Cyberknife Procedure Update
Comments
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Kongo,Kongo said:PSA NADIR WITH RADIATION
Larry, as you noted, Cyberknife leaves the prostate intact after radiation so there is always going to be some PSA. What they look for is a PSA nadir that is below 1.0. A biological failure would be a rising PSA after nadir. It sometimes takes 3 years to reach a nadir. I am unaware of any biological failures using Cyberknife.
I wish you the best
Kongo,
I wish you the best results but do you really believe that there are “no biological failures using Cyberknife.” If that was the case this would be the only treatment used.0 -
KongoKongo said:Viper
Viper,
Thanks for the encouraging report on your personal experience with Cyberknife. I’m hoping for similar results. I have read your many posts on the Cyberknife Discussion Forum and know that you are a knowledgeable and enthusiastic advocate of the procedure.
My personal studies and analysis covered the same scope and reached similar conclusions as what you outlined on your website, although I’m always reluctant to take too much stock in success statistics regarding side effects because of the great disparity of how they’re set up and the definitions they use. Many studies on ED define potency as the ability to achieve an erection sufficient for penetration at least once a month. To me, that’s not very potent. Similarly, incontinence covers the gamut of zero bladder control and permanent catheter use to an occasional sense of urgency or increase in frequency of urination.
In the study that Randy cited in his post, it’s pretty clear that the excellent results described in this 2007 report out of New York Presbyterian Hospital, were a function of a highly skilled and experienced surgeon (they emphasized that point more than once in the paper). I believe that the studies that show a much lower success rate with respect to incontinence and ED following surgery are a result of less experienced surgeons. Randy had excellent results with his DaVinci procedure, but it wasn’t just luck. Randy did a disciplined, deliberate, and wide-ranging study like you and I did then made a decision which was best for him. He then sought out one of the finest DaVinci surgeons in the country to do his procedure and he’s now a poster boy for DaVinci.
Unfortunately, not all men have the same experience as Randy for a variety of reasons. I personally believe that a man’s pre-treatment physical condition and lifestyle play almost as much as role in post-treatment outcome as the treatment team. None of the studies I’ve read normalize age, physical condition, stage, lifestyle, and so forth in establishing the study group.
Another thing about studies…the results are easily skewed based on the selection of the cohort. In Cyberknife, for example, the men included in the studies must meet a strict protocol that includes stage T1/T2, PSA < 10, Gleason less than 7, minimal involvement from biopsy cores, and prostate contained. (I know this because I'm in a study myself and had to qualify using this criteria) I’m happy to be in that category but frankly, for someone with my pathology, just about any treatment protocol has an extremely high likelihood of success. I don’t have any idea of the restrictions on the cohort group in the study that Randy cited, but I’m sure there was some.
Viper, I see that you are new to this forum. The regulars here are very sensitive to any perception of hype associated with pushing one treatment over another. The general protocol here is to cite one’s personal experience and provide unbiased information as a means of helping others who must face similar treatment decisions. In the recent past there have been posters on this forum who had a hidden agenda and were using this discussion board as marketing tool for one treatment over another. As I know a bit of your background from the other forum, I don’t believe you’re pushing Cyberknife over anything else, but be cognizant of the general sensitivity. Most of the regular posters are highly conversant with the nuances of PCa, the relevant studies associated with the treatment options, and have a great deal of experience with the side effects of treatment.
Randy and BD: I think you should give our PCa brother, Viper, some slack here. Based on what I know of Viper from another forum I am pretty confident he’s not a “troll” like some of the recent other intruders we’ve seen here.
I was smiling so when reading your post....thinking "man he is way more a diplomat than I will ever be" I'll give the guy a break if he posts a disclaimer on the top of his web site in big unavoidable font something to the fact of:
THIS IS A PERSONAL WEB SITE WITH MY OWN PERSONAL OPINIONS REGARDING OUT COMES AND RATINGS OF TREATMENTS USING THE RESEARCH I FOUND THAT MAY BE OUTDATED, BIASED AND OBSOLETE
Yes, that would do...0 -
I TOO HAVING BEEN FOLLOWINGbdhilton said:Kongo,
As I have stated
Kongo,
As I have stated several times with you in the past and now, I am happy that you have chosen a process that you believe in and are moving forward in your journey. I also totally believe that lifestyle changes prior to and after surgery are critical for survival and keeping your health as good as you can…If fact I would call myself an “enthusiastic advocate” of diet and exercise.
Never once in my posts have I have stated that my procedure was the best, had the best results, etc… How and what we decide on as to treatment is a personal choice and the facts that are delivered here of all places should reflect the facts not manipulation of the facts or pure fantasy. Many of us have already had to sort through many “snake oil” salesmen to arrive to our treatment decisions. This whole PCa thing is enough to deal with without misrepresentation of outcomes or the realities of the specific treatments.
Based on my studies and consultations prior to my treatment selection, I found that there was some evidence to support as it relates to "CyberKnife" …”the idea of hypofractionation, but overall it cannot be denied that the procedure is experimental. Hypofractionation may well have merit, but long term (>10 year) results are not available for HDR Brachytherapy, which has been practiced since about 1997, and neither long nor short term (>5 year) peer reviewed results are yet available for CyberKnife.
Maybe in the long run, CyberKnife will prove to have similar (but possibly not better) outcomes vis-a-vis non-hypofractionated EBRT (External Beam Radiation Treatment), in which case, its selling point will be convenience.en it over methods with established records.”
Any man considering Cyberknife should make sure that his is a truly informed consent, and that he has chosen it over methods with established records….”
Sorry but counter to what you believe this individual has not stated the facts and this is a bit disturbing to me!
