CyberKnife Treatment of Prostate Cancer

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capusta
capusta Member Posts: 1
edited March 2014 in Prostate Cancer #1
I am Gleason 6 Stage 2 I have not had any treatment yet. A clinical trial for CyberKnife is going on in my area. Does anyone know what the short term and long term results are. My urologist doesn't want to talk about it. His recomodation is internal and external radiation.

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  • JoeMac
    JoeMac CSN Member Posts: 77
    #2
    Gleson 6
    Aloha Capusta,
    You can get the answers to the questions you are asking at
    http://www.yananow.net
    for the Cyberknife treatment.
    As I understand Cyberknife, it is probably not a good choice for your Stage 2.
    Internal radiation, seeding, is also questionable for prostate cancer Stage 2.
    EBRT/IMRT with ultra-sound would probably be split in to two parts, Pelvic Cavity & Prostate Specific. Other than chemo (not ADT alone) it is very difficult to nutralize your cancer Stage 2.
    What are the results of your biopsy? What is your PSA over 6 months? Why were you told you have Stage 2?
    Joe
  • ChrisOz2
    ChrisOz2 Member Posts: 5
    #3
    CyberKnife
    capusta

    Go to this link for Georgetown University Hospital. There are videos for CyberKnife and other information on pc that I found very useful. Dr Collins reviews the procedure and tells his criteria for accepting patients for this option. Hope it helps and good luck with your decision.

    Chris

    http://www.georgetownuniversityhospital.org/
  • tonybear
    tonybear Member Posts: 90
    #4
    radiation
    i am not sure what type of radiation you are being offered. i had brachy followed by tomo radiation. it isn't a overnight stay treatment. but i've had good results. find out what type of radiation and the side effects short term and long term. as my doctor told me, there is no silver bullet. best of luck....
  • ASAdvocate
    ASAdvocate Member Posts: 193 Member
    edited April 2018 #5
    Zombie Thread

    This thread was lasted updated in 2009. No sense in commnenting on it now.

  • Old Salt
    Old Salt CSN Member Posts: 1,653 Member
    #6
    ASAdvocate said:

    Zombie Thread

    This thread was lasted updated in 2009. No sense in commnenting on it now.

    Post removed

    ASAdvocate responded to a highly critical post that must have been removed.

  • Prostate2019
    Prostate2019 Member Posts: 1
    edited October 2019 #7
    questions to ask before Cyberknife

    I am scheduled to consult a dr. for cyberknife treatment for prostate cancer. Would appreciate any inputs regarding what questions I should ask. I am not sure if the machines would make difference in accuracy. 

    Thanks in advance. 

  • Clevelandguy
    Clevelandguy CSN Member Posts: 1,336 Member
    #8
    Questions to ask?

    Hi Prostate 2019,

    If you do a search on Google for Cyberknife their website should come up. It’s a excellent radiation based treatment, the highly focused beam goes completely through your body so ask about collateral damage to your bladder and colon. Your Oncologist should know how to protect thoses areas, could be done by just moving the beam around so as not to impact vital organs. From what I understand the treatment is painless but as with any treatment their could be side effects. Cyberknife is done on a table with a highly accurate rotating head guided by a computer so I don’t know what you mean by a machine would make a difference?

    Dave 3+4

  • mstoriop
    mstoriop Member Posts: 43 Member
    #9
    Good Luck

    Hello Prostate2019

    Cyberknife is the trade name for Accuray equipment.  I am two years removed from Cyberknife treatment.  There are others like Varian that are all part of the SBRT (stereotactic body radiation therapy) technology.  I have no reason to think that one brand would be better than another.  As someone posted on here a long time ago its the difference between a Ford and a Chevy.  As Cleveland mentioned you can do some searches and find a lot of info.  I have a couple of documents in pdf form but can't seem to figure oui if and how to attach for you.  In summary as far as machine accuracy they locate and repeat to less than a human hair diameter for the machine itself.  Taking into account all things involved with delivering the treatment to your body the targeting accuracy is extremely accurate published at about .004 inch.  I won't try to defend or argue that one but I think delivery accuracy is not the biggest concern.  The doctor will insert (in my case) 4 tiny gold fiducials to be used as targets.  By using a combination of MRI and CT scans they will more or less make a 3D model of your prostate and then develop the treatment paths.  As Cleveland mentioned the beam passes through your body so by using all of the machine axis features will do a plan to hit the prostate and miss things that shouldn't be hit.  Somr basic questions would be as with any other treatment how long the doctor has been at it, how many patients treated,  results to be normally expected, what was the Doctors worst outcomes etc.  I would ask how many treatments he wants to do and how many days to deliver.  Seems like originally they did 5 days in a row and now more and more they are doing every other day or so.  I seemed to gravitate to rest time between treatmentrs and with Doc's permission went right on 2 weeks total.  Also how much radiation total does the Doc use.  36.25 Gy was the baseline but some doctors are using 35Gy.  Hope this helps you a little with your consultation and ultimate decisions.         

  • RMLNS77
    RMLNS77 Member Posts: 1
    edited March 2021 #10
    SBRT for Prostate Cancer facilities

    Brand new to this, please bear with me. Are there any reliable websites that indicate which facilities have more experience and/or better outcomes?

  • Old Salt
    Old Salt CSN Member Posts: 1,653 Member
    edited March 2021 #11
    RMLNS77 said:

    SBRT for Prostate Cancer facilities

    Brand new to this, please bear with me. Are there any reliable websites that indicate which facilities have more experience and/or better outcomes?

    No such database

    But if yuo tell us where you are located, I might be able to suggest some good places.

