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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!

hopeful and opt...
Posts: 1282
Joined: Apr 2009

For some reason, I did not notice the information that you posted about the biopsy?

Consider having a second opinion of the slides of the biopsy by a world class pathologist who specializes in prostate cancer since determining gleason is subjective.

Did you have an MRI or other diagnostic test to have an indication of extracapsular extension? Steven, It's important to know if the cancer is localized, that is within the prostate or in addition outside the prostate. This will be a determining factor for treatment

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What are the credentials of the surgeon? Has he been fellowship trainned? How many robotic surgeries has he performed? etc, etc. There is a steep learning curve for robotic surgery....one needs to perform at least several hundred to be somewhat proficient....thousands are better.

Yes you are right, many docs are self serving.  Remember you are the CEO of your case; these docs work for you. It is important to read books, attend support groups and see multiple docs in various specialties. You need to find the best that you can in each specialty even if you have to travel to Tim buck To.

 

If you need , take a little extra time to make the right decision for you.

 

.......................

Steven, Both SBRT and Robotic Surgery are viable  treatments for men with a Gleason 7 providing that there is no extracapsular extention. Generally SBRT is 95 percent cure effective and has minimal side effects.

There were valid comments written above.

Good idea to see an experienced SBRT specialist for a consultation and visit the cyberknife web site as mentioned above.

 

P.S. Don't worry about your balls falling off ...many of us who had this happen use super glue to reattach

lewvino's picture
lewvino
Posts: 1004
Joined: May 2009

Steven,

Hi and welcome to our forum. I started to send a message several times yesterday and got delayed. I see you mention Chattanooga. I live just up the road in Cleveland TN and would be more than happy to meet with you or talk with you via the phone.

I had robotic surgery at age 54 (four years ago). Each person has there own preferences for treatment since that is what they experienced. If you decide to go Robotic look for a Doctor that has a great level of experience. Four years ago I could not find any one in the Chattanooga area with what I considered fast experience with the robot. It does have a large learning curve to become very precise and profecienet with the robot. I chose Dr. Smith at Vanderbilt in Nashville.

Post surgery I had a positive margin and have been monitored closely since surgery on the PSA. In August this year my psa was at .3 so elected to have what is called salvage radiation to the prostate bed. I have two more sessions to go of 38.

Even though I had a positive margin I still consider my surgery a success. I had no issues with urine control. I do use Levitra and am able to still enjoy the sexual side of life.

I looked into the cyberknife option four years ago. At that time they would not treat a gleason 7. I do not know if that is true or not today. At that time the closest cyperknife was up in Knoxville TN.

Again if you would like to chat in person or via phone just let me know. This forum has an email feature you can contact me through that method. Or I'm free most days after 5pm and would be willing to meet you somewhere.

Lewvino In cleveland TN

 

hopeful and opt...
Posts: 1282
Joined: Apr 2009

Now Gleason 7 and above are routine being treated with SBRT. For the most part containment in the prostate is critical to treatment. For more aggressive cancers SBRT uses greater margins.

lewvino's picture
lewvino
Posts: 1004
Joined: May 2009

Thanks for sharing Hopeful and opt. I did not know that. Was just going on what I had been told 4 years ago.

Lewvino

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

Steve,

 

Welcome to the forum although I am sorry you are here.  I had CK in 2010 and still am free from any side effects.  Your urologist, in my opinion, has given you misleading and slanted information about modern radiation techniques and understated the potential risks associated with RP.  I have posted dozens of times about my experiences and the technical aspects of the CyberKnife SBRT treatment method and you may find it useful to look back in the history of this forum to see some of these.  

Discussions about the best treatment method are often heated and emotional but that is usually a factor of men being passionate about their treatment choices.  There really aren't any do-overs in this so be very careful about the choice you eventually pick and make sure you are going in with your eyes wide open.

I strongly encourage you to deal directly with a radiation oncologist that specializes in CyberKnife treatment to see if this might be an option for you and to get another opinion on potential side effects.  There are several studies that you can peruse but a consultation with a specialist is the best way for a layman to get information.  Of course, radiation oncologists are biased toward their speciality just as robotic surgeons are biased toward thier own process.  You really need to listen to all of them to get a clear picture.

Every treatment option poses risk to your quality of life.  In my lay opinion, CK poses less risk than any other option and that is why I chose it.  I'm very happy that I did.  I also think that RP poses one of the highest risks to future quality of life.  Scroll back and read some of the stories and judge for yourself where the risks are.

Good luck.

K

equinox747
Posts: 1
Joined: Nov 2013

Hi guys/Kongo,

 

I’m new here so forgive my Naivety. just came across this site today from a friend, just in the middle of the ball park game, after having A 3D MRI and MULTI MAPPING Perineum BIOPSY still waiting for results, but as of yet i was told after the ULCH in London had seen my MRI that i had LOW RISK LOCALISED Cancer and that they would know better after the biopsy how to go forward with treatment options. Came across this Cyberknfe and am pinning my hopes on it, as i was initially swayed towards Radiotherapy against the Surgery for all the reason highlighted here, but was a little put off with the possible severe side effects of colon cancer with the radiotherapy they use. But then read about the advances with CYBERKNIFE. Still taking on board all posts and help. And will definitely check out  the doctors  credentials and second opinions, as my GP said this is why you ‘sign a consent form’ to acknowledge that you know what you are signing for. Any further thought on CYBERKNIFE would be welcomed.

 

hopeful and opt...
Posts: 1282
Joined: Apr 2009

Please repost after you receive the results from the biopsy, the paper work so we can provide input....in the event that your biopsy is positive, which ihopefully it will not be, there are various options that are available to include but not limited to SBRT(cyberknife). We will be happy to provide input at that time.