Best to you
I TOO HAVING BEEN FOLLOWING THIS CONVERSATION BUT FEEL I MUST CHIME IN. THERE ARE SO MANY TREATMENT OPTIONS AVAILABLE TO US SOMETIMES IT CAN BE OVERWHELMING. TO SAY ONE TREATMENT IS BETTER THAN ANOTHER IS UNREALISTIC. MY THOUGHTS ON THIS SUBJECT ARE SIMPLE. IF THE OPTION YOU CHOOSE IS SUCESSFUL, THEN THAT OPTION IS THE "BEST"(FOR YOU). LETS JUST HOPE AND PRAY THAT ALL OF US CHOOSE THE BEST TREATMENT FOR OURSELVES, AND IF WE SHOULD BE FORTUNATE ENOUGH TO BE TALKING ABOUT THIS MANY YEARS FROM NOW, WE CAN ALL SAY WE CHOSE THE BEST TREATMENT.-------ALOHA--DAN0 -
Biological Failuresbdhilton said:Kongo,
I wish you the best
Kongo,
I wish you the best results but do you really believe that there are “no biological failures using Cyberknife.” If that was the case this would be the only treatment used.
BD, you're right. I misstated what I was trying to say. I should have said that in the low risk PCa groups that have been documented in various studies, I am not aware of any failures. That's based on the studies I have read using the low risk cohort and admitedly, the follow-up time is less than 5 years. Overall, I understand that there is a failure rate of 3-4% but this includes the higher risk patients. Failure is usually defined as an increasing PSA after nadir.0 -
Sheeshrandy_in_indy said:Kongo
I was smiling so when reading your post....thinking "man he is way more a diplomat than I will ever be" I'll give the guy a break if he posts a disclaimer on the top of his web site in big unavoidable font something to the fact of:
THIS IS A PERSONAL WEB SITE WITH MY OWN PERSONAL OPINIONS REGARDING OUT COMES AND RATINGS OF TREATMENTS USING THE RESEARCH I FOUND THAT MAY BE OUTDATED, BIASED AND OBSOLETE
Yes, that would do...
You're a tough, hombre, Randy but I get your point.0 -
CyberKnife StudiesKongo said:Sheesh
You're a tough, hombre, Randy but I get your point.
Hope all of remain free of PCa.
The CyberKnife is an economic treat to all other options. There are several published peer review studies that include the first patient treated(2003) at Stanford by Dr. Chris King. Last updated in 2009 and is in the process of being updated.
Stereotactic body radiotherapy for organ-confined prostate cancer
BMC Urology 2010, 10:1 doi:10.1186/1471-2490-10-1
Alan J Katz
Stereotactic Body Radiotherapy: An Emerging Treatment Approach for Localized Prostate Cancer
Technology in Cancer Research and Treatment
ISSN 1533-0346
Volume 8, Number 5, October 2009
©Adenine Press (2009)
by Jay L. Friedland, M.D.1
Debra E. Freeman, M.D.1*
Dr. Don Fuller has published studies and last time we spoke 4-21-2010 he had treated over 200 patients with no failures.
Zero recurrence for any therapy is unrealistic. Surgery can not remove cells they can not see, one PCa Stem Cell that survives any form of RT Chemo, Cyro or HIFU may result in a recurrence.
The number of patients with recurrence for the CyberKnife is low. From the three major studies combined I think the total number is less than 10. The expected 10 year cure rate is 98% or higher based HDR Brachy Therapy results. I like those odds.
I know two brothers that were diagnosed with PCa at about the same time. One was treated with the CyberKnife the other opted for surgery. Both felt they made the best choice for them.
The CyberKnife is no more experimental than surgery with robotics. The ASTRO leadership has misrepresented the CyberKnife in print and electronic media.
Based on my research and treatment outcome I am biased and believe the CyberKnife is the best option for localized PCa.
What is most important is for men to have the opportunity to make an informed choice after considering the risk and reward for each modality in conjunction with their doctors.
PCa patients must do their your own research and trust no one including me.
The patient has to live or die with the choice they make. Make is wisely!0 -
Knowledge is King!viperfred said:CyberKnife Studies
Hope all of remain free of PCa.
The CyberKnife is an economic treat to all other options. There are several published peer review studies that include the first patient treated(2003) at Stanford by Dr. Chris King. Last updated in 2009 and is in the process of being updated.
Stereotactic body radiotherapy for organ-confined prostate cancer
BMC Urology 2010, 10:1 doi:10.1186/1471-2490-10-1
Alan J Katz
Stereotactic Body Radiotherapy: An Emerging Treatment Approach for Localized Prostate Cancer
Technology in Cancer Research and Treatment
ISSN 1533-0346
Volume 8, Number 5, October 2009
©Adenine Press (2009)
by Jay L. Friedland, M.D.1
Debra E. Freeman, M.D.1*
Dr. Don Fuller has published studies and last time we spoke 4-21-2010 he had treated over 200 patients with no failures.
Zero recurrence for any therapy is unrealistic. Surgery can not remove cells they can not see, one PCa Stem Cell that survives any form of RT Chemo, Cyro or HIFU may result in a recurrence.
The number of patients with recurrence for the CyberKnife is low. From the three major studies combined I think the total number is less than 10. The expected 10 year cure rate is 98% or higher based HDR Brachy Therapy results. I like those odds.
I know two brothers that were diagnosed with PCa at about the same time. One was treated with the CyberKnife the other opted for surgery. Both felt they made the best choice for them.
The CyberKnife is no more experimental than surgery with robotics. The ASTRO leadership has misrepresented the CyberKnife in print and electronic media.
Based on my research and treatment outcome I am biased and believe the CyberKnife is the best option for localized PCa.
What is most important is for men to have the opportunity to make an informed choice after considering the risk and reward for each modality in conjunction with their doctors.
PCa patients must do their your own research and trust no one including me.
The patient has to live or die with the choice they make. Make is wisely!
Prostate Cancer Patients must be informed!
Comparative Effectiveness of Minimally Invasive vs Open Radical Prostatectomy
http://jama.ama-assn.org/cgi/content/abstract/302/14/1557
Role of experience and surgery
http://www.sciencedaily.com/releases/2007/07/070724161655.htm
Everyone has an opinion!0 -
BDbdhilton said:Kongo,
As I have stated
Kongo,
As I have stated several times with you in the past and now, I am happy that you have chosen a process that you believe in and are moving forward in your journey. I also totally believe that lifestyle changes prior to and after surgery are critical for survival and keeping your health as good as you can…If fact I would call myself an “enthusiastic advocate” of diet and exercise.
Never once in my posts have I have stated that my procedure was the best, had the best results, etc… How and what we decide on as to treatment is a personal choice and the facts that are delivered here of all places should reflect the facts not manipulation of the facts or pure fantasy. Many of us have already had to sort through many “snake oil” salesmen to arrive to our treatment decisions. This whole PCa thing is enough to deal with without misrepresentation of outcomes or the realities of the specific treatments.
