Cyberknife Treatment--Side Effects

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Comments

  • cyberman
    cyberman Member Posts: 1
    Gleason six. Two positive

    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="560" height="315" 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

  • jose_vale
    jose_vale Member Posts: 2
    Prostate Cancer Medication

    I’m 65 and am about to start on prostate cancer treatments. I’m prescribed doxorubicin which is mostly affordable, but my Dr. has suggested Viagra to go with it, and I’m not making a lot of money at the moment. My Dr. also mentioned alternatives such as “generics” and his personal off the record reassurance about Canadian pharmacies as an option, which I am a little skeptical of. Has anyone every used one of these online sources, or have any experience?

  • jose_vale
    jose_vale Member Posts: 2

    For some reason, I did not

    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

    ;;;;;;;;;;;;;;;

    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

    Prostate Cancer Medication

    Thanks for the feedback. I did some research on my own, and had a few users shoot me some information. I found that alot of the "Canadian" or domestic pharmacies did ship drugs sourced in India, but I found one that I did order from. When I called the 800 number, I was able to speak to someone in Canada who answerd all questions pretty clearly. http://canadapharmacyrx.com/generic-viagra.html?ProductID=22 is the link I ordered from, just wanted to share with everyone, thank you very much for the messages and support!

  • Swingshiftworker
    Swingshiftworker Member Posts: 1,017 Member
    jose_vale said:

    Prostate Cancer Medication

    I’m 65 and am about to start on prostate cancer treatments. I’m prescribed doxorubicin which is mostly affordable, but my Dr. has suggested Viagra to go with it, and I’m not making a lot of money at the moment. My Dr. also mentioned alternatives such as “generics” and his personal off the record reassurance about Canadian pharmacies as an option, which I am a little skeptical of. Has anyone every used one of these online sources, or have any experience?

    Online Pharmacies

    You may want to repost your message in a new thread rather than buried at the end of this old thread on CK which has NOTHING to do w/online pharmacies.

    That said, I can tell you that there are many "good" discount pharmacies available online.  I've been using ProgressiveRx for years to buy daily dose cialis, which only costs me around 60 for a 3 month (90 pill supply) which is about 2/3rds less than what Walgreens will charge me for the same medication. 

    ProgressiveRx has offices in the State of Washington but the drugs are made and shipped from Bangalore, India. Never had any problems in the shipment and/or quality of any medications received by me from them.

    You can find their website here: http://www.progressiverx.com/store/

    They also get good feedback on Facebook: https://www.facebook.com/ProgressiveRx

  • pavlograd
    pavlograd Member Posts: 2
    Checking on CK for possible treatment

    Sorry if this message is long.  After my PSA rose to about 4.5, I had a TRUS biopsy in 4/2015 that resulted in Gleason 6 in 2 cores and I was put on AS.  For next year, PSA never went above 5.5.  In April of 2016, and just before 2nd TRUS biopsy, my PSA was 4.4.  Second biopsy resulted in 5 cores positive for Gleason 6 and low agression scores on OncoDX genetic test.  URO recommended CK and I declined.  Had a 2nd opinion top oncologist at Barrett Cancer Center (at Univ of Cincinnati) tell me not to DARE kill my prostate over Gleason 6, but he recommended that I have a multi-parametric MRI to see of maybe there was something worse hiding among the Gleason 6 and explained that a TRUS biopsy is not accurate at all.  I had the mpMRI and they found a suspicious spot and then did an MRI guided biopsy on this spot and it turned out to be a 3+4 Gleason 7 about 18mm size.  Then I learned about real time MRI guided Focal Laser Ablation (You all should read about it!)  I believe it is the best treatment for me because it only burns just the cancer and leaves my prostate intact and functioning.  However, the FLA is not covered by insurance and CK is!  I am a very healthy 67 year old with 48 year old wife of 15 years and very happily married.  The FLA will cost me $20K out of my pocket and I'm trying to decide if it is worth that money to retain my prostate for hopefully another 8-10 years.  I could do the CK, insurance pay for it (I'm still working with employer insurance) and be done with it.  But, I understand that there is no long term data concerning recurrance with CK just like there isn't with FLA.  I would also like to know what you guys who have had CK feel about the chance of me being impotent.  Is sex close to the same after CK?  Does the Viagra really work (I have never tried it)?  I'm trying to decide what to do.  Doctor's have said I'm a perfect candidate for the FLA, and my URO would be more than happy to have me help his return on investment for his CK machine.  Any thoughts?