In your statement, please include age, psa history,DRE results, what led to you having a biopsy,  number of cores taken in biopsy, number positive, the gleason score of each core that was positive and the amount of involvement of each core that is positive. Also include any other diagnositic tests taken.

In the biopsy that you had, have any of the suspicious lesion found in the MRI been targeted?

Also please start a new thread. This can be done by clicking new forum topic on the upper left side of the discussion boards

lewvino's picture
lewvino
Posts: 1004
Joined: May 2009

I would assume since the Cyper Knife beam is directed at the prostate that the nerves would also receive some radiation. The nerves that contol erections are in a thin layer that surrond the prostate.

 

also was good to chat with you on the phone today.

 

lewvino

hopeful and opt...
Posts: 1282
Joined: Apr 2009

 

Here is a 6 year study that is informative

 

cancer: disease control and quality of life at 6 years

Alan J Katz, Michael Santoro, Fred Diblasio and Richard Ashley

For all author emails, please log on.

Radiation Oncology 2013, 8:118 doi:10.1186/1748-717X-8-118

Published: 13 May 2013

Abstract (provisional)

Background

Stereotactic body radiotherapy (SBRT) may yield disease control for prostate cancer in a brief, hypofractionated treatment regimen without increasing treatment toxicity. Our report presents a 6-year update from 304 low- (n = 211), intermediate- (n = 81), and high-risk (n = 12) prostate cancer patients who received CyberKnife SBRT.

Methods

The median PSA at presentation was 5.8 ng/ml. Fifty-seven patients received neoadjuvant hormonal therapy for up to one year. The first 50 patients received a total dose of 35 Gy in 5 fractions of 7 Gy. The subsequent 254 patients received a total dose of 36.25 Gy in 5 fractions of 7.25 Gy. Toxicity was assessed with the Expanded Prostate Cancer Index Composite questionnaire and the Radiation Therapy Oncology Group urinary and rectal toxicity scale. Biochemical failure was assessed using the nadir + 2 definition.

Results

No patients experienced Grade III or IV acute complications. Fewer than 5% of patients experienced any acute Grade II urinary or rectal toxicities. Late urinary Grade II complications were observed in 4% of patients treated to 35 Gy and 9% of patients treated to 36.25 Gy. Five (2%) late Grade III urinary toxicities occurred in patients who were treated with 36.25 Gy. Late Grade II rectal complications were observed in 2% of patients treated to 35 Gy and 5% of patients treated to 36.25 Gy. Bowel and urinary quality of life (QOL) scores initially decreased, but later returned to baseline values. An overall decrease of 20% in the sexual QOL score was observed. QOL in each domain was not differentially affected by dose. For patients that were potent prior to treatment, 75% stated that they remained sexually potent. Actuarial 5-year biochemical recurrence-free survival was 97% for low-risk, 90.7% for intermediate-risk, and 74.1% for high-risk patients. PSA fell to a median of 0.12 ng/ml at 5 years; dose did not influence median PSA levels.

Conclusions

In this large series with long-term follow-up, we found excellent biochemical control rates and low and acceptable toxicity, outcomes consistent with those reported for from high dose rate brachytherapy (HDR BT). Provided that measures are taken to account for prostate motion, SBRT's distinct advantages over HDR BT include its noninvasiveness and delivery to patients without anesthesia or hospitalization.


 

waldipup
Posts: 2
Joined: Dec 2013

I was treated by Dr. Katz , a Dr. in the study linked by hopeful and opt....18 months ago . The entire C/K procedure was mundane with nothing of note , except bring your own music cd to listen to during treatment ,  theirs sucked , in fact I let them keep mine and the tech guy was appreciative .

Also , I was a big baby during the perineal implants and got scared of the needles , the whole thing took 5 minutes and no big deal .

After effects were trouble peeing for a few days due to prostate swelling due to the fact that I didn't listen to Dr. Katz who told me to take extra anti inflammatories during treatment , but that went away in a day or two .

Also , not diareah but "looseness" for about a week or so , no big deal .

In fact , overall no big deal .

Dont go just anywhere , use a quality RO - even Dr. Samadi , the reknowned NY Prostate surgeon who prefers surgery to radiation , cautions to use a good surgeon if you go that way , research your RO before using one , Dr. Katz for example is a C/K innovator with 500-600 cases worth of experience and a success rate of 97% low risk and above 90% intermediate with low side effects . He uses advanced targeting technique that all C/K RO's dont use , so shop around . 

No L/T effects so far after 1 1/2 yr .      

 

cyberman
Posts: 1
Joined: Jan 2014

Gleason six. Two positive specimins. Diagnosed early 2013. Treated March 2013

Initially my urologist somewhat pushed his Da Vinci surgery but he also sent me to HIS radiation treatment center. They offered the 8 week treatment which I chose not to do. After him-hauling around they finally mentioned cyberknife. After a little research it was pretty much a no-brainer. Almost no side effects until now... almost 10 months later. I have been having minor discomfort after sex. Apparently the orgasm might be causing the pain. Not during but the next few days after sex. This was the first time I had this pain and it's slowly subsiding. It's not bad enough to bother me all the time so hopefully it's just a stage of healing. They say the prostate literally dies and shrinks. Little to no ejaculate so it is quite a bit different than when everything was normal. Doctor calls it "shooting blanks". Beats the alternative.

I video'd one of my sessions.... enjoy

<iframe width="550" height="309" src="//www.youtube.com/embed/q4Hp2V1iyl8" frameborder="0" allowfullscreen></iframe>

 

Well it looks like <object> and <embed>tags do not work even though the notes here say we can use them.

Here is a direct link...

http://www.youtube.com/watch?v=q4Hp2V1iyl8

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