Based on my studies and consultations prior to my treatment selection, I found that there was some evidence to support as it relates to "CyberKnife" …”the idea of hypofractionation, but overall it cannot be denied that the procedure is experimental. Hypofractionation may well have merit, but long term (>10 year) results are not available for HDR Brachytherapy, which has been practiced since about 1997, and neither long nor short term (>5 year) peer reviewed results are yet available for CyberKnife.
Maybe in the long run, CyberKnife will prove to have similar (but possibly not better) outcomes vis-a-vis non-hypofractionated EBRT (External Beam Radiation Treatment), in which case, its selling point will be convenience.en it over methods with established records.”
Any man considering Cyberknife should make sure that his is a truly informed consent, and that he has chosen it over methods with established records….”
Sorry but counter to what you believe this individual has not stated the facts and this is a bit disturbing to me!
Best to you
You and I agree on most issues here but I take strong exception with your statement that Cyberknife is "experimental" as you characterize it. Cyberknife was approved by the FDA for cancer treatment in 2000 --- the same year DaVinci was approved by the FDA --- and has been used to treat prostate cancer since 2003 where it started at Stanford. DaVinci was approved for use in radical prostectomies by the FDA in 2005. How do you define "experimental?" I also don't understand your comment about HDR Brachy not have long term results as I have read many. And finally, I take exception to your assertion that in the long run Cyberknife may prove to have similar (but not better) outcomes over EBRT. I really have no idea what you are basing this authoritive assumption on as the cyberknife procedure delivers radiation much more accurately with much less dosage to surrounding tissue, not to mention several other factors relating to dosage efficacy, particularly with respect to early cancers. I fear you've misrepresented the facts in downplaying this treatment option.
I agree with you completely that diet and lifestyle are critical factors in long term success regardless of treatment options and I share your loathing for the snake oil salesmen who prey on patients looking for hope.
And I agree that its far to presumptuous to second guess another's treatment choice if they've gone through the rigor of investigating and evaluating all the options available that are relevant to their individual cancer situation. After re-reading all the posts in this thread, I don't see where anyone has said their treatment choice is better than anothers, except perhaps you're disparaging remarks about "experimental" Cyberknife and other misrepresentations.
Best to you as well.0 -
HRD Brachytherapybdhilton said:Kongo,
As I have stated
Kongo,
As I have stated several times with you in the past and now, I am happy that you have chosen a process that you believe in and are moving forward in your journey. I also totally believe that lifestyle changes prior to and after surgery are critical for survival and keeping your health as good as you can…If fact I would call myself an “enthusiastic advocate” of diet and exercise.
Never once in my posts have I have stated that my procedure was the best, had the best results, etc… How and what we decide on as to treatment is a personal choice and the facts that are delivered here of all places should reflect the facts not manipulation of the facts or pure fantasy. Many of us have already had to sort through many “snake oil” salesmen to arrive to our treatment decisions. This whole PCa thing is enough to deal with without misrepresentation of outcomes or the realities of the specific treatments.
Based on my studies and consultations prior to my treatment selection, I found that there was some evidence to support as it relates to "CyberKnife" …”the idea of hypofractionation, but overall it cannot be denied that the procedure is experimental. Hypofractionation may well have merit, but long term (>10 year) results are not available for HDR Brachytherapy, which has been practiced since about 1997, and neither long nor short term (>5 year) peer reviewed results are yet available for CyberKnife.
Maybe in the long run, CyberKnife will prove to have similar (but possibly not better) outcomes vis-a-vis non-hypofractionated EBRT (External Beam Radiation Treatment), in which case, its selling point will be convenience.en it over methods with established records.”
Any man considering Cyberknife should make sure that his is a truly informed consent, and that he has chosen it over methods with established records….”
Sorry but counter to what you believe this individual has not stated the facts and this is a bit disturbing to me!
Best to you
HDR Brachy therapy has been used for over 19 years not "5"
http://www.cetmc.com/ Started HDR Brachy therapy in 1991
http://linkinghub.elsevier.com/retrieve/pii/S0302283804006219 1992-2001 First patient in this study was treated in 1992
http://www.springerlink.com/content/tarm2hj0h1ff583v/ 2002-2003 HDR BT treatment
Science of Hypo fractionation:
Int. J. Radiation Oncology Biol. Phys., Vol. 52, No. 1, pp. 6–13, 2002
Copyright © 2002 Elsevier Science Inc.
DIRECT EVIDENCE THAT PROSTATE TUMORS SHOW HIGH SENSITIVITY
TO FRACTIONATION (LOW / RATIO), SIMILAR TO LATE-RESPONDING
NORMAL TISSUE
DAVID J. BRENNER, PH.D., D.SC.,* ALVARO A. MARTINEZ, M.D., F.A.C.R.,†
GREGORY K. EDMUNDSON, M.SC.,† CHRISTINA MITCHELL, R.N., B.S.N.,† HOWARD D. THAMES, PH.D.,‡
AND ELWOOD P. ARMOUR, PH.D.†
*Center for Radiological Research, Department of Radiation Oncology, Columbia University, New York, NY; †Department of
Radiation Oncology, William Beaumont Hospital, Royal Oak, MI; ‡Department of Biomathematics, M. D. Anderson Cancer Center,
Houston, TX
Int. J. Radiation Oncology Biol. Phys., Vol. 48, No. 2, pp. 315–316, 2000
Copyright © 2000 Elsevier Science Inc
TOWARD OPTIMAL EXTERNAL-BEAM FRACTIONATION FOR
PROSTATE CANCER
DAVID J. BRENNER, D.SC.
Center for Radiological Research, Columbia University, New York, NY
Int. J. Radiation Oncology Biol. Phys., Vol. 57, No. 4, pp. 912–914, 2003
Copyright © 2003 Elsevier Inc
HYPOFRACTIONATION FOR PROSTATE CANCER RADIOTHERAPY—WHAT
ARE THE ISSUES?
DAVID J. BRENNER, PH.D., D.SC.