  • hopeful and optimistic
    hopeful and optimistic Member Posts: 2,339 Member
    edited September 2016 #67
    What does your doc say about

    What does your doc say about continuing with AS? 

    At Johns Hopkins and some other instiutions men over age 70 continue AS with Gleason 3+4+7

    Did you have a second opinion on the pathology of the biopsy by a world class pathologist.....say at Johns Hopkins....deterimining gleason is subjective, and a world class expert to review is appropriate.

     

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

    Here is information about HIFU

    http://csn.cancer.org/node/301487

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

    SBRT aka cyberknife is around about 10 years and tracking is available for I think about 8 years.....so far very good.

    Posters who have had SBRT aka cyberknife can provide specific information about the treatment.

    Personally if I were to choose betweeen HIFU and SBRT, I would choose SBRT, since I wonder if current technology is advanced for best results from HIFU. However I suggest you do research about this. At the USTOO.com board there is a disscussion about HIFU, that gives a lot of detail that you may wish to read

     

     

  • pavlograd
    pavlograd Member Posts: 2

    What does your doc say about

    What does your doc say about continuing with AS? 

    At Johns Hopkins and some other instiutions men over age 70 continue AS with Gleason 3+4+7

    Did you have a second opinion on the pathology of the biopsy by a world class pathologist.....say at Johns Hopkins....deterimining gleason is subjective, and a world class expert to review is appropriate.

     

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

    Here is information about HIFU

    http://csn.cancer.org/node/301487

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

    SBRT aka cyberknife is around about 10 years and tracking is available for I think about 8 years.....so far very good.

    Posters who have had SBRT aka cyberknife can provide specific information about the treatment.

    Personally if I were to choose betweeen HIFU and SBRT, I would choose SBRT, since I wonder if current technology is advanced for best results from HIFU. However I suggest you do research about this. At the USTOO.com board there is a disscussion about HIFU, that gives a lot of detail that you may wish to read

     

     

    Focal Laser Ablation is NOT HIFU

    Just wanted to say for the record that real time MRI guided focal laser ablation (FLA) is no where the same as HIFU (High Intensity Focused Ultrasound).  In FLA a fiber optic cable is carefully guided and inserted up into the center of the cancerous lesion.  The other end connects to a laser machine.  The laser is turned on and the tip of the fiber optic heats up.  The temperature is monitored and raised to about 60 degrees C and 'cooks' the cancer from inside out.  No side effects and you keep your prostate!

  • hopeful and optimistic
    hopeful and optimistic Member Posts: 2,339 Member
    edited September 2016 #69
    pavlograd said:

    Focal Laser Ablation is NOT HIFU

    Just wanted to say for the record that real time MRI guided focal laser ablation (FLA) is no where the same as HIFU (High Intensity Focused Ultrasound).  In FLA a fiber optic cable is carefully guided and inserted up into the center of the cancerous lesion.  The other end connects to a laser machine.  The laser is turned on and the tip of the fiber optic heats up.  The temperature is monitored and raised to about 60 degrees C and 'cooks' the cancer from inside out.  No side effects and you keep your prostate!

    As I understand focal laser

    As I understand focal  ablation can be administered by various methods to target the cancer, hifu is one of them.

    Here is a study that I just googled

    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4080850/

    a paragraph from this

    "A number of energy sources have been investigated for focal ablation of the prostate, including cryotherapy,13 high-intensity focused ultrasound (HIFU),14 photodynamic therapy,15 and laser ablation.16"

  • Swingshiftworker
    Swingshiftworker Member Posts: 1,017 Member
    edited September 2016 #70
    pavlograd said:

    Checking on CK for possible treatment

    Sorry if this message is long.  After my PSA rose to about 4.5, I had a TRUS biopsy in 4/2015 that resulted in Gleason 6 in 2 cores and I was put on AS.  For next year, PSA never went above 5.5.  In April of 2016, and just before 2nd TRUS biopsy, my PSA was 4.4.  Second biopsy resulted in 5 cores positive for Gleason 6 and low agression scores on OncoDX genetic test.  URO recommended CK and I declined.  Had a 2nd opinion top oncologist at Barrett Cancer Center (at Univ of Cincinnati) tell me not to DARE kill my prostate over Gleason 6, but he recommended that I have a multi-parametric MRI to see of maybe there was something worse hiding among the Gleason 6 and explained that a TRUS biopsy is not accurate at all.  I had the mpMRI and they found a suspicious spot and then did an MRI guided biopsy on this spot and it turned out to be a 3+4 Gleason 7 about 18mm size.  Then I learned about real time MRI guided Focal Laser Ablation (You all should read about it!)  I believe it is the best treatment for me because it only burns just the cancer and leaves my prostate intact and functioning.  However, the FLA is not covered by insurance and CK is!  I am a very healthy 67 year old with 48 year old wife of 15 years and very happily married.  The FLA will cost me $20K out of my pocket and I'm trying to decide if it is worth that money to retain my prostate for hopefully another 8-10 years.  I could do the CK, insurance pay for it (I'm still working with employer insurance) and be done with it.  But, I understand that there is no long term data concerning recurrance with CK just like there isn't with FLA.  I would also like to know what you guys who have had CK feel about the chance of me being impotent.  Is sex close to the same after CK?  Does the Viagra really work (I have never tried it)?  I'm trying to decide what to do.  Doctor's have said I'm a perfect candidate for the FLA, and my URO would be more than happy to have me help his return on investment for his CK machine.  Any thoughts?

    CK as a +10 year track record . . .

    FWIW, CK (SBRT) now has an over 10 year track record of effectiveness.   I was treated in Sep 2010 when some 5 year studies were just being published and I think I saw a 10 year study recently (but I'd have to look for it). 

    Basically, SBRT has been found as effective in terms of remission and mortality data as other treatment modalities (including but not limited to IMRT, IGRT and surgery - both open and robotic) BUT with a much lesser incidence of delibitating side effects, which I believe is due primarily to the degree of precision with which the radiation is applied in killing the cancer. 

    That precision is at the sub-mm level, can be delivered in 360 degrees and can adjust for body and organ movement on the fly by the radiation operator.  Nothing else comes close to it in terms of radiation treatment and this precision prevents unintended damage to collateral organs -- the rectum, bladder and urethra -- which is the main cause of side effects such as ED, incontenence and bleeding.

    After I was treated w/CK over 6 years ago, I had some annoying and troubling PSA variability but that has gone away and my PSA has dropped below 1 (the redline for radiation treatment) and still continues to drop indicating that my cancer is in remission.  Other than the variable PSA readings, I experienced NO side effects whatsoever -- no ED, no incontience and no bleeding.  I took only 3 treatments over a week's time.  I was able to continue working during the treatments and they had no effect on my quality of life whatsoever.  A number of other men on this forum have had the same (if not better) experiences than I did.  Can't do much better than that.

    I don't know much about FLA but you can't do much better than CK (SBRT) for the treatment of prostate cancer, provided that you are a qualifieid candidate for the treatment, especially if it can be paid for my your medical insurance carrier.  I'd suggest you consult w/a radiation oncologist at a facility that offers CK for a consultation to discuss it.

    Good luck!

     

  • schin
    schin Member Posts: 9
    pavlograd said:

    Checking on CK for possible treatment

    Sorry if this message is long.  After my PSA rose to about 4.5, I had a TRUS biopsy in 4/2015 that resulted in Gleason 6 in 2 cores and I was put on AS.  For next year, PSA never went above 5.5.  In April of 2016, and just before 2nd TRUS biopsy, my PSA was 4.4.  Second biopsy resulted in 5 cores positive for Gleason 6 and low agression scores on OncoDX genetic test.  URO recommended CK and I declined.  Had a 2nd opinion top oncologist at Barrett Cancer Center (at Univ of Cincinnati) tell me not to DARE kill my prostate over Gleason 6, but he recommended that I have a multi-parametric MRI to see of maybe there was something worse hiding among the Gleason 6 and explained that a TRUS biopsy is not accurate at all.  I had the mpMRI and they found a suspicious spot and then did an MRI guided biopsy on this spot and it turned out to be a 3+4 Gleason 7 about 18mm size.  Then I learned about real time MRI guided Focal Laser Ablation (You all should read about it!)  I believe it is the best treatment for me because it only burns just the cancer and leaves my prostate intact and functioning.  However, the FLA is not covered by insurance and CK is!  I am a very healthy 67 year old with 48 year old wife of 15 years and very happily married.  The FLA will cost me $20K out of my pocket and I'm trying to decide if it is worth that money to retain my prostate for hopefully another 8-10 years.  I could do the CK, insurance pay for it (I'm still working with employer insurance) and be done with it.  But, I understand that there is no long term data concerning recurrance with CK just like there isn't with FLA.  I would also like to know what you guys who have had CK feel about the chance of me being impotent.  Is sex close to the same after CK?  Does the Viagra really work (I have never tried it)?  I'm trying to decide what to do.  Doctor's have said I'm a perfect candidate for the FLA, and my URO would be more than happy to have me help his return on investment for his CK machine.  Any thoughts?

    This a decision that is

    This a decision that is ultimately yours to make, of course.

    But I would urge you to consider CK.  CK has better long-term outcome data than FLA, I think.  And it will ablate your entire prostate, which should prevent any new areas of cancer from developing later.  If you do a focused laser ablation, you could very well develop cancer elsewhere in the organ in the future, right (honest question; I don't know much about FLA)?

    I had CK for Gleason's 6 almost 2 years ago.  I had the virtually unavoidable acute side-effects such as pain with urinating and bowel movements for 2-3 weeks.  But once those routine short-term issues settled down I have had NO side-effects whatsoever.  No problems with urination, no problems with bowel movements, and I remained just as potent as I was before treatment (and never required Viagra or anything else to achieve that).  Sex is the same now as it was before, with no pills, pumps, or injections.

    Like Swingshift Worker my PSA has wandered since treatment, but that is part and parcel for radiation therapy, and I am still less than 2 years out.

    Bottom line is, if I were you I'd give serious thought to treating the entire gland now, so that you don't have the possibility of having to re-address this down the road.

  • mikedayton62
    mikedayton62 Member Posts: 22
    edited September 2016 #72
    I asked a radiation oncologist yesterday

    I was diagnosed last month, 1 core of 12 at 35%, PSA 12, Gleason 6. I have had no treatment yet, we are still deciding. My radiation oncologist said that I should consider the fact that the side effects of CK beyond 10 years are unknown, because it has only been done for 10 years so far. For that reason alone, he recommended against it.

  • schin
    schin Member Posts: 9
    edited September 2016 #73

    I asked a radiation oncologist yesterday

    I was diagnosed last month, 1 core of 12 at 35%, PSA 12, Gleason 6. I have had no treatment yet, we are still deciding. My radiation oncologist said that I should consider the fact that the side effects of CK beyond 10 years are unknown, because it has only been done for 10 years so far. For that reason alone, he recommended against it.

    Well, he is right that solid

    Well, he is right that solid data beyond 10 years does not exist.

    But the data out to 10 years for cancers like yours is very good with an extremely high likelihood of cure with a low probability of any significant side-effects and virtually no interruption of your lifestyle during therapy.

    I think you should talk to an RO who does CK for PCa.  Then you can make an informed decision about what choice is best for you.  Personally, I was willing to accept the uncertainty beyond 10 years because of what is known about the first 10.

     

  • MEtoAZ
    MEtoAZ Member Posts: 37
    edited September 2016 #74

    I asked a radiation oncologist yesterday

    I was diagnosed last month, 1 core of 12 at 35%, PSA 12, Gleason 6. I have had no treatment yet, we are still deciding. My radiation oncologist said that I should consider the fact that the side effects of CK beyond 10 years are unknown, because it has only been done for 10 years so far. For that reason alone, he recommended against it.

    I concur with Schin..

    The fact that this doctor says nothing is known post 10 years because the procedure doesn't have data that far back (because it is relatively new), seems like FUD to me (Fear, uncertainty and doubt).  I suspect this RO doesn't do CK.  Talk to a CK RO.  At least you will have both sides to consider and they will represent what they do fairly.  I found in my experience of doing the research that each specialist represented what they did very well and rarely were "fair" about other options, well, the conventional RO guys and urologists I visited were in alignment (and then I found out they worked for same conglomerate!).  My PCP was thankfully very neutral, if it wasn't for him I wouldn't have even found out about CK.   My CK experience, like others responding has been very positive.  Granted, my treatment was in April of this year but, everything still works with no lengthy rehab and my PSA is dropping as expected.

