Cyberknife Procedure Update

hopeful and optimistic

2ndBase said:

Wow
I read this thread and have to say just let it it go already. If not there may be a cure for cancer before this thread ends. I am dying a little more each day and working at my job and in the garden and playing golf and spending time with my wife and friends is what keeps me going. Much of my long survival is due to getting the stress out of my life and it pains me to read all the stressfull posts in this thread. You should all be so happy you got treated in time to save your lives and stop trying to one up each other. You would understand this if you knew your life was to be cut off in a few weeks. I will let his be my very last post and wih you all the best. Be kind to others and perform a random act of kindness every day. Peace, Mark

amen
G-d Bless............Ira

viperfred

2ndBase said:

Wow
I read this thread and have to say just let it it go already. If not there may be a cure for cancer before this thread ends. I am dying a little more each day and working at my job and in the garden and playing golf and spending time with my wife and friends is what keeps me going. Much of my long survival is due to getting the stress out of my life and it pains me to read all the stressfull posts in this thread. You should all be so happy you got treated in time to save your lives and stop trying to one up each other. You would understand this if you knew your life was to be cut off in a few weeks. I will let his be my very last post and wih you all the best. Be kind to others and perform a random act of kindness every day. Peace, Mark

Make an Informed Decision!
Opinions are what they are: subjective statements thoughts, emotion and or interpretation of facts about a topic. Hopefully this thread will stimulate men to do their own research about all options to allow an informed decision for the option that is best for them. My opinions about the options are unchanged by this thread, no scientific study has been provided to suggest an error.

There are many options and they have all have patients with good outcomes. No option is good or available for all patients. I acknowledge a bias for the CyberKnife on my web site.

Comparative peer review evidence is non-existent. We struggle to find evidence of the risk and benefit of each modality trying to understand each modality to allow an informed choice.

Prostate cancer management is a lottery, poor detection subject to error. News reports including comments by so called experts are misleading, ineffective at diagnosing fraud, biased, and much of what appears in peer-reviewed journals is scientifically lacking.

No informed patient pursuing optimal care will unthinkingly trust a patient community (or a physician), on-line or off. We all need to be informed consumers. No physician or consumer should unthinkingly trust evidence from any source including medical journals.

In my view, only when men realize all of this, can they make truly an informed decision, otherwise the choice is made with blinders and/or our heads in the sand.

Trust No One!

Best wishes to those who have been treated and to those to be treated!

Swingshiftworker

Kongo said:

Marge
Marge, thanks for the encouragement.

One thing about all of these studies which I find enormously frustrating is that most never seem to make head-to-head comparisons of treatment options, as indicated in the conclusion for the study you referenced. In the study you cite, for example, you can’t really draw a relevant conclusion because we don’t know the experience level of the surgeon, the state of urinary or ED functionality before treatment, the age of the patient, the staging of the cancer, and so forth. We can’t statistically normalize the study. What we have is basically: A bunch of guys had many different forms of treatment someplace and there were differing results with respect to side effects.

Randy has cited a study in this thread that shows a much different outcome for RP side effects out of NY Presbyterian done in 2007 where the patient cohort had a continence rate of over 90% and sexual function of nearly 80 percent. The caveat is that these were highly experienced surgeons using the Da Vinci machine. Of course, we really don’t know how they defined continence or sexual function but giving them the benefit of the doubt, those are certainly encouraging results for those considering RP.

Outside of NY Presbyterian, some of the large studies that draw upon the VA or Medicare databases show higher rates of RP side effects with respect to incontinence and ED. My personal belief on this is that the experience of the surgeon is the critical factor. As RP has only been approved for PCa treatment for about five years and the number of facilities offering it is growing dramatically, there is obviously a learning curve that comes into play, and Randy has always maintained that a man considering Da Vinci should seek out the most experienced surgeon available. (I heard a commercial on the radio this morning on the way to work touting a new Da Vinci machine at a local hospital – I wondered to myself how much experience the surgeon who fires that baby up for the first time will have had.) If I was going the RP route, I would be on a plane to the most expensive, most highly acknowledged, and most experienced surgeon I could find.

