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Cyberknife Treatment--Side Effects

jmadison
Posts: 5
Joined: Nov 2010

I am interesting in hearing from anyone who has had Cyberknife treatment for PC. Particularly any short term/long term side effects. Is this considered a nerve-sparing treatment? What about bowel and urinary side effects?

Thanks!

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

Welcome to the forum. I had CyberKnife treatment in June and have had zero side effects. After CK, some men (about 4%) experience a mild degree of bowel toxicity (they have loose stools) and urinary urgency (they feel like they have to go to the toilet frequently). Both of these symptoms tend to pass within a few days or weeks of treatment. Urinary urgency can be treated with Flomax or in mild cases, Advil.

"Nerve sparing" is not really a term used with CyberKnife. I assume you're wondering if you can still have sex afterward. The nerves really don't come into play with CK, although very long term effects of SBRT on the nerve bundles that encase the prostate is unknown, other forms of radiation frequently have the effect of damaging these nerve bundles several months to years after being irradiated. They typical radiation dose pattern for the prostate using CK avoids concentrating radiation dosages at or near the nerve bundles, but since it is an external source of radiation there is some exposure as the entire prostate is radiated. Over 85% of men with no ED issues before treatment have no ED issues after treatment. Of all forms of radiation used to treat prostate cancer, SBRT (which CK is one method of delivery) has the least amount of side effects. Age, of course, also affects the level of potency. The good news is that even if there is a decrease in potency as a long term side effect of radiation, it is a condition easily corrected by Viagra like drugs.

If you scroll through two or three pages of posts you will see several threads (some have sparked heated debates) pertaining to CyberKnife that pretty much plumb the depths of the pros, cons, and technical aspects of this treatment protocol. I would suggest you read the previous posts and I'm sure any of the men who have undergone this treatment would be happy to address any further technical questions you might have.

As you may know, CK is pretty much for low risk prostate cancer and is not appropriate for intermediate or advanced stages.

Best to you.

=====================

Diagnosed in March 2010 at age 59 with an elevated PSA of 4.3. Biopsy revealed 1 of 12 cores positive with 15% involvement. Gleason 3+3=6. Confirmed with second pathology reading. DRE negative. No physical symptoms and no family history of prostate cancer.

Treatment: 5 fractions of SBRT using CyberKnife. No side effects. 3 month PSA level was 1.3.

YTW's picture
YTW
Posts: 62
Joined: Apr 2010

I completed my CK treatment in August. Unlike Kongo, I had a few (minor) side effects. After my 3rd treatment, I had heavy urgancy to urinate that lasted about a week and began to subside. My URO prescribed Flomax and after about 3 weeks, the problem cleared up. If you decide on CK, I would advise asking your URO for Flomax and begin taking it BEFORE treatment.
Another problem was very loose stools but by taking Gasex and Immodiam, the problem was solved. I am now a bit past 3 months post CK and have virtually zero problems. By the way, my age is 71 and in otherwise, good health......Best of luck........Jimmy/Cleveland..........

phil9200
Posts: 2
Joined: Dec 2011

I'm concerned about the side effects since I had a lot of problems with urinating before I was diagnosed with Prostate Cancer. I'm worried that the cancer may be cured but the problems with urinating may get worse. I've been on Flomax for 3 years. Any thoughts? Maybe Robotic Surgery would be a better option? Thanks

rch
Posts: 78
Joined: Nov 2011

Significant lower urinary tract symptoms are one of the exclusionary cretiria for Brachytherapy; but I had thought that SBRT was more precisely targeted and had no such collateral penetration. I'm glad medications are helping you, otherwise what are the other options? balloon dilatation ? TURP of radiated prostate?

Swingshiftworker
Posts: 616
Joined: Mar 2010

If you're worried about urination following treatment, RP is definitely NOT better than CK or anything else for that matter.

Of all of the currently available treatments, CK provides the most accurate method of radiation delivery with the least potential for causing the types of tissue damage that result in urination and other problems following treatment and all of the men here (including me) who have received CK report no or just minimal side effects following treatment.