  • Swingshiftworker
    Swingshiftworker Member Posts: 1,017 Member
    edited September 2016 #75

    I asked a radiation oncologist yesterday

    I was diagnosed last month, 1 core of 12 at 35%, PSA 12, Gleason 6. I have had no treatment yet, we are still deciding. My radiation oncologist said that I should consider the fact that the side effects of CK beyond 10 years are unknown, because it has only been done for 10 years so far. For that reason alone, he recommended against it.

    Risks No Different . . .

    The fact that CK has not be in use for much beyond 10 years is a really STUPID reason not to recommend the procedure, given the extraordinarily GREAT results that have been reported for the procedure for use in the NOT ONLY prostate cancer, but also brain, spine, lung, liver and pancreatic cancer as well!!!

    Point in fact, the risks of CK treatment beyond 10+ years should be no different than any other radiation treatment that has been administered over that time period AND, in fact, the risks should be even less than other other methods because of the degree of accuracy achieved in the delivery of radiation by CK vs older an less precise radiation delivery methods BECAUSE the negative long term effects are mostly due to damage caused to "healthy" and non-cancerous tissue by the relevant treatment method.

    Here's a link to a report by the American Cancer Society on a study done to compare the "long term" (15+ years) effects of surgery vs radiation treatment for prostate cancer: http://www.cancer.org/cancer/news/study-confirms-long-term-side-effects-from-prostate-cancer-treatment.  You can find more info like it by just Googling "long term radiation side effects prostate cancer treatment."

    The report notes that the long term side effects for the treatment of prostate cancer by surgery and radiation were very similiar and were limited primarily to ED, incontinence and bowel urgency.  These are the same side effects reported by men treated for less than 5, 10 and 15 years!!  The reports of ED may have NOTHING to do w/the method of treatment because most of the men treated were over 60 when treated and would have been over 75 at the time of the study.  I think we can agree that most men over 75 will have some form of ED.  It comes with the territory. As for incontinence, that is mainly a problem caused by surgery, not radiation.  And, as for bowel urgency, that is a long term effect of OLDER forms of radiation that resulted in damage to the rectal wall due to radiation leakage during treatment.  This long term problem is much less likely with CK because of the degree of precision (not previously available) used by CK (down to the sub-mm level) to delivery radiation to the prostate.  So, I highly doubt that I (or anyone else treated with CK) in the past 10 years will experience such problems. 

    Here's the point.  If, after YOU have fully reserached the method and considered it against other options, you've decided that YOU don't want to make use of the treatment, fine BUT, if you're relying solely on your RO's recommendation against it, you are being foolish.  You must take responsibility for your own treatment choices.  Doctors do NOT necessarily have your best interests in mind and you cannot rely on them for making the relevant choice. 

    All of the survivors here learned that LONG AGO and our best advice to you is to make YOUR OWN DECISION!

  • DanS
    DanS Member Posts: 1
    Number of CK treatments

    I am new to this board and really glad I found it.  Hopefully my question is appropriate for this thread. 

    I wasn't too surprised when I learned a few weeks ago that I had PC.  It is very prominent in my family so I'm following in the footsteps of my father, brother and uncles.  However they we all 7+years ago and didn't know about CK.  

    My urologist went to robotic surgery immediately and didn't mention CK. I learned about it from a friend.  However, his treatments were 5 times a week for 3 weeks.  Everything I'm ready says 5 daily treatments in a row.   Is it different based on severity or other factor?

    For the record, I'm 61 and otherwise in very good health. GS was 3+3=6, PSA 7.8.  Biopsy of 20 only showed 1 area 8% and one suspicious. Because of family history I had regular check up so it was caught early. 

  • hopeful and optimistic
    hopeful and optimistic Member Posts: 2,339 Member
    DanS said:

    Number of CK treatments

    I am new to this board and really glad I found it.  Hopefully my question is appropriate for this thread. 