In Cyberknife, for example, my doctor took great pains to tell me that men who have poor sexual function before treatment will have ED issues afterward and those men with enlarged prostates or urinary issues before radiation will have a more difficult recovery than men without symptoms. I suspect there is a similar analog to RP. So, if you look at a VA or Medicare study with men at a more advanced age possessing incumbent ED and urinary issues, the study will report more side effects. I think the studies should pay much more attention to pre-treatment diet, health, and vitality and the impact it has on successful outcomes. BDHilton has made some good points on the importance of diet and exercise to recovery in other threads.

Just about any personal opinion about PCa or treatment options can cite some study or another for justification. I personally believe that flaming someone who cites a particular study that doesn’t fit your personal view of the world is unproductive and stymies the free exchange of information about subjects which many are seeking. A more civilized approach, in my opinion, would be to tactfully disagree and cite your own study and explain why you think it may be more relevant to a particular cancer situation. Personal attacks are not only against website rules; they tend dampen the free exchange of information which might turn out to be instrumental in helping someone find the right path for them. And at the end of the day, I don’t think any specific study is totally authorative by itself -- It’s just another piece of the puzzle we all have to put together as we sift through the myths, folklore, lies, and damn lies on the road to recovery.

I’ve completed all of my preparatory work and start Cyberknife treatment on June 21.

Good Luck, Kongo!
Hi, Kongo:

I've been on vacation driving around the southwest for a month.

Had a marvelous time and didn't bother logging on here while I was away. I had already decided to go w/CyberKnife too before I left on vacation and have to wait until July 1st when my insurance coverage changes from Kaiser to Blue Shield to go ahead with the treatment at UCSF.

Looking forward to your report about the treatment and subsequent results. I'll be reporting that info here too as soon when the time arrives.

Good luck!

Kongo

Swingshiftworker said:

Good Luck, Kongo!
Hi, Kongo:

I've been on vacation driving around the southwest for a month.

Had a marvelous time and didn't bother logging on here while I was away. I had already decided to go w/CyberKnife too before I left on vacation and have to wait until July 1st when my insurance coverage changes from Kaiser to Blue Shield to go ahead with the treatment at UCSF.

Looking forward to your report about the treatment and subsequent results. I'll be reporting that info here too as soon when the time arrives.

Good luck!

Swing
Hope you had a good trip! I start my treatment Monday morning and will let you know how it goes. So far, I've impressed with the treatment I've received, the education on what to expect, and the professionalism of the staff.

One thing you might want to consider when you get to the point where you're talking about the treatment schedule. After reading a recent study out of Stanford I elected to have my radiation treatments every other day instead of consecutively. The Stanford study showed that there were fewer incidents of urinary urgency issues when they gave the urethera a day to recover. Anyway, something to ask the doctor about.

Hope your process goes as smoothly as mine has.

Keep in touch.

Swingshiftworker

Kongo said:

Swing
Hope you had a good trip! I start my treatment Monday morning and will let you know how it goes. So far, I've impressed with the treatment I've received, the education on what to expect, and the professionalism of the staff.

One thing you might want to consider when you get to the point where you're talking about the treatment schedule. After reading a recent study out of Stanford I elected to have my radiation treatments every other day instead of consecutively. The Stanford study showed that there were fewer incidents of urinary urgency issues when they gave the urethera a day to recover. Anyway, something to ask the doctor about.

Hope your process goes as smoothly as mine has.

Keep in touch.

I read that about the
I read that about the CyberKnife treatment schedule too.

Discussed it w/the Director of the CyberKnife program at UCSF who said that they do not have any significant urgency problems with the 4 consecutive day schedule that they use. Contacted 3 prior CyberKnife patients at UCSF, who are all about our age and who all say that they had no problems w/urgency or ED. So, I'm not too worried about it but, when the time comes I'll ask if "every other day" is an option or not.

I don't anticipate any problems at UCSF. They've using CyberKnife for awhile and their procedures are well established. I just need to get a "referral" by my new primary care physician (PCP) at UCSF to urology and radiation oncology in order to get an MRI and CAT and the fiduciary placement prior to treatment. The PCP I'm choosing at UCSF knows the CyberKnife Director and I've already transferred all of my urology records from Kaiser to UCSF. So, the "referral" will just be a formality and I expect to begin receiving my treatments no later than some time in August and maybe as early as the late July.

We'll see . . .