RP is at the opposite end of the scale in terms of risk and can potentially cause the MOST problems of all kinds following treatment, including extended periods of urinary incontinence and, in the worst case, the need for the implant of an artificial urinary sphincter. If you haven't seen the following article about the risks of prostate surgery, I urge you to read it before taking any action to pursue RP for treatment:

http://www.hifurx.com/prostate-cancer/prostate-cancer-after-effects

Good luck!

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

Welcome to the forum. Before anyone can give you any thoughts on your questions I think we need a bit more information about your situation such as what your cancer diagnosis is in terms of stage, Gleason Score, latest PSA, number of positive cores, and so forth. It would also be helpful to know about the urinary issue. Is it caused by BPH? If so, what is the size of your prostate? Have you taken anything besides Flomax?

K

Beau2
Posts: 228
Joined: Sep 2010

Hey Phil,

I had an enlarged prostate and had the problems of frequent urination at night (2 to 3 times per night) and very low flow (it took a loooong time to wizz ... I would stand at a public urinal at a ball game and listen to guys behind me complain).

One of the positive side effects of the surgery was that I no longer need to get up at night and I wizz like a race horse. I did not know this would be a side effect when I chose surgery, and I am not advocating you chose surgery for this reason; however, in my case it was an unexpected positive.

Good luck and best wishes in your fight with PCa.

Swingshiftworker
Posts: 616
Joined: Mar 2010

I had CK treatment almost 3 months ago now and I too had some urgency issues (and still do) but I did/do not consider it a major problem. No ED or any other problems.

I had a problem w/urinary frequency before treatment which led to the discovery of my PCa. The frequency problem continued and I also developed a minor urgency problem following treatment. I was took Hytrin (major headaches), Ditropan (no apparent effect) and Flomax (dried up my ejaculate, which is a known side effect of Flomax) before treatment to control frequency but stopped taking all of them in lieu of taking saw palmetto extract, both before and after treatment, which has controlled the frequency and urgency problems to my satisfaction.

I'm due to take my 1st PSA follow-up test tomorrow and will report the results here as soon as I get them.

jmadison
Posts: 5
Joined: Nov 2010

Thanks to all above who have responded. I'm taking your comments into consideration for my own decision to do CK or not.

Swingshiftworker
Posts: 616
Joined: Mar 2010

You're speaking to the choir here but, if you're eligible, I highly encourage you to go for CK!

You can troll this forum for threads (one very recent) about the substantial risks of surgery which can not only result in permanent ED (which may require a penile implant) but also MAJOR urinary and bowel dysfunction (which may require a urinary sphincter implant and/or multiple surgeries and many years to remedy). Why subject yourself to that kind of risk when it's unnecessary?

The argument often given for surgery is that you can have radiation after surgery but can't have surgery after radiation. Frankly, that is not true. Surgery is difficult but not impossible after radiation treatment BUT surgery to remove the prostate following radiation treatment is usually unnecessary, because surgery following radiation does not achieve any a better result than simply doing followup radiation, chemo and/or hormone treatment which is what you'd have to do after a failed surgery anyway. And, don't let anyone fool you, you still have the same risk of failure (return of the cancer) after surgery as you do following radiation. Radiation does present a minor risk of acquiring a 2ndary cancer later, but if you have followup radiation after surgery, which is quite common, that risk is the same.

There are certain situations when surgery is the best choice for treatment, but early stage Pca is not one of them. If you have early stage PCa, there is absolutely no reason to remove the prostate surgically in order to treat your PCa because CK can effectively attack the cancer with virtually no side effects and with the same prognosis for recovery as surgery. So, the choice for me was a no brainer.

As far as I know, we've got 4 members of the CK club here currently (the 3 who have already posted here and ViperFred who doesn't post very often is another) and I'm looking forward to welcoming you as a new member.

Good luck & best wishes!

bdhilton
Posts: 752
Joined: Jan 2010

My 2 cents is that you explore all options available to you and make an informed decision with what you feel will work best for you....Best to you in this journey…

jmadison
Posts: 5
Joined: Nov 2010

Thanks for you comment. I have been exploring other options in addition to CK...proton therapy, surgery, HIFU...and considering watchful waiting.

