. We would also like to have the first radiation treatment next week if possible. Who should provide the referral the surgeon who did the CT or our regular vet?

    Thank you for your time, Wendy Finch

    • Dr. Susan Ettinger on June 2, 2013 at 5:18 pm

      Please contact Dr Joseph and the Neurology Service at my practice tomorrow. 914-457-4000

      Pituitary Macroadenomas come in through Neuro, and they will be able to give you all the info.
      For those traveling to NY, planning would be Monday and treatment later that week. Some neuro cases are 1 treatment, some are 3 (Wed to Friday)
      All my best, Dr Sue

  20. John on April 21, 2013 at 11:12 am

    Aloha Dr. Ettinger,
    Our 7.5 year old Cairn Terrier, Bonnie, was just diagnosed with oral squamous cell on the maxilla during a dental clean. Our Vet removed 2 teeth, but referred us to an internal medicine specialist (not a Board Certified Oncologist–apparently none in Honolulu) for further treatment. After reading your section in the Dog Cancer Survivor Guide, we believe that radiation therapy, preferably Cyberknife, is the one of the best treatments for this type of cancer and its location, but in Hawaii there is no radiation therapy option for pets.

    We will consider taking Bonnie to the mainland for Cyberknife treatment, but would like to understand how many treatments are typically involved for this type of surgery and what the typical period is between Cyberknife treatments.

    Thanks in advance for any advice you can offer.

    • Dr. Susan Ettinger on April 28, 2013 at 11:07 am


      Thanks for your interest in CyberKnife. If you are still interested, please call mu hospital tomorrow/this week. One of my nurses will give you an overview. Typically my radiation oncologist will then talk to cases that are traveling so far prior to your trip. While we would be happy to help in NY, there is also radiosurgery at CSU (Colorado State) if you think that is easier. Again, we are happy to help. Our # is 914-457-4000.

      Aloha, Dr Sue

  21. Elinore on February 10, 2013 at 7:40 am

    Hello Dr. Ettinger,

    My 8 year old spayed female Rottweiler, Abigail was diagnosed with Brain Cancer on the overnight of December 21st, after having a seizure

    I took her to GSVS in Red Bank, NJ, where they did tests and an MRI, which showed the brain cancer. I was told it was 2x3x2 CN and it was right sided. They also mentioned “old factory lobe”, which I have no idea what that is. Was also told that it was aggressive and had already eaten so e of the bone.

    Abigail is not and has never acted any differently than she has her whole life.

    Would appreciate and be ever so grateful for any and all information.

    Do you think cyberknife would help her?
    Currently, she’s only on Phenobarbital (90 mg twice a day). She weighs approximately 104 lbs.

    Thanking you in advance,

    • Dr. Susan Ettinger on February 11, 2013 at 4:55 pm

      Hi Elinore,

      Sorry to hear about Abigail and her brain tumor. She may be a candidate for CyberKnife. Patients with brain tumors come in through the Neuro Service (not my Medical Oncology Service), so if you are interested, you can call 914-457-4000 to make an appointment. One of the neurology nurses can answer some basic questions on logistics, etc. We are in Yonkers NY so not too far from Red Bank. You can check our our web site too!

      Good luck to you and Abigail.
      Dr Sue

  22. Tammy G on January 3, 2013 at 8:43 am

    I wanted to check in because I posted on this article 6-27-12. Our dog Owen has an inoperable liver tumor…it is right-lobed and is pushing on the vena cava. UW-Madison vet tried to remove it but because of the size (16cm) and location, Owen likely wouldn’t have survived the surgery. We looked into all of his options including the cyber knife at Colorado State U and Dr. LaRue looked over his scans but said the procedure would be too damaging to his other organs. We then took him for a study in NYC at AMC where they performed a Transarterial Chemoembolization. That was done in July and only shrunk his tumor by a very small amount. The tumor has now grown a little but we will be checking him to see if Palladia is helping keep the tumor from growing too fast. He is in fabulous heath otherwise–eating great, tons of energy and most of all happy! We will take however long we have with him and we know that even though this procedure didn’t shrink his tumor a lot, it has made a huge difference in how he feels. Other candidates have had the tumor shrink enough to surgically remove. So that is another option for liver cancer.

  23. Larri Weber on August 11, 2012 at 7:39 am

    I have been told that my dog, rufus has a brain tumor, I have a CT scan appointment for Tuesday August 14th at blue pearl. Do you know of anywhere in Minnesota where they perform cyberknife?