Department of Radiation Oncology, Center for Radiological Research, Columbia University, New York, NY
Int. J. Radiation Oncology Biol. Phys., Vol. 52, No. 1, pp. 3–5, 2002
Copyright © 2002 Elsevier Science Inc.
THE PROSPECTS FOR NEW TREATMENTS FOR PROSTATE CANCER
JACK F. FOWLER, D.SC., PH.D.,* RICK J. CHAPPELL, PH.D.,† AND MARK A. RITTER, M.D., PH.D.*
Departments of *Human Oncology and †Biostatistics and Medical Informatics, University of Wisconsin-Madison, Madison, WI
Int. J. Radiation Oncology Biol. Phys., Vol. 60, No. 4, pp. 1241–1256, 2004
Copyright © 2004 Elsevier Inc.
A CHALLENGE TO TRADITIONAL RADIATION ONCOLOGY
JACK F. FOWLER, PH.D., D.SC., WOLFGANG A. TOMÉ, PH.D., JOHN D. FENWICK, PH.D.,
AND MINESH P. MEHTA, M.D.
Department of Human Oncology, Medical School of the University of Wisconsin, Madison, WI
Acta Oncologica, 2005; 44: 265/276
REVIEW ARTICLE
The radiobiology of prostate cancer including new aspects of
fractionated radiotherapy
JACK F. FOWLER
Emeritus of Medical School of Wisconsin University, Department of Human Oncology, University of Wisconsin-Madison,
USA
Published in final edited form as:
Semin Radiat Oncol. 2008 October ; 18(4): 249–256. doi:10.1016/j.semradonc.2008.04.007.
Rationale, conduct, and outcome using hypofractionated
radiotherapy in prostate cancer
Mark Ritter, M.D., Ph.D. [Professor]
Department of Human Oncology and Medical Physics, University of Wisconsin School of Medicine
and Public Health, 600 Highland Avenue – K4/B100, Madison, WI 53792, ritter@humonc.wisc.edu
Trust no one, do the research and you will maximize the chance for cure and minimize risk.0 -
I have no vested interest inKongo said:BD
You and I agree on most issues here but I take strong exception with your statement that Cyberknife is "experimental" as you characterize it. Cyberknife was approved by the FDA for cancer treatment in 2000 --- the same year DaVinci was approved by the FDA --- and has been used to treat prostate cancer since 2003 where it started at Stanford. DaVinci was approved for use in radical prostectomies by the FDA in 2005. How do you define "experimental?" I also don't understand your comment about HDR Brachy not have long term results as I have read many. And finally, I take exception to your assertion that in the long run Cyberknife may prove to have similar (but not better) outcomes over EBRT. I really have no idea what you are basing this authoritive assumption on as the cyberknife procedure delivers radiation much more accurately with much less dosage to surrounding tissue, not to mention several other factors relating to dosage efficacy, particularly with respect to early cancers. I fear you've misrepresented the facts in downplaying this treatment option.
I agree with you completely that diet and lifestyle are critical factors in long term success regardless of treatment options and I share your loathing for the snake oil salesmen who prey on patients looking for hope.
And I agree that its far to presumptuous to second guess another's treatment choice if they've gone through the rigor of investigating and evaluating all the options available that are relevant to their individual cancer situation. After re-reading all the posts in this thread, I don't see where anyone has said their treatment choice is better than anothers, except perhaps you're disparaging remarks about "experimental" Cyberknife and other misrepresentations.
Best to you as well.
I have no vested interest in what treatment you select or have taken and I sincerely wish you the best of luck in your journey.
The items you “object” to are in “quotation marks” and are from very reliable medical scientist in my opinion…I am sorry that they do not agree with your “thought” or “belief”. No one likes to hear that the path they choose was wrong and they could have selected some magic bullet with no side effects…and that is what started the objection today first with Viper….
Your statement that “I am unaware of any biological failures using Cyberknife” and even your explanation after your statement that low risk PCa groups that have been documented in various studies, I am not aware of any failures”… Sorry 100% long term success rates do not exist with any treatment low or high risk cases.
Your treatment has the same side effects that any other radiation treatment has including long term ED issue 2-3 years after treatment… I hope you have the best outcome.
The jury is still out on the long term effectiveness of CyberKnife and the effect of larger cy dosages given (yes less days but larger dosages)...Does not mean it is not effective but the jury is out…I wish you the best
I have no interest to continue this dialog. From my perspective, this site is to help guys not slant the facts or press one treatment or agenda…
Best to all0 -
LOL - yes Kongo, I go to theKongo said:Sheesh
You're a tough, hombre, Randy but I get your point.
Mat when I feel I am right about something.
This prostate thing is pretty tricky sometimes...but then again it seems simple if you have very little involvment and catch it early....I am guessing that those who catch it early and very little involvement will have pretty much a 95-99% cure rate no matter what treatment choice is selected....There really needs to be studies done by many different variables like:
Age
fitness
volume of cancer
gleason
lifestyle
diet
family history
mental health status
surgeon skill level
Oncologist skill level
for starters...I am sure many other factors could and should be considered besides these few off the top of my head...but think if they could categorize much of this and then take them against the treatment choice a more definitive path could be created for cure.
A guru on Prostate Cancer should be organizing a database to collect all this data and crunch it for better prostate cancer care.
my two cents
Randy in Indy0 -
A Dr. Critz near Atlantarandy_in_indy said:LOL - yes Kongo, I go to the
Mat when I feel I am right about something.
This prostate thing is pretty tricky sometimes...but then again it seems simple if you have very little involvment and catch it early....I am guessing that those who catch it early and very little involvement will have pretty much a 95-99% cure rate no matter what treatment choice is selected....There really needs to be studies done by many different variables like:
Age
fitness
volume of cancer
gleason
lifestyle
diet
family history
mental health status
surgeon skill level
Oncologist skill level
for starters...I am sure many other factors could and should be considered besides these few off the top of my head...but think if they could categorize much of this and then take them against the treatment choice a more definitive path could be created for cure.