Best regards,
JMadison

Swingshiftworker
Posts: 616
Joined: Mar 2010

I believe that all of us who chose CK looked at all the same options you are considering nd decided that CK was the best for us.

Of course, that may not be the case for you. So, please let us know which treatment method you choose and why. Good luck!

budoinst
Posts: 1
Joined: Mar 2012

I am a newbie and have recently completed my five sessions of Cyberknife treatment. I had a early stage issue and reviewed virtually every alternative available. Cryo was the first one aimed my way and I quickly negated that after reading about its after effects. I then reviewed 8 week radiation treatments , spoke to several individuals and decided against that also. I was set to have DaVinci surgery in mid-December 2011, but an important family issue caused me to postpone it. I then received a call from a good friend in Maryland who suggested Cyberknife. After looking into it deeply, I decided that would be the method I would use.

Outside of being a bit tired (mainly from the voiding practices prior to treatment and two hours of driving a day), I have basically no other issues. A bit of a slower flow and a little more frequent bowel movement is all I noticed.

So far, so good and I am initially very pleased that I made it my final choice.

Swingshiftworker
Posts: 616
Joined: Mar 2010

Welcome to the Forum.

Sorry you need to be here w/us but I'm happy to learn that you were able to avoid surgery and chose CK to treat your cancer, like many of us here have already done.

Let us know how you're doing as time goes on.

Ciao!

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

Budo, as another CK survivor I would like to welcome you to the club. I completed my CyberKnife treatments in June 2010 and have no side effects. Hope you continue to have smooth sailing.

K

aj39494
Posts: 4
Joined: Oct 2012

I oomplete my treatment in late April, I had minimal side effects, but about 3 months later I was seeing small amounts of blood in my urine, and seems to happens every 3-4 weeks, I contacted the Urologist and was told this was normal, Has this happened to anyone else? I feel fine other that this.

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

I had my CK treatment in June 2010 and although I did not experience the effects you describe my doctor also told me that small amounts of blood were not unusual and that it would gradually pass. Good luck to you.

K

aj39494
Posts: 4
Joined: Oct 2012

How long did it last? was it months?

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

I don't recall exactly and I think that everyone is different but a few months seems reasonable. If it is persistent then there may be something else going on.

mrspjd
Posts: 688
Joined: Apr 2010

Welcome to the PCa forum and congrats on completing your SBRT tx by CK. It must be a relief to be looking at that in the rear view mirror!

Most CSN newcomers (patients and patient advocates) are encouraged to share their or their loved one’s PCa history. I invite you to consider sharing yours. Doing so helps others better understand your PCa stats, tumor staging/risk level, tx decision process/choice and journey. This info may include facts such as age @ PCa dx, PSA history, factors leading to biopsy, biopsy results including % of involved cores/cancer volume, prostate volume, and any 2nd opinion pathology results/reports obtained from a lab specializing in analyzing PCa biopsy specimen slides. In your case, it might be informative to understand which CK protocol and dosing was used for your tx, i.e. consecutive day vs alternate day, total Gy and # of fractions delivered. You may also wish to clarify your statement “Outside of being a bit tired (mainly from the voiding practices prior to treatment…)” Perhaps your CK treatment required a bowel cleanse prior to each session?

As I’m sure you’re aware, a growing number of patients, advocates, medical professionals and physicians in the PCa community believe that AS/AM (active surveillance/active monitoring) is a very viable and appropriate plan of action for men dx’d with low - moderate risk PCa. Of course, choices related to PCa are always a highly personal decision.

Good luck on your journey.

mrs pjd

robert1
Posts: 82
Joined: Apr 2011

Hello jmadison:

Guys like us have so many choices today, but these choices are separated by whether you are a true low, intermediate or high risk patient, your age, documented cure rates and then your personal perceptions of both having cancer and treatment side effects. Some guys get through their ordeal without any side effects, but not a high percentage.

In any event, the one truth I continue to support is that the vast majority of us have some time to make our decisions. When guys do their homework, treatment choices become much more obvious.

Whatever your choice, I strongly recommend you work with the absolute best doctor/oncologist you can find. This is a huge factor in success or any kind.