    • Dr. Susan Ettinger on August 17, 2012 at 5:28 pm

      Hi Larri,
      Sorry about Rufus. No, CyberKnife is still pretty uncommon. If travel is an option, you could come to my practice in NY or Colorado State U also preforms stereotactic radiosurgery.
      All my best, Dr Sue

  24. Anne M on August 5, 2012 at 3:38 pm

    Dr. Ettinger,
    My dog Roxy had Cyberknife in February of this year. She is having a tough time with what is described as a late effect brain injury most likely caused by the cyberknife. When I heard about cyberknife I never found any articles that mentioned that things can go wrong. I know of other dogs that have had the cyberknife and have had issues too. How do you address this? I was hoping for 16 months with my dog and now it seems that if we make it to 6 we will be lucky.

    You can read Roxy’s blog at: http://roxycyberknifebraintumor.blogspot.com/
    “Late side effects, which are rare, occur months or years following treatment and are often permanent. They include:

    brain changes
    spinal cord changes
    lung changes
    kidney changes
    colon and rectal changes
    joint changes
    mouth changes
    secondary cancer
    fracture of bones”

    • Dr. Susan Ettinger on August 10, 2012 at 11:22 am

      Hi Anne,
      I am sorry Roxy did not do as well as expected. There are always dogs that happily do better than the statistics and some that sadly do worse. When I do a consultation for a potential CyberKnife (CK) case, myself and the radiation oncologist always review the specific side effects based on where the tumor is located and where we are radiating. Unfortunately there are still side effects with CK and they will vary case by case. In general the side effects are much less severe than they would be with connventional radiation.
      As for the list of side effects you posted, they too will vary with the tumor. Clearly if you are radiating near the colon, it may have side effects, but you won’t have this with nasal CK. That’s why a one on one consultation with a specialist is so important.
      I am simply trying to educate Guardians about CK so they know it MAY be an option for some cases.
      Again sorry about Roxy’s results. While I do not know her case personally, I know it is heartbreaking.
      All my best, Dr Sue

  25. Greg Gola on July 31, 2012 at 2:32 pm

    Dr. Ettinger, we have been told that our 10 yo Wheaten Terrier (Zoey) has an inoperable menengioma on the brain stem. We met today with the Oncologist (Dr. Feinmehl) at Veterinary Specialty Center in Buffalo Grove, Illinois. We were shown the MRI visualizing the tumor. Dr. Feinmehl indicated that radiation therapy might give Zoey 1-2 years more with us and that Cyberknife might give her 2-3 years. We are very concerned about Zoey’s quality of life post procedure. I think Dr. Feinmehl is contacting your program on our behalf.

    • Dr. Susan Ettinger on August 10, 2012 at 9:48 am

      Hi Greg,
      Sorry to hear about Zoey, but I am glad you know about CyberKnife! Brain tumor cases come in thru Neuro Department for CyberKnife, so your vet would be speaking to Dr Joseph or Dr Berg. Were they able to contact them? If not email me through my website and I can try to help.
      All my best, Dr Sue

  26. Chris on July 27, 2012 at 5:13 am

    Thanks Dr. Ettinger. You’re correct that what was used at WSU was a gas anasthetic, specifically desflourane (which I’m guessing is related to sevoflourane). I’ll have to see if the clinic with whom I’m currently in consultation can use it if we go ahead with the UGELAB procedure, assuming it is a strong enough anasthetic for the procedure.

    You’re also correct that it was stereotactic radiosurgery which the specialist with whom I discussed this said that it was not, unfortunately, an option for bladder TCC, as you noted. However, you also mentioned that it can be used for urethral tumors. Does that mean that this could be a palliative procedure for my girl’s TCC that has spread to her urethra?


    • Dr. Susan Ettinger on August 10, 2012 at 9:42 am

      Hi Chris,
      Glad you have been getting more info that is helping answer your questions. CyberKnife can be used for the urethra, but remind me, is she getting conventional radiation to the bladder?
      Dr Sue

  27. Linda on July 12, 2012 at 5:49 am

    Dr. Ettinger,

    Can the Cyberknife be used with a dog that was diagnosed with Leiomyosarcoma of the esophagus? Also what is the cost and risks of the treatments? What is the likely prognosis if treated?
    Thank you,

    • Dr. Susan Ettinger on July 13, 2012 at 3:31 am

      Hi Linda,
      Thanks for your question, typically CyberKnife is NOT good for hollow organs like the urinary bladder and esophagus, as there is a concern that the treatment if effective will result in a hole in the site. I obviously cannot make more specific recommendations over the internet, but in general, unfortunately CyberKnife is not the right treatment option for tumors in the esophagus.
      Sorry, and good luck!
      Dr Sue

  28. Grace Schuyler on July 11, 2012 at 5:55 am

    I have a situation similar to what Tammy G. said on 6-27-12 (liver tumor close to vena cava.) Surgery was done but could not go too close to the vena cava. Have had a follow-up sugery to de-bulk the tumor while options are being explored. What are your thoughts on CyperKnife treatment, please?
    Thank you,