    I wasn't too surprised when I learned a few weeks ago that I had PC.  It is very prominent in my family so I'm following in the footsteps of my father, brother and uncles.  However they we all 7+years ago and didn't know about CK.  

    My urologist went to robotic surgery immediately and didn't mention CK. I learned about it from a friend.  However, his treatments were 5 times a week for 3 weeks.  Everything I'm ready says 5 daily treatments in a row.   Is it different based on severity or other factor?

    For the record, I'm 61 and otherwise in very good health. GS was 3+3=6, PSA 7.8.  Biopsy of 20 only showed 1 area 8% and one suspicious. Because of family history I had regular check up so it was caught early. 

    Dan

    I am sorry for your diagnosis.

    You most likely qualify for  Actiive Surveillance to monitor your cancer, that is closely monitoring the progress or non progress of the disease, and seek treatment only if it progresses. You will not have to take the risk of possible side effects from treatment.

    SBRT of which cyberknife is one of the machines that deliver  is given , depending on the doctor in four or five sessions for low and intermediate risk diagnosis.This is done in one to two weeks.

    It will be best for you to repost, and start a new thread that will be focused only on you, and will give you input on diagnostic tests, resources and answer questions that are pertinent to you.

    Best

     

  • Old Salt
    Old Salt Member Posts: 1,277 Member

    Dan

    I am sorry for your diagnosis.

    You most likely qualify for  Actiive Surveillance to monitor your cancer, that is closely monitoring the progress or non progress of the disease, and seek treatment only if it progresses. You will not have to take the risk of possible side effects from treatment.

    SBRT of which cyberknife is one of the machines that deliver  is given , depending on the doctor in four or five sessions for low and intermediate risk diagnosis.This is done in one to two weeks.

    It will be best for you to repost, and start a new thread that will be focused only on you, and will give you input on diagnostic tests, resources and answer questions that are pertinent to you.

    Best

     

    Concur

    Moreover, radiation oncology is a fast moving field and some of the info in this old thread isn't valid anymore (or never was to begin with)

  • Swingshiftworker
    Swingshiftworker Member Posts: 1,017 Member
    edited September 2017 #79
    DanS said:

    Number of CK treatments

    I am new to this board and really glad I found it.  Hopefully my question is appropriate for this thread. 

    I wasn't too surprised when I learned a few weeks ago that I had PC.  It is very prominent in my family so I'm following in the footsteps of my father, brother and uncles.  However they we all 7+years ago and didn't know about CK.  

    My urologist went to robotic surgery immediately and didn't mention CK. I learned about it from a friend.  However, his treatments were 5 times a week for 3 weeks.  Everything I'm ready says 5 daily treatments in a row.   Is it different based on severity or other factor?

    For the record, I'm 61 and otherwise in very good health. GS was 3+3=6, PSA 7.8.  Biopsy of 20 only showed 1 area 8% and one suspicious. Because of family history I had regular check up so it was caught early. 

    Not Typical of CK

    CK treatments are generally limited to 3 or 4 done every other day over a week; not 5 times a week for 3 weeks.  15 treatments sounds more like IMRT or IGRT.

    If you want to know about your available options, please look for my "Choices You Need to Consider" post near the top of the following thread:

    https://csn.cancer.org/node/307947

    I was successfullyl treated w/CK over 7 years ago without any side effect whatsoever and have been cancer free ever since.  I highly recommend the procedure if you are eligible for it.

    Good luck!

     

  • hopeful and optimistic
    hopeful and optimistic Member Posts: 2,339 Member
    swingshift

    My research indicates that SBRT is given in 4 or 5 sessions; not 3 or 4 sessions. I never heard of SBRT given in 3 sessions, so, I would appreciate if you can increase my knowledge and document the 3 session protocol...............thanks

    PS Here is an example of SBRT given in five fractions.

    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.

  • dao1
    dao1 Member Posts: 2
    long term cyberknife effects

    i am trying to decide whether to get cyberknife.diagnosed 10 years ago,65 years old,psa-6.4,gleason 6.i am worried about urinary problems 3-5 years after cyberknife,as well as rectal issues,rectal cancer etc ;,a delayed reaction to the radiation as well as sexual issues.i dont know whether at my age it would be better to continue to not have tx or to have the tx .appreciate your response,thankyou