Best wishes,

robert1

Mrs rec
Posts: 3
Joined: Apr 2012

My husband had cyber knife treatment last September 2011, with only mild side effects a week later. Now, more than 6 months later, he is having severe problems. For the last two weeks he has had pain , burning, urgency, and blood in the urine. He was prescribed an antibiotic and flomax for a week, which did not relieve his symptoms. Yesterday we back to the doctor. He did a cistscope to check his bladder, a sonogram, and urine test. He said that husband does not have an infection, and took him off of the other meds, and put him on vesicare. He said that symptoms are a result of the cyber knife surgery last September. He still has all of the symptoms, and cannot sleep because of the pain and having to constantly go to bathroom. Has anyone else had this, or have any advise ? Please let us know, as he is miserable. Thanks

Swingshiftworker
Posts: 616
Joined: Mar 2010

I had CK done in Sept 2010, a year before your husband, and have not had any such problems.

Although not unheard of, they are very rare and I am sorry that your husband is experiencing them. The men (including me) here who have received CK treatment w/in the past year or so, have not reported any such problems.

I suggest that you go to Accuray's (the maker of CK) Patient Forum, where there is a greater range of knowledge and experience about CK available. You an find the site here:

http://www.cyberknife.com/Forum.aspx?g=topics&f=2586

Please let us know here what the cause and solution are as soon as you are able.

Good luck!

Mrs rec
Posts: 3
Joined: Apr 2012

Thank you so much for your reply, I will check it out. I did read on another site of a man who was experiencing similar, but much milder symptoms. I hope that something can be done to relieve him, the doctor acted like he would just have to live with it. Thanks!

mrspjd
Posts: 688
Joined: Apr 2010

Mrs rec,

From wife to another, welcome to the CSN PCa discussion board. From reading your post, it seems that your current RO (the same doctor that provided the CyberKnife tx?) has confirmed that the painful symptoms your husband is experiencing resulted from his CK treatment. Did he say how/why this might have occurred? Apparently that RO (radiation oncologist) has been unable to provide solutions to mitigate the painful side effects/symptoms. I strongly recommend that you seek 2nd opinions ASAP from another RO as well as from a knowledgeable urologist who can do a complete evaluation to determine exactly what is causing your husband’s symptoms and provide some answers/solutions to mitigate the painful side effects.

Here’s some info that probably won’t be found on either the Accuray or CyberKnife websites about risks and patient safety re CyberKnife (aka SBRT): Last year, the respected American Society for Radiation Oncology (ASTRO) released a summary paper titled “Quality and Safety Considerations in Stereotactic Radiosurgery (SRS) and Stereotactic Body Radiation (SBRT) Therapy.” The document was commissioned by ASTRO and approved by their Board of Directors to address patient safety.

ASTRO’s executive summary paper states: “Given that very high-dose fractions of radiation are delivered, the margin of error for SRS and SBRT is significantly smaller than that of conventional radiotherapy and therefore special attention and diligence is required. A SMALL ERROR IN TARGET LOCALIZATION FOR ANY 1 FRACTION RISKS UNDER TREATMENT OF PORTIONS OF THE TUMOR BY 20% OR MORE, AND INADVERTENT OVER DOSAGE OF ADJACENT NORMAL TISSUES COULD ESCALATE THE RISK OF SERIOUS INJURY TO A MUCH GREATER DEGREE THAN AN EQUIVALENT TREATMENT ERROR IN A COURSE OF RADIOTHERAPY WHERE A SUBSTANTIALLY LOWER DOSE PER FRACTION IS USED [IG/IMRT].”

I have posted this info before and know it is not what you want to read but, without knowing more about your husband’s PCa history, stats, his clinical staging, the CK tx protocol used, dosing, the expertise & skill of his radiation team, including the radiation oncologist, the dosimetrist/physicist, the CK technician, etc., its difficult to know for certain whether your husband may have suffered permanent or temporary injury and/or collateral tissue damage from his CK/SBRT tx. I hope you find some answers soon, and that the symptoms are short term, treatable, and the pain resolves quickly.

Best of luck to you both.