    • Dr. Susan Ettinger on July 13, 2012 at 3:42 am

      Hi Grace,
      Thanks for your question. CyberKnife can be considered for non-surgical liver tumors, but it depends on how close to the vena cava it is. We would need a CT to better know. Also there has to be measurable tumor for CyberKnife, not microscopic disease. For cases like this, it is case by case. You can contact my Oncology Service if you want more info on CyberKnife. After we have more info, I can discuss the specifics with our radiation oncologist.
      Thanks, Dr Sue

  29. Tim on July 9, 2012 at 5:34 am

    Dr. Ettinger,

    We live in Southern Indiana. The closest large city would be Louisville, KY which is about ten minutes away but we would be willing to do some traveling if we had a good option. We’ve been told the tumor is about the size of a cantaloupe.


    • Dr. Susan Ettinger on July 13, 2012 at 3:46 am

      Hi Tim, My radiation has some concerns about the size. Probably best to contact my Oncology Service if you want more info on CyberKnife and send us medical records if you are interested. After we have more info, I can discuss the specifics with our radiation oncologist. It can be considered on a case by case basis.
      Thanks, Dr Sue

  30. Tim on July 5, 2012 at 11:14 am

    Our beagle mix has an adrenal carcinoma. If we can find somewhere that offers this nearby would she be a candidate? They tried surgery but were unable to remove any of it. The only option the current vet has given is chemotherapy.


    • Dr. Susan Ettinger on July 7, 2012 at 8:11 am

      Hi Tim,
      Sorry about your dog. CyberKnife could be considered for a non-surgical adrenal tumor. It would depend on the invasion into the vena cava and the CT scan. Where are you located?
      Dr Sue

  31. Janice on June 30, 2012 at 6:58 pm

    Thank you for your response and concern. It is not clear whether my mother’s dog has a tumor or encephalitis and from what I’ve read online about others’ experiences an MRI might not definitively resolve the issue. My mother was concerned about being advised to have x-rays and a sonogram to rule out other issues before having the MRI. Her decision to proceed with medication seems to have been a good one. He continues to improve on prednisone and phenobarbital has resolved the seizures. I saw on the Apocaps website that only a smaller dosage would be advisable with his medication.

  32. Chris on June 28, 2012 at 4:05 pm

    Dr. Ettinger, just saw your facebook page, saw a reference to stereotactic radiosurgery that seems to imply that CyberKnife is another name for stereotactic radiosurgery. Is that correct? If so, then I already know the answer to my question, which is that this procedure does not unfortunately work on bladder TCC.

    • Dr. Susan Ettinger on June 29, 2012 at 4:23 pm

      Hi Chris,
      I think you are referring to gas anesthetic, like sevofluorane, which is excreted through the lungs. Many universities and specialty hospitals like mine will use it for patients with complicated medical issues.
      As for the name, CyberKnife is the brand name of our stereotactic radiosurgery unit. You may also hear to it as stereotactic body radiotherapy. It can get confusing!
      Unfortunately tumors of the bladder are not good candidates due to risk of bladder rupture. However, we can use it for urethral and prostate tumors.
      Thanks for your questions!
      Dr Sue

  33. Janice on June 28, 2012 at 11:10 am

    My mother’s dog almost certainly has a brain tumor, since he exhibited the symptoms mentioned on the University of Minnesota website yesterday and the neurologist says it is either a tumor or inflammation. He was hospitalized for seizures and is cleared to come home soon since he has improved on steroids and seizure medication. My mother will make a decision on further diagnostics but after her prior dog’s liver cancer and the lack of success with surgery and treatment she wants to start with conservative treatment. It sounds as if Apocaps, Halo food and at least following the protein, grain and vegetable combination of the dog cancer diet would be consistent with reducing inflammation. If she was near the University or where cyberknife surgery is done she might be willing to do more. Both the vet and neurologist support the conservative approach but have not mentioned dietary changes. Are they appropriate under the circumstances?

    • Dr. Susan Ettinger on June 29, 2012 at 4:17 pm

      Janice, Sorry about your mom’s dog. Advanced imaging (ideally MRI, or CT if MRI not available) of the brain can help figure out the cause of the seizures. Depending on your location, you may be able to travel for radiosurgery like CyberKnife.
      I know it is hard when another pet had another cancer, because all the emotions get stirred up, but different cancers can have different treatment options and prognoses, so I hope you can get a diagnosis and make a good educated decision. There is no wrong or right decision, but it helps to get more info.
      I’ve asked Dr D to address the supplements and diet question. Also remember there is a ton of info and emotional support in our book, the Dog Cancer Survival Guide.
      All my best,
      Dr Sue

  34. Chris on June 28, 2012 at 10:58 am

    A question, and a comment.