A guru on Prostate Cancer should be organizing a database to collect all this data and crunch it for better prostate cancer care.
my two cents
Randy in Indy
A Dr. Critz near Atlanta keeps an extensive database on his patients that he treats with a technique called prostrcision. I'm not sure what all variables he keeps but I did visit him before selecting on Davinci. When he ran all my numbers through his computer database He only gave me a 54% chance of being cancer free in 10 years following his treatment. To me that was a crap shoot and I wanted a better chance of being cancer free from first line of treatment.
larry0 -
Larrylewvino said:A Dr. Critz near Atlanta
A Dr. Critz near Atlanta keeps an extensive database on his patients that he treats with a technique called prostrcision. I'm not sure what all variables he keeps but I did visit him before selecting on Davinci. When he ran all my numbers through his computer database He only gave me a 54% chance of being cancer free in 10 years following his treatment. To me that was a crap shoot and I wanted a better chance of being cancer free from first line of treatment.
larry
People with little involvement of cancer have a much better chance of using just about any theraphy and having a better result....that's why the doc's all clammer for them after viewing their biopsy results to build a success story to sell to others....it's somewhat of a money game with many of the surgeons...after they learned about my background they all wanted to treat me. I found a cocky athletic type guy that basically said he was a rock star surgeon and I believed him because he was pretty much like myself...so far he was right. I will give him the award after 10 years of Non-detectable readings. - if this site is still here I will post to it in 10 years....mark my words.
Randy In Indy0 -
Viperviperfred said:HRD Brachytherapy
HDR Brachy therapy has been used for over 19 years not "5"
http://www.cetmc.com/ Started HDR Brachy therapy in 1991
http://linkinghub.elsevier.com/retrieve/pii/S0302283804006219 1992-2001 First patient in this study was treated in 1992
http://www.springerlink.com/content/tarm2hj0h1ff583v/ 2002-2003 HDR BT treatment
Science of Hypo fractionation:
Int. J. Radiation Oncology Biol. Phys., Vol. 52, No. 1, pp. 6–13, 2002
Copyright © 2002 Elsevier Science Inc.
DIRECT EVIDENCE THAT PROSTATE TUMORS SHOW HIGH SENSITIVITY
TO FRACTIONATION (LOW / RATIO), SIMILAR TO LATE-RESPONDING
NORMAL TISSUE
DAVID J. BRENNER, PH.D., D.SC.,* ALVARO A. MARTINEZ, M.D., F.A.C.R.,†
GREGORY K. EDMUNDSON, M.SC.,† CHRISTINA MITCHELL, R.N., B.S.N.,† HOWARD D. THAMES, PH.D.,‡
AND ELWOOD P. ARMOUR, PH.D.†
*Center for Radiological Research, Department of Radiation Oncology, Columbia University, New York, NY; †Department of
Radiation Oncology, William Beaumont Hospital, Royal Oak, MI; ‡Department of Biomathematics, M. D. Anderson Cancer Center,
Houston, TX
Int. J. Radiation Oncology Biol. Phys., Vol. 48, No. 2, pp. 315–316, 2000
Copyright © 2000 Elsevier Science Inc
TOWARD OPTIMAL EXTERNAL-BEAM FRACTIONATION FOR
PROSTATE CANCER
DAVID J. BRENNER, D.SC.
Center for Radiological Research, Columbia University, New York, NY
Int. J. Radiation Oncology Biol. Phys., Vol. 57, No. 4, pp. 912–914, 2003
Copyright © 2003 Elsevier Inc
HYPOFRACTIONATION FOR PROSTATE CANCER RADIOTHERAPY—WHAT
ARE THE ISSUES?
DAVID J. BRENNER, PH.D., D.SC.
Department of Radiation Oncology, Center for Radiological Research, Columbia University, New York, NY
Int. J. Radiation Oncology Biol. Phys., Vol. 52, No. 1, pp. 3–5, 2002
Copyright © 2002 Elsevier Science Inc.
THE PROSPECTS FOR NEW TREATMENTS FOR PROSTATE CANCER
JACK F. FOWLER, D.SC., PH.D.,* RICK J. CHAPPELL, PH.D.,† AND MARK A. RITTER, M.D., PH.D.*
Departments of *Human Oncology and †Biostatistics and Medical Informatics, University of Wisconsin-Madison, Madison, WI
Int. J. Radiation Oncology Biol. Phys., Vol. 60, No. 4, pp. 1241–1256, 2004
Copyright © 2004 Elsevier Inc.
A CHALLENGE TO TRADITIONAL RADIATION ONCOLOGY
JACK F. FOWLER, PH.D., D.SC., WOLFGANG A. TOMÉ, PH.D., JOHN D. FENWICK, PH.D.,
AND MINESH P. MEHTA, M.D.
Department of Human Oncology, Medical School of the University of Wisconsin, Madison, WI
Acta Oncologica, 2005; 44: 265/276
REVIEW ARTICLE
The radiobiology of prostate cancer including new aspects of
fractionated radiotherapy
JACK F. FOWLER
Emeritus of Medical School of Wisconsin University, Department of Human Oncology, University of Wisconsin-Madison,
USA
Published in final edited form as:
Semin Radiat Oncol. 2008 October ; 18(4): 249–256. doi:10.1016/j.semradonc.2008.04.007.
Rationale, conduct, and outcome using hypofractionated
radiotherapy in prostate cancer
Mark Ritter, M.D., Ph.D. [Professor]
Department of Human Oncology and Medical Physics, University of Wisconsin School of Medicine
and Public Health, 600 Highland Avenue – K4/B100, Madison, WI 53792, ritter@humonc.wisc.edu
Trust no one, do the research and you will maximize the chance for cure and minimize risk.
When are you going to update your rediculous advertising web site to include the latest and probably the largest study results of Robotic surgery results. Your page is grossly wrong for the average person using a dart board to pick their urological surgeon.
http://nyp.org/news/hospital/robotic-prostate-surgery-study.html
Robotic Prostate Surgery Study Finds 5-Year Outcomes Favorable
One of Largest Studies of Its Kind Led by Dr. Ketan K. Badani, Newly Appointed Director of Robotic Surgery at NewYork-Presbyterian Hospital/Columbia University Medical Center
NEW YORK (Dec 18, 2007)
Prostate cancer patients receiving robotic prostatectomy—an advanced procedure to remove the prostate using a surgical robot—have excellent outcomes five years after surgery.