M (mrs pjd)
wife of PCa survivor

Mrs rec
Posts: 3
Joined: Apr 2012

Mrspjd, Thank you for your information. The doctor that we saw was a urologist. After the vesicare did not work, husband was put on cortisone dose pack, which he has almost finished. His pain was so bad this morning, he was fighting back tears, and he never cries. When he took 4 ibuprofen , that helped temporarily . I need to keep a record of all the info, but right now do not have all info. The gleeson score was pretty low, and the cancer was early stage , I think it was in three of the core samples. I really appreciate your help and recommendations. I will take him to get a second opinion with a radiation oncologist ASAP . We are in north Florida, so I will try to schedule an appt at the Mayo Clinic. Also, will try to follow up on the findings from Astro. Thank you so much !

mrspjd
Posts: 688
Joined: Apr 2010

Mrs rec,

If a 2nd opinion consult @ Mayo Clinic confirms that your husband has suffered collateral tissue damage from CyberKnife treatments, you may wish to ask them about a type of tx called Hyperbaric Oxygen Therapy (HBOT). According to the American Cancer Society, there is “some evidence suggesting Hyperbaric Oxygen Therapy may be helpful as an extra tx for soft tissue injury caused by radiation.” Use your search engine w/ key words “Hyperbaric Oxygen Therapy + radiation” to further research this subject and to determine if it might be an appropriate therapy to mitigate your husband’s symptoms. Follow this link for more info from the ACS:
http://www.cancer.org/Treatment/TreatmentsandSideEffects/
ComplementaryandAlternativeMedicine/HerbsVitaminsandMinerals/hyperbaric-oxygen-therapy

There is a learning curve for all physicians providing txs to PCa patients—RO's providing CyberKnife tx are no exception. With CK’s aggressive marketing/advertising campaign and as one of the “newer” (not new, but newer) txs in the PCa tx arsenal, CK centers seem to be everywhere, from small clinics to large, teaching medical centers/hospitals. As a primary mono tx for low risk PCa or as a secondary tx for isolated PCa tumor mets (even newer), it is imperative for anyone considering this tx to choose a skilled and experienced CK radiation team at a medical/RT center of excellence. This is not an endorsement for CK but rather a recommendation for choosing the best of the best--an expert--for any PCa tx--especially with regard to newer txs such as Robotic RP or CK/SBRT, where the learning curve may be greater.

I encourage you to consider checking back with updates, sharing what you've learned and how you both are doing.

All the best.

M (mrs pjd)

mrdezzy
Posts: 23
Joined: Mar 2012

Mrs rec, can you share the location of your procedure and what they say about the side effects your husband is experiencing? Would expect them to very involved.

jak30022
Posts: 2
Joined: May 2012

Mrs rec,

Was there any resolution to yuor husband's side effects?  Having similar issues but not as severe.  Am told it will take care if itself over time but I am now almost 12 months post Ck and symptoms not improving.  

MJG
Posts: 1
Joined: Nov 2013

recently diagnosed with very low risk prostate cancer. psa 6.3, Gleason 6 and found in 2 of 12 cores (5% and 7%). Exploring all options....so confused. urologist suggest surgery, friends suggest Cyberknife and another doc standard radiation....any input would help

hopeful and opt...
Posts: 1278
Joined: Apr 2009

I am sorry for your diagnosis, We are here to help you.

 

So you can receive the attention that you deserve, It is best  that you start a new thread by clicking new forum topic on the upper left side of the discussion boards, Please include your age, Any diagnostic tests other than a biopsy. What led to you having a biopsy, was the digital rectal exam normal?

aj39494
Posts: 4
Joined: Oct 2012

I had my treatments around the same time you did, did you have any issues a few months later??

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

I have had no issues at all. Keeping my fingers crossed.

Raltrt41's picture
Raltrt41
Posts: 16
Joined: Mar 2013

Hey Guys,

 

      I'm glad I stumbled on this site. I am early in the journey. PSA went from 1.38 to 2.7 in a year.  Positive DRE and MRI-S from a HIFU provider  in FLA....2nd opinion from a Cyberknife guy in Marirtta , Ga was iffy, with a negative DRE

 

       Followup DRE (3rd) mildly suggestive, but PSA @ 2.6, free PSA 21.2, and PCA3 46.   MRI with comtrast, but NO coil, showed suspicious left side involvement.  12 core biopsy scheduled on 04/04/13.

