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CyberKnife

YTW's picture
YTW
Posts: 64
Joined: Apr 2010

I have just been diagnosed with Pca. in March. PSA went from 6.6 to 18.3 in six months. Biopsy of 12 cores shows 11 neg. and 1 pos. Gleason 3+4=7 CT scan...Bone Scan...MRI of pelvis...Ultrasound & DRE all negative. I am considering CyberKnife treatment....
I'd like to hear from any of you as to the pros & cons of that treatment.I'm a newbe.

Thanks

Kongo's picture
Kongo
Posts: 1167
Joined: Mar 2010

Y, I too was diagnosed in March and I have recently made a decision to go forward with Cyberknife treatment. Dx PSA = 4.2, 1/12 cores positive, Gleason 3+3=6, Stage T1c. Like any of the potential treatments, there are pros and cons. Pros are a (relatively) quick and easy procedure that is done in five treatment sessions where most people go immediately back to work after their session. Long term prognosis is as good or better than other forms of radiation but since they have only been using Cyberknife to treat prostate cancer for about five years, there isn't the long term data that XBRT, brachy, or proton radiation. The initial indications are on par or better than the others with a fairly dramatic PSA drop and a PSA nadir reached at about 15 months. The long term complications of urinary incontinence and ED are largely absent from Cyberknife patients although again, the long term data isn't there.

Cyberknife, as you probably know, uses a highly focused, extremely accurate beam of high dose radiation in five treatments. The sub-millimeter accuracy of Cyberknife minimizes potential damage to adjacent organs such as the rectum and bladder. About the only measurable problem is that about 20% or less of patients have a sense of "urgency to pee" after Cyberknife which resolves itself in a few weeks. Potency at 4 years is over 80% and those with issues respond well to Viagra-like drugs.

Others here will be happy to go over pros and cons of surgical options and potential side effects.

I have consulted with a Cyberknife center near me and am happy with the credentials, the staff, and the number of patients who have been treated.

There is a similar procedure to Cyberknife that uses a Novalis Tx machine but the end result is essentially the same. My impression from my consultation with them was that it is used more as an adjunct to other forms of radiation (like XBRT) rather than as a stand alone procedure.

I reached my decision after several consultations and a lot of research which you can read about in my post on this site titled "Decisions, Decisions."

Before jumping on Cyberknife I would strongly encourage you to seriously explore the other treatment options that your symptoms indicate might be feasible such as surgery, XBRT, Seeds, HDR brachy, nerve sparing cryo, and active surveillance.

Cyberknife hosts an excellent discussion board which is moderated by Cyberknife doctors who answer queries just like yours. Check it out at www.cyberknife. com

Best of luck in your journey.

YTW's picture
YTW
Posts: 64
Joined: Apr 2010

Kongo: Thanks much for your timley response. I will certainly take my time to research and make my decision.

chitown
Posts: 90
Joined: Mar 2010

Kongo - Thanks for your insightful research and sharing of the finding. I was convinced on the da vacinci surgery, but want to explore Cyberknife particular as a hospital near my home does it. Would greatly appreciate your frank, personal and pointed advise. Will value every word you say.

I am very healthy and athletic at 48. Biopsy last month put gleason at 3+3, PSA was at 2.1 with palpable nodule found during DRE. My father died of PC at 61 and my uncle even at an mealier age! My age and health and great surgeon here is driving me towards surgery. Have clear understanding on the serious nature and life quality impact of surgery.

Let me know if I can share any more info.
Thanks in advance

Kongo's picture
Kongo
Posts: 1167
Joined: Mar 2010

Chitown, I don't think you can lose anything by going to Cyberknife and ask them about your situation. I found the doctors and staff at the Cyberknife near me to be extremely competent, frank, and eager to provide advice about treatment courses.

One thing that struck me during my own consult was that the head of the Cyberknife center, a superbly qualified radiologist from Harvard, insisted on reviewing ALL the potential treatments that he felt would be applicable in my situation. Thse included surgery, other forms of radiation, and active surveillance. The point here is that at least at this center they weren't pushing Cyberknife...they were pushing what was best for me. All the other specialists I met with had a habit of subtling putting down other forms of treatment than the one they were pushing.

Chitown, it doesn't hurt to go for a consult and hear it straight from the horse's mouth, so to speak. I would value that advice over that of any other patient. At worst, you might end up being out of pocket for the co-pay but that's a pretty cheap price to pay for knowledge you will gain.

One thing about Cyberknife is that some insurance companies will not cover it. Medicare will cover it but at your age you're not there yet. I use Tricare, (a benefit from being retired military) and it is covered as well. Cyberknife is about half the cost of surgery and about a quarter of the price of proton treatment...all of which are routinely covered by most insurance companies. I have heard that some HMOs, like Kaiser, consider Cyberknife to be experimental although the procedure was approved for use in cancer treatment by the FDA in 2001.

My advice is go see them in person. And good luck. With your diagnosis at such a young age and your family history I know your are anxious about making the right choice. My guess is that any of several options give you a high probability of achieving a long and healthy life.

Best of luck as you sort this tough nut out.

hopeful and opt...
Posts: 1331
Joined: Apr 2009

Dr Daniel Fuller of the San Diego Cyberknife Center will be on the Dr. Barken show at 6pm pacific time tomorrow evening(Tues) The telephone call in number is 1877-727-3301.....this will be informative for those who are investigating cyberknife as a treatment option

Ira

Swingshiftworker
Posts: 634
Joined: Mar 2010

After 3 months of research, I also decided to go w/CyberKnife (CK) at UCSF Medical Center in San Francisco. Expect to receive treatment in July or August this year.

CK the least detrimental treatment (in terms of quality of life issues and treatment risks) for early stage, localized prostate cancer, which has the same prospects for success as all other treatments, including DaVinci robotic surgery, Brachytherapy (BT) and Proton Beam Therapy (PBT). You may be on the "margin" of what they consider acceptable for CK treatment, but, as long as your cancer is contained w/in the boundaries of the prostate, it should be a suitable form of treatment for you.

Like PBT there are only a few locations around the country that offer CK for PCa -- mostly at hospitals affiliated with medical schools, like UCSF, UCLA, Harvard, etc., but there are private hospitals and treatment centers that are offering it around the country as well. A simple Google search will find them and here's a link to the manufacturer's (Accuray's) website for further info about the technology, as well as a forum specifically related to CK: http://cyberknife.com.

Do your own research on CK and the other options and make your own judgment about what makes the most sense for you.

Good luck!

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