    The question – is this procedure effective/useful on canine bladder transitional cell carcinoma?

    The comment – that is a lot of anesthesia, but as you probably know, standard radiation therapy can take up to fifteen days of treatments as well, with anesthesia required each day, so, pretty comparable. When I took my pup to Washington State University for her radiation therapy, they were using what I believe was a newer anesthesia for a couple of reasons:

    1. It was reversible, so the patient was only under for about twenty to thirty minutes, and when they woke up, the effects were pretty much gone.
    2. It’s excreted through the respiratory system, not the veinous system, so, basically, the way it was reversed was that the dog just breathed it out.

    On the downside, it was apparently more expensive than the anesthesia that they’d been using previously, but the increased cost was pretty much negligible, and the benefits were undeniable. My pup handles anesthesia EXTREMELY poorly, and every day when she came out from her treatments, she was trotting along with her tail wagging, behaving pretty much as if she’d just woken up from a very satisfying nap.

    Unfortunately, I can’t recall the name of the anesthesia, but if anyone is doing any kind of treatment or procedure that require multiple daily doses of anesthesia such as this one, I’d definitely suggest contacting the WSU veterinary hospital and ask them if they can tell you what type of anesthesia they’re using for canine radition therapy.

  35. Patricia Helfer on June 27, 2012 at 9:16 am

    Dr. Ettinger:

    My dog, Vicky, was diagnosed with brain cancer (menigioma) in December, 2011. The specialist in Richmond, VA told us about Radiosurgery and regular radiation treatment; he also advised against surgery because it was too risky. I attempted to contact the New York vet hospital that does the radiosurgery and was told that I had to set up an appointment in New York in order to obtain the details. I read the Dog Cancer book and everything else I could find. I did not want to send her away for 17 days of regular radiation at the nearest location (5 hours from home) because she has never been away from home.

    Just by chance, I found an article in my local Sunday paper (on the front page of the Daily Press out of Newport News VA) on March 25, 2012 that informed me that the University of Minnesota Vet School was conducting a clinical trial, at no cost to the patient, regarding Canine Brain Tumors. My Vicky had the surgery on April 13, 2012 in Minnesota and the entire tumor was removed. We left Minnesota 48 hours later as a HEALTHY 11 year old Sheltie.

    WHY does the Dog Cancer Survival Book NOT MENTION possible clinical trials?
    My Vicky’s prognosis was that she would live between 3 weeks and 3 months when she was diagnosed via an MRI on December 12, 2011. I prayed for a miracle, I read everything I could find on Canine Cancer, I changed her diet to the homemade cancer diet in Dr. Dressler’s book, and she was saved by a newspaper article.

    I thank the Dog Cancer Survival Book for the diet information – I doubt Vicky would have made it to March 25th had I not followed the diet. However, I could have avoided 4 months of anxiety had the book mentioned the clinical trial that is currently being conducted in Minnesota regarding Canine Brain Cancer wherein they remove as much of the tumor as possible (and have never lost a dog as a result of the surgery/recovery) at NO COST to the patient.

    Please mention the clincal trial on your websites/blogs for others with brain cancer.

    • Dog Cancer Vet Team on June 27, 2012 at 10:21 am

      Thanks for your comments, Patricia, and we are thrilled to hear that your dog is doing so well. The Dog Cancer Survival Guide mentions clinical trials in many places, but most specifically in Part IV, Making Confident Choices. In chapter 24, on page 272, the doctors have a section on Clinical Trials, including some websites that list current trials. Calling local organizations or schools is also a great way to find out about clinical trials, as the doctors point out in that section. Another place they mention clinical trials as a resource is in Chapter 22, on page 261, where they advise you to ask your vet about clinical trials for your dog’s specific diagnosis as one of the hundreds of suggested questions. Many readers have taken advantage of clinical trials, and we’re always glad to reinforce that medicine is always evolving and changing, and new options are always coming in. Of course, it’s impossible to list all of the trials in a book that will be used for years — this information is quickly outdated. This is why the book directs you to places where you can find out about current trials, rather than list the ones current at publication. Thanks for your post!

  36. Tammy G on June 27, 2012 at 2:06 am

    I would love to explore this with our dog who has an inoperable tumor on his liver. It is on the right side and crushing his vena cava, so there are many complications in removing it with conventional surgery.

    • Dr. Susan Ettinger on July 13, 2012 at 3:45 am

      Hi Tammy,
      Thanks for your question. CyberKnife can be considered for non-surgical liver tumors, but it depends on how close to the vena cava it is and how invasive. We would need a CT to better know. You can contact my Oncology Service if you want more info on CyberKnife. After we have more info (like previous imaging), I can discuss the specifics with our radiation oncologist.
      Thanks, Dr Sue

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