The results of what may be the largest and longest study of its kind are published in a recent issue of the journal Cancer, and led by Dr. Ketan K. Badani, the newly appointed director of robotic surgery at NewYork-Presbyterian Hospital/Columbia University Medical Center and assistant professor of urology at Columbia University College of Physicians and Surgeons. Previously, Dr. Badani was a clinical fellow in robotic and laparoscopic urologic oncology at Henry Ford Hospital in Detroit, where the 2,766 procedures followed in the investigation were conducted over a six-year period.
Dr. Badani says, "We found that in highly experienced hands, the results after robotic surgery are outstanding for cancer control, with minimal complications and few side effects of urinary incontinence and sexual dysfunction."
"In addition, blood loss is far less than with traditional surgery. This, along with minimizing trauma to the body tissues, translates into short hospital stays, and more importantly, quick recovery—allowing patients to resume their regular activities, whether that means going for a run or playing 18 holes of golf," adds Dr. Badani, who has personally performed more than 700 of the robotic procedures.
Specific study findings include the following:
•Ninety-three percent (93%) of patients achieved normal urinary function, with a median time of complete control of three weeks.
•Only slightly more than seven percent (7.2%) of patients had recurrence of prostate cancer symptoms (presence of prostate specific antigen, or PSA). Less than one percent (0.5%) of patients died during 71 months of follow-up.
•Nearly 80 percent (79.2%) of patients reported normal sexual function.
The study also compared clinical outcomes of the first 200 patients with that of the final 200 patients to see if there were improvements. They found a reduced amount of blood loss and fewer cases of positive surgical margins (4 percent, down from 7 percent)—when the initial cut does not cut away all of the cancerous tissue. The surgery also was performed faster (131 minutes vs. 160 minutes).
"With five years of follow-up, we can now see that, not only is robotic prostate surgery safe and effective, but it continues to improve," says Dr. Badani. "As with any highly technical operation, the study points to the importance of experience. With the knowledge and practice of many procedures, outcomes for patients improve. NewYork-Presbyterian/Columbia is one of only a few premier centers that can offer this level of specialized surgery to patients."
Dr. Badani has helped pioneer novel techniques to preserve sexual potency in men undergoing robotic prostatectomy while optimizing cancer control. He has performed live robotic demonstrations at both national and international meetings and has lectured and published extensively on outcomes of patients undergoing robotic surgery. He received his medical degree from Case Western Reserve University School of Medicine in Cleveland, Ohio, and completed both his urologic residency and fellowship in robotic and laparoscopic urologic oncology at the Vattikuti Urology Institute at Henry Ford Hospital in Detroit.
The Cancer study is co-authored by Drs. Sanjeev Kaul and Mani Menon—both of the Henry Ford Hospital in Detroit.
NewYork-Presbyterian/Columbia offers a comprehensive urologic surgery program with robotic surgery available for robotic prostatectomy, robotic nephrectomy (kidney), robotic cystectomy (bladder) and robotic adrenal gland surgery. In addition to Dr. Badani, members of the robotic urologic surgery team include Drs. Mitchell C. Benson, James M. McKiernan, Erik Goluboff and Carl A. Olsson.
Robotic Prostatectomy
During robotic prostatectomy, the physician makes five to six small incisions in the abdomen, through which surgical instruments and a tiny stereoscopic camera are inserted. The camera improves visibility, and robotic arms make for easier suturing.
Robotic prostatectomies make use of Intuitive Surgical's da Vinci™ Surgical System, which has been approved by the FDA for a number of innovative clinical procedures employed at NewYork-Presbyterian Hospital.
Prostate cancer is the second most common cancer death after lung cancer. Each year, over 200,000 Americans are diagnosed with prostate cancer, and as many as 32,000 will die from the disease.0 -
Yes Knowledge is KING is rightviperfred said:Knowledge is King!
Prostate Cancer Patients must be informed!
Comparative Effectiveness of Minimally Invasive vs Open Radical Prostatectomy
http://jama.ama-assn.org/cgi/content/abstract/302/14/1557
Role of experience and surgery
http://www.sciencedaily.com/releases/2007/07/070724161655.htm
Everyone has an opinion!
Viper
When are you going to update your rediculous advertising web site to include the latest and probably the largest study results of Robotic surgery results. Your page is grossly wrong for the average person using a dart board to pick their urological surgeon.
http://nyp.org/news/hospital/robotic-prostate-surgery-study.html
Robotic Prostate Surgery Study Finds 5-Year Outcomes Favorable
One of Largest Studies of Its Kind Led by Dr. Ketan K. Badani, Newly Appointed Director of Robotic Surgery at NewYork-Presbyterian Hospital/Columbia University Medical Center
NEW YORK (Dec 18, 2007)
Prostate cancer patients receiving robotic prostatectomy—an advanced procedure to remove the prostate using a surgical robot—have excellent outcomes five years after surgery.
The results of what may be the largest and longest study of its kind are published in a recent issue of the journal Cancer, and led by Dr. Ketan K. Badani, the newly appointed director of robotic surgery at NewYork-Presbyterian Hospital/Columbia University Medical Center and assistant professor of urology at Columbia University College of Physicians and Surgeons. Previously, Dr. Badani was a clinical fellow in robotic and laparoscopic urologic oncology at Henry Ford Hospital in Detroit, where the 2,766 procedures followed in the investigation were conducted over a six-year period.
Dr. Badani says, "We found that in highly experienced hands, the results after robotic surgery are outstanding for cancer control, with minimal complications and few side effects of urinary incontinence and sexual dysfunction."
"In addition, blood loss is far less than with traditional surgery. This, along with minimizing trauma to the body tissues, translates into short hospital stays, and more importantly, quick recovery—allowing patients to resume their regular activities, whether that means going for a run or playing 18 holes of golf," adds Dr. Badani, who has personally performed more than 700 of the robotic procedures.
Specific study findings include the following:
•Ninety-three percent (93%) of patients achieved normal urinary function, with a median time of complete control of three weeks.
•Only slightly more than seven percent (7.2%) of patients had recurrence of prostate cancer symptoms (presence of prostate specific antigen, or PSA). Less than one percent (0.5%) of patients died during 71 months of follow-up.
•Nearly 80 percent (79.2%) of patients reported normal sexual function.