 

     I'm down to Cyberknife, or secondly HIFU.

 

     Here are my CK questions :

     1) anyone have experience with the CK facility in Marietta GA ?.....I think they have 100 treated cases of PC in last 3 years ith 4 failures based on PSA.

 

      2)  The head guy there blew me off when I asked about every other day treatment modality.  I've read some positive data about that lessening side effects.

 

       3) Any data on long term risk of CK related bladder/colon cancer compared to other forms of radiation therapy ??

 

        4) The HIFU urologist I saw in FLA diagnosed me with PC based on MRI-S and DRE, and PSA Velocity.  Anyone here been diagnosed without a biopsy ?

 

      Many thanks for your thoughts, and I am a boots-on- the-ground guy in RVN, 1970-1971.

 

Regards to all,

BG

 

      

 

 

ralph.townsend1's picture
ralph.townsend1
Posts: 350
Joined: Feb 2012

Welcome Vietnam vet. I was boots on the ground station at Camp Eagle, with the 178th Avn Chinooks, 1st Avn Bge and 478th Avn at Da Nang with the Fying cranes.

Love them Cobra's, really when we flew our missions it was nice to have a Cobra fying around.

Rvn 1970-1971

Good luck, Have you filed with VA for Agent Orange and got compensated?

Raltrt41's picture
Raltrt41
Posts: 16
Joined: Mar 2013

I flew hooks a tour then Cobras....both in the Delta out of Can Tho........I've started the Agent Orange Fastrack but no answer yet. Although I have a written diagnosis of PC from a urologist, I'm not sure if the VA will approve a disability claim prior to my biopsy...WELCOME HOME !

ralph.townsend1's picture
ralph.townsend1
Posts: 350
Joined: Feb 2012

If your privite Urologist said you have cancer, they should give you a 100% for PC. That is about $2,800.00 and if you are married, it more. If the cancer curable then they will lower it down after 6 months to 30-40%. They might make you do C&P with VA hospital. Fast track is maybe 12 months, but usually longer. Look at the list of condition's for AO that VA has, you might find that you have other conditions???  If you need help I will be boots on the ground at this site.

Welcome Home

 

hopeful and opt...
Posts: 1278
Joined: Apr 2009

Diagnosis is based on the results of the biopsy; all other information such as MRI's, PSA"s, etc are indicators only.

It's great that you are doing research, keep on going....however, a treatment choice is based on many factors,suh as Gleason score, indication of inside or outside the capsule, PSA, dre, size of your prostate, etc, etc,  so picking a treatment type at this point is premature.

" The head guy there blew me off when I asked about every other day treatment modality. I've read some positive data about that lessening side effects"

There was a study , when cyberknife was developed that showed that there is less short term  side effects with every other day treatment...there is also a promininent doctor now who thinks that every day in  a row is fine.,.....If your final decision is sbrt, I would ask the doc to do every other day

SBRT has been in existance about 8 years so long term datra is lnon existant.

YTW's picture
YTW
Posts: 62
Joined: Apr 2010

hopeful/opt:   I underwent C.K. about two 1/2 years ago at age 70.  My PSA has been decreasing from 6.5 down to 1.25 about a month ago.  I experianced some slight urinary & bowel problems for about a month but with the use of Flomax & Immodium, those problems have subsided.  My treatments were done every other day as advised by my Radiation Oncologist.  He also advised me NOT to take any anti-oxident supplements for at least a month after completeing C.K.  Ther reason being that with any type of radiation its purpose is to destroy Ca cells.  Anti-oxidents try to help cells survive and that includes Ca cells.  I did not use any type of supplements for about 6 months.  By the way, everything still works at age 73 and I mean everything Best of luck.....Jimmy/Cleveland 

hopeful and opt...
Posts: 1278
Joined: Apr 2009

SBRT will be my first choice if I require active treatment and my diagnosis allows. I would ask for every other day treatment.

