KUTRRH undertakes first CyberKnife treatment in sub-Saharan Africa

History has been made at the Kenyatta University Teaching, Referral and Research Hospital (KUTRRH) following the commissioning of the facility’s CyberKnife radiotherapy services on September 27, 2023.

Following the launch of the CyberKnife System, the first and only fully robotic radiotherapy device for cancer treatment last May, the first patient has undergone treatment today, in a trailblazing move geared at expanding access to advanced cancer care in Kenya.

(TOP: KUTRRH Medical Physicist Peter Loreh – left – updates Chairperson Prof Olive Mugenda as Board Members Kavi Mwendwa and Nzumbi Mulatya look on the occassion of the first CyberKnife treatment).

Through KUTRRH, Kenya became the first country in sub-Sahara Africa to acquire the CyberKnife, making it possible for local patients to obtain access to the extremely precise stereotactic radiosurgery (SRS) and stereotactic body radiation therapy (SBRT) treatments the system delivers.

Speaking after witnessing the first patient treatment, KUTRRH Chairperson Prof Olive Mugenda said the journey to acquire the CyberKnife started last year as part of the Level Six facility’s corporate vision to create a Centre of Excellence in oncology by providing end-to-end diagnosis and treatment options for cancer patients.

On the diagnostic side, the hospital acquired the much-needed Positron emission tomography–computed tomography (PET-CT) and Single-photon emission computed tomography (SPECT-CT) services to complement existing linear particle accelerator (LINAC) and brachytherapy machines for treating cancerous tumours.

“The commissioning of the CyberKnife system today is a major milestone for oncology management in Kenya. As part of the strategic plan, for the last few years, we have harboured the need to move into high precision treatment, and thanks to the Government’s support, KUTRRH finally managed to acquire the CyberKnife machine, which is a bold but best decision for Kenya in the effort to decrease outbound medical tourism and increase inbound medical tourism,” Prof Mugenda said.

The commencement of CyberKnife treatment services today comes after an intense and much-awaited completion of the commissioning process after the launch of the CyberKnife Centre by President William Ruto last May.

The commissioning has been a tedious and delicate process jointly undertaken by medical physicists from Accuray, the equipment manufacturer, and KUTRRH Medical Physicists, Doctors, Radiotherapists, and Oncologists.

Added Prof Mugenda: “This process, which took five months after the launch by the President, included a dry run and the collection of very delicate data to ensure that the machine processes were accurate and ready to deliver precise and successful treatment to our patients. The commencement of the treatment also marks a key milestone for Kenya, the region and Africa in general. The services are now available without travelling outside Kenya for Kenyans or outside Africa for the regional patients.”

The experts who were involved in today’s CyberKnife treatment included:

• Abdil Jabbari -Application specialist and Medical physicist from Accurray USA.
• Ruth Wambui – A radiation Therapist and the KUTRRH CyberKnife Centre Manager with many years of experience with CyberKnife operations in the UK.
• Peter Loreh– A medical physicist and Radiotherapy Head of Department at KUTRRH. One of the few trained Medical physicists in the country with experience in Stereotactic Radio Surgery.
• Dr Tracy Irura– A trained Radiation Oncologist at KUTRRH and the lead oncologist in CyberKnife.
• Dr. Shridhar -A radiation oncologist at HCG INDIA with many years’ experience in CyberKnife and has delivered over 4000 CyberKnife treatments.

The patients set to undergo the CyberKnife system treatment regimen have been carefully selected to ensure that they meet the specified criteria by the experts. They have been well briefed about the treatment and what to expect and are psychologically ready for this unique precision treatment. KUTRRH Board and Management are grateful to the Government for availing the funds to acquire this first-of-its-kind equipment, which gives the patient the best chance of overcoming the disease challenge.

CyberKnife treatment is an essential advancement in radiation therapy, offering precise and effective treatment options for a wide range of medical conditions, especially cancer, while minimizing side effects and improving the overall patient experience.

Importance of CyberKnife Treatment

1. Precision: CyberKnife uses a combination of advanced imaging and robotics to deliver highly precise and targeted radiation therapy. It can track the movement of tumours in real time, adjusting the radiation beams accordingly. This precision is crucial in treating tumours near critical structures or delicate body areas.
2. Non-Invasive: Unlike traditional surgery, CyberKnife is a non-invasive treatment option. It does not require incisions or anaesthesia, which leads to quicker recovery times and fewer complications for patients.
3. Reduced Side Effects: The precise targeting of radiation with CyberKnife helps minimize damage to surrounding healthy tissues. This reduced collateral damage leads to fewer side effects, enhancing the patient’s overall quality of life during and after treatment.
4. Fewer radiation sessions: The CyberKnife treatment is delivered in 3 to 6 outpatient sessions compared to traditional radiation therapy, which requires 20 to 30 sessions to complete treatment.
5. Treatment of Inoperable Tumors: CyberKnife can treat tumours considered inoperable due to their location or the patient’s health. This provides new treatment options for patients who may not have had other viable choices.
6. Improved Outcomes: The precision and accuracy of CyberKnife treatment can lead to better treatment outcomes, including higher rates of tumour control and increased survival rates for some cancers.

Conditions treated with a CyberKnife.

CyberKnife treatment is recommended for various conditions, including cancerous and non-cancerous tumours. Its precise tumour treatment capacity to sub-millimetre accuracy levels makes treatment preferred using CyberKnife for the following conditions.

1. Cancer: CyberKnife is commonly used to treat cancerous tumours, including Prostate Cancer, Lung Cancer, brain Tumors, Spine Tumors, and Liver Cancer, among others.
2. Treatment of non-cancerous conditions, including Trigeminal Neuralgia.
3. Treatment Arteriovenous Malformations (AVMs), which are abnormal tangles of blood vessels, and Acoustic Neuromas, which are benign tumours on the acoustic nerve. These benign tumours are responsible for hearing and balance.
4. CyberKnife treatment is also applied for pancreatic Lesions. Specific non-cancerous pancreatic lesions can be treated with CyberKnife.
5. Functional Disorders: CyberKnife can also treat certain functional disorders, such as epilepsy, by targeting specific brain areas responsible for seizures.
6. Radiosurgery: CyberKnife can be used for stereotactic radiosurgery (SRS) and stereotactic body radiation therapy (SBRT), which are highly focused and precise radiation therapy used for various conditions. 

Conditions Qualifies for CyberKnife Treatment

It’s important to note that the specific conditions and patients eligible for CyberKnife treatment may vary from case to case. Treatment decisions are made on a case-by-case basis, considering factors like the type and location of the tumour, the patient’s overall health, and the potential benefits of CyberKnife treatment. We suggest that oncologists contact our medical team here at KUTRRH to discuss their patients’ eligibility so that they are booked accordingly. 

Contribution To UHC

The acquisition of the machine and the commencement of the treatment supports the government’s efforts for universal healthcare in the sense that:

• The treatment is available to all Kenyans from different socioeconomic backgrounds.
• It also supports UHC given that it is fully covered by NHIF, and patients with NHIF don’t have to add any money to access the treatment. 

Treatment Cost

Accessing CyberKnife treatment has been costly for many patients from Kenya and the region, given the machine was not available in Africa except in Egypt, which was also recently installed. The fact that NHIF will cover the cost of treatment will be of great benefit to many Kenyans. KUTRH is also engaging other insurance companies to meet the cost of treatment between 300-350 thousand Kenya shillings. Treatment costs are also a small fraction of the current cost charged for similar treatment in Asia, Europe and America, especially those self-paying or using other insurance plans.