The study also compared clinical outcomes of the first 200 patients with that of the final 200 patients to see if there were improvements. They found a reduced amount of blood loss and fewer cases of positive surgical margins (4 percent, down from 7 percent)—when the initial cut does not cut away all of the cancerous tissue. The surgery also was performed faster (131 minutes vs. 160 minutes).
"With five years of follow-up, we can now see that, not only is robotic prostate surgery safe and effective, but it continues to improve," says Dr. Badani. "As with any highly technical operation, the study points to the importance of experience. With the knowledge and practice of many procedures, outcomes for patients improve. NewYork-Presbyterian/Columbia is one of only a few premier centers that can offer this level of specialized surgery to patients."
Dr. Badani has helped pioneer novel techniques to preserve sexual potency in men undergoing robotic prostatectomy while optimizing cancer control. He has performed live robotic demonstrations at both national and international meetings and has lectured and published extensively on outcomes of patients undergoing robotic surgery. He received his medical degree from Case Western Reserve University School of Medicine in Cleveland, Ohio, and completed both his urologic residency and fellowship in robotic and laparoscopic urologic oncology at the Vattikuti Urology Institute at Henry Ford Hospital in Detroit.
The Cancer study is co-authored by Drs. Sanjeev Kaul and Mani Menon—both of the Henry Ford Hospital in Detroit.
NewYork-Presbyterian/Columbia offers a comprehensive urologic surgery program with robotic surgery available for robotic prostatectomy, robotic nephrectomy (kidney), robotic cystectomy (bladder) and robotic adrenal gland surgery. In addition to Dr. Badani, members of the robotic urologic surgery team include Drs. Mitchell C. Benson, James M. McKiernan, Erik Goluboff and Carl A. Olsson.
Robotic Prostatectomy
During robotic prostatectomy, the physician makes five to six small incisions in the abdomen, through which surgical instruments and a tiny stereoscopic camera are inserted. The camera improves visibility, and robotic arms make for easier suturing.
Robotic prostatectomies make use of Intuitive Surgical's da Vinci™ Surgical System, which has been approved by the FDA for a number of innovative clinical procedures employed at NewYork-Presbyterian Hospital.
Prostate cancer is the second most common cancer death after lung cancer. Each year, over 200,000 Americans are diagnosed with prostate cancer, and as many as 32,000 will die from the disease.0 -
It sounds like there is a shake-up atrandy_in_indy said:Viper
When are you going to update your rediculous advertising web site to include the latest and probably the largest study results of Robotic surgery results. Your page is grossly wrong for the average person using a dart board to pick their urological surgeon.
http://nyp.org/news/hospital/robotic-prostate-surgery-study.html
Robotic Prostate Surgery Study Finds 5-Year Outcomes Favorable
One of Largest Studies of Its Kind Led by Dr. Ketan K. Badani, Newly Appointed Director of Robotic Surgery at NewYork-Presbyterian Hospital/Columbia University Medical Center
NEW YORK (Dec 18, 2007)
Prostate cancer patients receiving robotic prostatectomy—an advanced procedure to remove the prostate using a surgical robot—have excellent outcomes five years after surgery.
The results of what may be the largest and longest study of its kind are published in a recent issue of the journal Cancer, and led by Dr. Ketan K. Badani, the newly appointed director of robotic surgery at NewYork-Presbyterian Hospital/Columbia University Medical Center and assistant professor of urology at Columbia University College of Physicians and Surgeons. Previously, Dr. Badani was a clinical fellow in robotic and laparoscopic urologic oncology at Henry Ford Hospital in Detroit, where the 2,766 procedures followed in the investigation were conducted over a six-year period.
Dr. Badani says, "We found that in highly experienced hands, the results after robotic surgery are outstanding for cancer control, with minimal complications and few side effects of urinary incontinence and sexual dysfunction."
"In addition, blood loss is far less than with traditional surgery. This, along with minimizing trauma to the body tissues, translates into short hospital stays, and more importantly, quick recovery—allowing patients to resume their regular activities, whether that means going for a run or playing 18 holes of golf," adds Dr. Badani, who has personally performed more than 700 of the robotic procedures.
Specific study findings include the following:
•Ninety-three percent (93%) of patients achieved normal urinary function, with a median time of complete control of three weeks.
•Only slightly more than seven percent (7.2%) of patients had recurrence of prostate cancer symptoms (presence of prostate specific antigen, or PSA). Less than one percent (0.5%) of patients died during 71 months of follow-up.
•Nearly 80 percent (79.2%) of patients reported normal sexual function.
The study also compared clinical outcomes of the first 200 patients with that of the final 200 patients to see if there were improvements. They found a reduced amount of blood loss and fewer cases of positive surgical margins (4 percent, down from 7 percent)—when the initial cut does not cut away all of the cancerous tissue. The surgery also was performed faster (131 minutes vs. 160 minutes).
"With five years of follow-up, we can now see that, not only is robotic prostate surgery safe and effective, but it continues to improve," says Dr. Badani. "As with any highly technical operation, the study points to the importance of experience. With the knowledge and practice of many procedures, outcomes for patients improve. NewYork-Presbyterian/Columbia is one of only a few premier centers that can offer this level of specialized surgery to patients."
Dr. Badani has helped pioneer novel techniques to preserve sexual potency in men undergoing robotic prostatectomy while optimizing cancer control. He has performed live robotic demonstrations at both national and international meetings and has lectured and published extensively on outcomes of patients undergoing robotic surgery. He received his medical degree from Case Western Reserve University School of Medicine in Cleveland, Ohio, and completed both his urologic residency and fellowship in robotic and laparoscopic urologic oncology at the Vattikuti Urology Institute at Henry Ford Hospital in Detroit.
The Cancer study is co-authored by Drs. Sanjeev Kaul and Mani Menon—both of the Henry Ford Hospital in Detroit.
NewYork-Presbyterian/Columbia offers a comprehensive urologic surgery program with robotic surgery available for robotic prostatectomy, robotic nephrectomy (kidney), robotic cystectomy (bladder) and robotic adrenal gland surgery. In addition to Dr. Badani, members of the robotic urologic surgery team include Drs. Mitchell C. Benson, James M. McKiernan, Erik Goluboff and Carl A. Olsson.