Thanks for the tip about anti- oxidents

 

 

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

BG,

 

Welcome to the forum and I think you're smart to be researching potential treatment options.  The first thing that struck me is that other than a rather confusing DRE test you really don't have any definite indication that PCa might be present.  Your PSA is very low and the slight rise between tests over a year period could be caused by a number of factors such as sex the night before the blood draw, a DRE exam before the blood draw, certain types of exercise, or just the time of the day or the phase of the moon.  PSA results have been shown to vary at different times of the day for no apparent reason but certainly orgasm or anything that puts pressure on the prostate (even a hard stool) can cause a slight elevation in PSA that lasts up to 48 hours.

I had Cyberknife in July 2010 at age 59 and have had no side effects.  I did purposely ask for and received the every other day treatment based on Dr. King's initial study which showed every other day had less prostate inflammation which decreased the chances for urinary urgency.

I would be running as fast as possible away from a HIFU urologist that diagnosed you on the basis of image scanning and PSA velocity.  If the two data points you listed are what he used he is trying to sell you a bill of goods...or a quickie trip to Jamacia for his HIFU procedure.  The ONLY way prostate cancer can be diagnosed is through a biopsy.  Everything else is just a guess.

Good luck to you.

 

Raltrt41's picture
Raltrt41
Posts: 16
Joined: Mar 2013

Thanks for your thoughts.  I agree that I seemed to be a self funded profit center to the first HIFU/urologist I consulted.

 

You are correct, I do not have a biopsy-confirmed PCa diagnosis yet. I have a 12 core biopsy scheduled 4/4 for the following reasons:

 

1) PSA velocity....1.38--2.7 in one year

2) 2 of 4 DREs felt left hemisphere ridge

3) Free PSA 21.2%

4) PCa3...46

5) Both MRIs and color Doppler ultrasond indicated left side tumors, equivocal ECE

 

I wanted to avoid the biopsy because of potential needle tracking, and other known risks. However, I feel I can no longer avoid it, and need the results to make a more informed decision on treatment. CK is presently my leading choice, and I have had a consult with the CK provider in Marietta , Ga......my hardest decision will be WHERE to go for optimum CK therapy.

Thanks for your forum info,

BG

 

 

 

 

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

I share your concerns about needle tracking.  Most doctors dismiss it but pathologies after surgical removal often find prostate cancer growing along needle marks.  My personal lay opinion is that while there may be some small spillage of cancer cells in conjunction with a biopsy, they are relatively few in number and a healthy immune system will probably take care of it just fine.

One thing I learned when going through the CyberKnife process is that there is a great amount of checks and balances between the radiation oncologist, the radiologist, the nuclear physics people and the technicians that run the machines.  It's all about the proper planning of the radiation treatment and the computer pretty much does everything else.  Check their credentials.  My doctors freely offered to provide references of former patients and you can check the history, education, and malpractice incidents of the physician online.

Good luck.

fawnsbuck1's picture
fawnsbuck1
Posts: 8
Joined: Jul 2013

Hi, I am going through Cyberknife treatment now. I am 51 and T1c. Gleason score of 3+3=6. 4 out of 12 samples positive. 3.2 Psa. I haven't had any urinary problems before treatment. My Cyberknife Doctor said there's 50% chance of having ED problems. This side effect could show up up to a year after treatment. I was told if you don't have any urinary problems before treatment you have a better chance not to have as many problems later. So far the worst part of Cyberknife is the markers being put in. But it wasn't as bad as a biopsy. Some insurance company's fight paying for this treatment but they give in. Good Luck and God Bless.

Tim

tasha_111's picture
tasha_111
Posts: 2041
Joined: Oct 2008

I go for my treatment tomorrow, pretty scared but reading this link has helped a lot and I am sure I am doing the right thing.  Have mets breast cancer to spine, painful as all hell.  Fingers crossed for tomorrow.  Good luck all, Tash xxx

VascodaGama's picture
VascodaGama
Posts: 1511
Joined: Nov 2010

Good luck to you too Tasha.

Best wishes for complete success.

VG

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stevenkimbell
Posts: 3
Joined: Oct 2013

I am scheduled for robotic surgery next week, but with all the reading i have been doing over the past few days I am not sure it is the best choice.  I moved pretty quickly on the option of robotic surgery.  when i found out about my cancer diagnosis i immediately made some calls and set up a date.  that was about 4 weeks ago.  since then i have been reading about cyber knife and am finding information that either my uro / surgeon didnt give me or it conflicts with it. 