    I was treated at Georgetown U Med School's CyberKnife center (Washington DC).

     

  • TJWA103
    TJWA103 Member Posts: 5
    edited November 2021 #12
    Cyber Knife

    Hey Old Salt, I am at the point of my journey of deciding what type of treatment I should do. Do I understand that you had the Cyper Knife type of treatment ? Like everyone else I am doing my research and I am leaning twards that type of treatment. How long ago have you had the treatment. How was your experiance with it and are you still cancer free ? Sorry if I get to personal but I have just joined the group... Thanks for your help TJ

  • ASAdvocate
    ASAdvocate Member Posts: 193 Member
    #13
    TJWA,

    A study showing very impressive SBRT results for you:

    https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2723641

  • VascodaGama
    VascodaGama CSN Member Posts: 3,732
    edited November 2021 #14
    SBRT clinics have strict standards in accepting patients

    T,

    You posted in another thread that "... you have a 4+3 gleasons rating but has not spread outside of prostate...". This means that your case falls in the group of  less favorable to be accepted for treatment in a SBRT clinic.I wonder if UCLA would accept you for the treatment.

    Typically, they check the results of the biopsy (number of positive cores and % of each G rate involved) and the radiologist's findings (CT, MRI and BS scans). A simple comment of "contained" by an urologist is not enough. 

    SBRT involves high intensity radiation of 7.0 grays in each treatment session requiring detailed study of the field for radiation because some tissues/organs have low limits of absorbing radiation prohibiting doses higher than 2.0 grays (the typical dose of IMRT).

    SBRT clinics have and continue doing clinical trials to certify risks involving high intensity radiation. So far they have found that the therapy is good to treat the prostate gland and bone but there are doubts when the treatment involves lymph nodes. This fact may have been the reason for adding IMRT in the protocol of Old Salt's multimodal therapy.

    Overall SBRT has demonstrated successful outcomes under limited risks. Your Gleason score 4+3 is considered a risk case if the rate 4 presents an high percentage or you have a voluminous cancer case.

    You need to consult a SBRT radiotherapist before opting for this treatment. 

    Here is a link explaining the history and advancements in SBRT;

    https://www.uclahealth.org/radonc/prostate-cancer-sbrt

    Welcome to the board.

    Best wishes, 

    VGama 

  • Old Salt
    Old Salt CSN Member Posts: 1,653 Member
    edited November 2021 #15
    What kind of risk category for you?

    My experience may not be meaningful for you because you may be in a different risk category.

    I had SBRT (on the CyberKnife platform) at Georgetown U Medical Center. However, as a (high risk) Gleason 9 case, I did not undergo standard SBRT (five sessions), but had three sessions followed by 25 IMRT sessions. Also had Androgen Deprivation Therapy (ADT; hormone therapy) for 18 months. The treatment, done under the dirction of Dr. Collins, was part of a clinical study. Some of the results of this study (still ongoing) have been reported in the medical literature. This kind of therapy is often referred to as triple therapy. 

    Very much in general, I have read (published papers) that SBRT has good outcomes for low and intermediate risk patients. Ten year data are available

    The paper cited by ASAdvocate is very relevant; not only are several of the authors pioneers in SBRT, but the data represent over 2000 patients.

    With respect to my case, I was treated eight years ago and am still typing (and engaging in my favorite things)...

  • Josephg
    Josephg CSN Member Posts: 515 Member
    #16
    SBRT

    I recently had SBRT on a PCa lesion on my pubic bone.  I had 3 doses of the radiation over 5 days (Thurs., Fri., and Mon.), and my last MRI showed the cancer to be in the process of dying out.  The process was completely painless, and the only side effect was that I felt some fatigue 3 to 10 days after the last dose of radiation.  Please note that this was not SBRT directly on the prostate, as I had that removed a decade ago.

  • TJWA103
    TJWA103 Member Posts: 5
    edited November 2021 #17
    Ty Old Salt

    Ty Old Salt

  • TJWA103
    TJWA103 Member Posts: 5
    #18
    Ty Sir, I just had a meeting

    Ty Sir, I just had a meeting with the head of the Oncology department at NYU where they specialize in Cyber Knife. Actually decided to go there for a second opinoin as far as treatment goes. After he looked at my prognoses the Dr agreed that I would be a good canditate. I am just having the hardest time deciding between Rapid Arc and Cyber Knife. Rapid Arc uses a lower dose of radiation with a larger foot print of the beam for serveral more sessions which could last up to 9 weeks, where as Cyber Knife uses a smaller higher intensity of radiation and more acturate beam for between 3 to 5 sessions. Sure lesser sessions sounds great but is there more of a chance to have damage to the surrounding organs...? It actually seams like these Doctors are competing for my business. Yes I know there is some truth to that. I just wish there was only one choice just to get it over with...

  • TJWA103
    TJWA103 Member Posts: 5
    #19
    Ty Sir, I just had a meeting

    Ty Sir, I just had a meeting with the head of the Oncology department at NYU where they specialize in Cyber Knife. Actually decided to go there for a second opinoin as far as treatment goes. After he looked at my prognoses the Dr agreed that I would be a good canditate. I am just having the hardest time deciding between Rapid Arc and Cyber Knife. Rapid Arc uses a lower dose of radiation with a larger foot print of the beam for serveral more sessions which could last up to 9 weeks, where as Cyber Knife uses a smaller higher intensity of radiation and more acturate beam for between 3 to 5 sessions. Sure lesser sessions sounds great but is there more of a chance to have damage to the surrounding organs...? It actually seams like these Doctors are competing for my business. Yes I know there is some truth to that. I just wish there was only one choice just to get it over with...

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