Robotic Prostatectomy
During robotic prostatectomy, the physician makes five to six small incisions in the abdomen, through which surgical instruments and a tiny stereoscopic camera are inserted. The camera improves visibility, and robotic arms make for easier suturing.
Robotic prostatectomies make use of Intuitive Surgical's da Vinci™ Surgical System, which has been approved by the FDA for a number of innovative clinical procedures employed at NewYork-Presbyterian Hospital.
Prostate cancer is the second most common cancer death after lung cancer. Each year, over 200,000 Americans are diagnosed with prostate cancer, and as many as 32,000 will die from the disease.
Columbia Presbyterian..........could be that ashutosh k. Tewari, M.D. is out.0 -
Randy, I'll be lookingrandy_in_indy said:Larry
People with little involvement of cancer have a much better chance of using just about any theraphy and having a better result....that's why the doc's all clammer for them after viewing their biopsy results to build a success story to sell to others....it's somewhat of a money game with many of the surgeons...after they learned about my background they all wanted to treat me. I found a cocky athletic type guy that basically said he was a rock star surgeon and I believed him because he was pretty much like myself...so far he was right. I will give him the award after 10 years of Non-detectable readings. - if this site is still here I will post to it in 10 years....mark my words.
Randy In Indy
Randy, I'll be looking forward to reading your post in 10 years. My dad is at about year 14 following Proton treatment. As you say his was caught early and had great success.
It was interesting when I talked to the guy in Atlanta that at least he was honest with me. When he asked if I was ready to select my treatment I said no. I have one more Doc i'm seeing up in Nashville. He then said are you Seeing Dr. Smith at Vanderbilt? I said yes, he then told me "he is one of the best you will find, give him my regards when you see him."
So glad you found a great surgeon also.
Did you listen to that lecture by Dr. Mulhall? SOmeone posted a link on another thread.
Very good lecture. Again I'm so glad I chose Davinci over radiation for first line of treatment. It seems that with radiation you won't start getting some of the side effects till 5 years down the road. That is exactly what happened with my dad. I thought at 54 I'm young and can fight any side effects now and win the battle. So far it has worked for me.
Larry0 -
Prostate Cancerlewvino said:Randy, I'll be looking
Randy, I'll be looking forward to reading your post in 10 years. My dad is at about year 14 following Proton treatment. As you say his was caught early and had great success.
It was interesting when I talked to the guy in Atlanta that at least he was honest with me. When he asked if I was ready to select my treatment I said no. I have one more Doc i'm seeing up in Nashville. He then said are you Seeing Dr. Smith at Vanderbilt? I said yes, he then told me "he is one of the best you will find, give him my regards when you see him."
So glad you found a great surgeon also.
Did you listen to that lecture by Dr. Mulhall? SOmeone posted a link on another thread.
Very good lecture. Again I'm so glad I chose Davinci over radiation for first line of treatment. It seems that with radiation you won't start getting some of the side effects till 5 years down the road. That is exactly what happened with my dad. I thought at 54 I'm young and can fight any side effects now and win the battle. So far it has worked for me.
Larry
Management of Prostate Cancer is very complex, add to that misinformation by doctors and misunderstood by many.
To know the long term 10 or 20 years of any therapy takes takes 10 or twenty years. Surgery and Photon therapy have been used for treating PCa for about 100 years. Both have improved with advancements in technology. Cyro and Proton and HIFU relatively new.
Surgery would be a great option if the cancer cells would limit their spread to the tissue being removed and stayed away from critical structures. Photon Therapy is in the same boat, if you could but the Brags Peak only on the cancer cells the cure would be very high. Photons (Rapid Arc, IGRT, IMRT and the CyberKnife, Brachytherapy : x-rays) are subject to the same problems of not knowing where the cancers cells are hiding. When critical structures are cut, bombarded with ionizing radiation, frozen or cooked we have side effects. Some side effects will be short term and resolve some will not.
ED is caused by two different incidents nerve damage by a slice during surgery and blood flow restriction caused by radiation. Blood flow can be improved by nature, drugs such as Viagra. Nerve damage may be repaired by nature or managed with injections or a pumps. Know all risk, look at the peer-review articles. The rest are full of opinions not subject to quality standards of peer-review.
Every therapy has risk. The treatment choice is difficult enough but add the fact that technology advancements continue to all therapies and their outcome good or bad will not be known for years.
I know of no long term studies (from the last 20 years) that show risk from radiation therapy for PCa that are higher than any other non RT modality. The time line may change and
I am happy to accept the side effect out in the future rather than at time zero of therapy.
When possible my site will be updated, most current information is from the rss feeds which will be expand when I have time.
I am a fan of my therapy as others are fans of theirs.
My goal is for men to be informed so they can make a choice that is best for them.
Stay Cancer Free and Healthy.
There are none so blind as do not wish to see.[1]
[1] Darwin, E. (1794). Zoonomia: or the Laws of organic life. Vol. II, p.244. Third edition (1801). J.Johnson, London0 -
Reading this thread is very hard, can people actually learn anything here?steckley said:Further insight
Hey guys I heard eating crow is a great cure for PCa ... or was it high blood pressure?
bdhilton writes..."From my perspective, this site is to help guys, not slant the facts or press one treatment or agenda…" However he presses his agenda, calling viper a "troll" etc. Name calling does not a happy well informed forum make.
Let's face it, no one who has a treatment that worked out great is a "troll", they simply want to share their good news and hope it extends to others. News on cyberknife, proton and HIFU is rare, let's not run these men - who have had a good go of it - off! Or, is the agenda here to only accept men who have had a bad go of it (except surgery...)? Of course these men who had good outcomes are slanted, they are happy! viper is years out, to come here and share his info is great, a true kind heart. There will be others who show up who are not happy after cyberknife, if you quit attacking people, we may get to the bottom of the show. Sift all info through your mind, don't tell us what to think about the person.
No one comes here to sell anything, the happy ones come hoping they can help someone find their state of happiness. You, that run off posters, are the ones trying to slant the facts and press treatments, covering up and supressing the new treatments.
Out of 4,000 men who have had cyberknife, only one is here, we need him.
BTW, my doctor told me incontinence is 60% after surgery.0
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