I was told, without a doubt, that i would experience ED and incontinence issue later if i had cycber, whereas if i have the robo i will have them up front but they will most likely go away.  all this with the caveat that anyting can happen and the standard statistics.  However, in my reading about cyber i am not finding anyone who complains of ED or other issues occuring later in life.  granted, i have only come across a few blogs/posts on it from guys who had cyber 5+ years ago, but still, it makes me wonder. 

I need feedback on this guys.  no matter what option you choose, everyone guarantees it is the best but i cant find a lot of corroborating evidience to support anyone's claim.  what is the experience in the group?  what are the real life experiences of men who have had cyber?

i have a PSA of 4.6,  gleason of 7, 3+3 @ 65%, and 3+4 @ 54%, other samples at 3+3 =<10%.  I am 54 and still very active physically and sexually.  in fact i am so healthy that i was supprised to find that anything was wrong with me at all.  I dont want to borrow trouble by choosing an option based solely on a surgeon's reccomendation. 

 

 

hopeful and opt...
Posts: 1278
Joined: Apr 2009

Prostate Cancer is a very slow growing disease, so it is best for the patient to do sufficient research to make atreatment choice that is the "best" based on knowledge. To this end please share the results of your biopsy and any pertinent information to include other diagnostic tests, what prompted you to get a biopsy, age, etc.  so we can provide insights for you.

The information that you have is wrong. Surgery generally has side effects at first to include but not limited to ED and Incontinence, howeverit is possible for  these side effects to be severe and last a life time.

SBRT is a new form of radiation that has been in existence about 8 years. Basically a high GY(dose) is given at each session to a total of 4 or 5 sessions on high tech machines, the Cyberknife machine is the most used now, however there are other machines that deliver the dose such as Novalis. The accuracy of these machines are very precise and may be an improvement over radiation such as IMRT where there are 40 sessions. A man can go about his daily activity after each SBRT treatment. It is not true that one will alway suffer side effects of ED and Incontinence, in fact the numbers are better than surgery, however with Cyberknife quite often there is no semen with intercourse.

 

stevenkimbell's picture
stevenkimbell
Posts: 3
Joined: Oct 2013

I had an elevated PSA about 3 years ago on a physical, 4.32.  Last year it was significantly lower at 3.4 so my Dr said it was probably just an infection that has cleared itself up.  anyway, my company has a great insurance plan and they encourage us to get a physical every year.  They offier the office visit at no co-pay or deductible and cover most of the lab work.  I went for one about 6 weeks ago and had my doc run the full gamut of tests.  The PSA came back at 4.6 this time round.  Again he suspected an infection since I am not in any way symptomatic of any issues - he says i am healthier than he is.  He mentioned taking an anitbiotic or going to a urologist just to be sure.  I opted for the uro and sure enough the biopsy came back positive for PC. 

The uro is not a surgeon but immediately recommended i look into the robotic surgery which he described as the best option for a man my age and in my condition.  I am 54, i exercise (sometimes), bike ride, scuba dive; i have a low carb diet and am in pretty good condition.  I still have an active sex life and hope to live out more years than i deserve. 

i sought out a uro that does the robo in Chattanooga.  he went over the procedure and described the side effects as well as the issue i would deal with during recovery.  when i asked about other options such as cryo and cyberknife he cautioned me against them saying that men who have the radiation treatments suffer issues later in life because of the tissue damage done by the treatments.  he told me that i would have to deal with the same issues following robo but they would be immediate and i would recover from them, whereas the other options presented side effects later that tended to be more permanent. 

To make a long story short, i kinda feel like he is more interested in paying for his investment in the machine than he is in getting me factual info on the options.  while i believe he wants me to heal and be cancer free, he is willing to convince me to use his method even though i might prefer another if i knew enough about it.  that is my goal here, to learn more about the cyber.  what are the side effects experienced by actual patients 5 years or more down the road?  i dont want to deal with the healing process and side effects of robo if i dont have to, but i dont want my balls to fall off later in life either.

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