Latest published results for CyberKnife Treatment option

VascodaGama

Here are the latest published results for CyberKnife treatments which will help guys with localized new PCa cases (low-risk prostate cancer patients) when deciding on a treatment option. The biochemical progression-free survival at 5 years was 93%. The short term side effects were resolved within 1-3 months from treatment completion.
Have a look in this site and their links;
http://www.ncbi.nlm.nih.gov/pubmed/21219625

I wish the best to all in our bumpy road.
VGama

lewvino

Thanks for providing the
Thanks for providing the link.

Indeed the treatment option of CyberKnife is promising for LOW RISK prostate Cancer patients.

In the article it states "The criteria for low-risk classification included a pre-treatment PSA of 10 ng/mL or less, Gleason score of 3+3 or lower and clinical stage T1c or T2a/b. Patients with a Gleason score of 3+4 were included if present in 2 or fewer cores and involving less than 5 mm aggregate tumor length"

All men facing prostate cancer need to study the treatment options carefully.
For me I was Gleason 4+3 Graded T2C with 5 of 12 cores finding cancer. This ruled out CyberKnife as a viable treatment option for me but am happy that the option is available for others!

Larry

Kongo

lewvino said:

Thanks for providing the
Thanks for providing the link.

Indeed the treatment option of CyberKnife is promising for LOW RISK prostate Cancer patients.

In the article it states "The criteria for low-risk classification included a pre-treatment PSA of 10 ng/mL or less, Gleason score of 3+3 or lower and clinical stage T1c or T2a/b. Patients with a Gleason score of 3+4 were included if present in 2 or fewer cores and involving less than 5 mm aggregate tumor length"

All men facing prostate cancer need to study the treatment options carefully.
For me I was Gleason 4+3 Graded T2C with 5 of 12 cores finding cancer. This ruled out CyberKnife as a viable treatment option for me but am happy that the option is available for others!

Larry

Right you are
Exactly right, Larry. CK results are based on a fairly strict criteria for low risk PCa. They are, however, doing a couple of early small studies for men with 4+3 Gleason scores. The very few failures to date have almost always been from men in this category. Georgetown University Hospital is also doing a study where they do a CK "boost" in conjunction with more conventional IMRT for men with intermediate to advanced diagnoses. So far it appears promising and are moving toward a Phase II trial. I think at some point in the future we may well see CK routinely used as a treatment option for a broader range of cancers than what is now done.

tarhoosier

Kongo said:

Right you are
Exactly right, Larry. CK results are based on a fairly strict criteria for low risk PCa. They are, however, doing a couple of early small studies for men with 4+3 Gleason scores. The very few failures to date have almost always been from men in this category. Georgetown University Hospital is also doing a study where they do a CK "boost" in conjunction with more conventional IMRT for men with intermediate to advanced diagnoses. So far it appears promising and are moving toward a Phase II trial. I think at some point in the future we may well see CK routinely used as a treatment option for a broader range of cancers than what is now done.

low risk risk
Success for low risk patients is inherent. ANY treatment, in fact, NO treatment,would show high success. What else have you got?

ob66

tarhoosier said:

low risk risk
Success for low risk patients is inherent. ANY treatment, in fact, NO treatment,would show high success. What else have you got?

Temper anger
tarhoosier, what you say may be totally correct. I believe success is not inherent and has it's risks, but scientifically would not rule it out, but it is how you say it. What is wrong with CK being performed on low risk candidates, and at the same time, achieving great results? I am all for that, for one. I sensed in your post that they were trying to pull a fast one. I have PCa, and it was treated in other way/ways. I am happy for the low risk patients who can achieve unbelievable prognosis' (would that be Prog-No-Ceez). Cheers

Kongo

tarhoosier said:

low risk risk
Success for low risk patients is inherent. ANY treatment, in fact, NO treatment,would show high success. What else have you got?

What else?
I'm missing the body language from your post, tarhoosier, but if you're suggesting that since many low risk PCa treatment options frequently do well , then what is so special here, I believe you've overlooked some key points.

While low risk PCa (Gleason 6 or less, PSA less than 10, low involvement) have similar long term survival rates between AS, RP, brachytherapy, IMRT, and SBRT (CK), they DO NOT have the same side effects following treatment. Thanks to widespread testing, most men initially diagnosed in the United States today fall into the "low risk" category and deaths from prostate cancer have significantly decreased in the last two decades as a result of early treatment of these cases. While AS may potentially offer the least amount of potential side effects, we don't know, with the technology today, which of these low risk cancers will progress. All advanced cancers started out at some point as low risk.

The other thing that is "special" here is that this study shows a very high percentage of men who are free of biochemical recurrence or progression at five years. About a third of surgery patients see a biochemical recurrence and require follow-on treatment of one sort or another. While five years is not forever, it's a strong indication of this trend will continue.

So to me at least, the point of the promising results of these new technologies to treat early stage prostate cancer is that men have more and better choices to minimize the potential side effects of their treatment, improve their quality of life for however long they have left, and have an excellent probability that their cancer will never return. In my decision process, it came down to choosing a treatment method that minimized side effects while maximizing the potential for a long term cancer free life.

There are other benefits here as well that the abstract Vasco posted does not touch upon that I feel are noteworthy which involve the cost and convenience of this treatment. CK is significantly less expensive than either surgery or IMRT, recovery time is not a factor, and treatments are completed within a few days rather than over a few months. Since this procedure also has fewer and less severe side effects than other treatments, the long term costs over the life of the patient are also significantly reduced. As a nation facing exponentially rising health care costs in general and prostate cancer costs specifically, we should be embracing new treatment options that successfully treat cancer, reduce side effects, and lower overall insurance and Medicare costs.

One thing to be aware of regarding this study. It is only the first one with a 5-year median follow-up and has a relatively small number of patients. The CK treatments common today use a protocol that has evolved from what was used in this first study in terms of how the dosage is delivered, schedule of fraction treatment, and so forth. For example, the Stanford study found that giving the five fractional doses every other day instead of consecutively greatly reduced near term urinary issues that involved urgency and frequent urination. As a result of the improved protocols as a result of early results from this study, future trial results which should be forthcoming in the next year or so are promising to be even more impressive with respect to side effects.

As recently as a few years ago many naysayers downplayed SBRT as too new, "experimental," and without long term results. As more and more of these types of results emerge and awareness increases among the medical community and newly diagnosed patients, I expect that it will become an increasingly more frequent choice for men who are fortunate enough to have a pathology that this treatment can well address. Ongoing research may also afford men with more advanced cancers the opportunity for more treatment choices as well.

K

mrshisname

Kongo said:

What else?
I'm missing the body language from your post, tarhoosier, but if you're suggesting that since many low risk PCa treatment options frequently do well , then what is so special here, I believe you've overlooked some key points.

While low risk PCa (Gleason 6 or less, PSA less than 10, low involvement) have similar long term survival rates between AS, RP, brachytherapy, IMRT, and SBRT (CK), they DO NOT have the same side effects following treatment. Thanks to widespread testing, most men initially diagnosed in the United States today fall into the "low risk" category and deaths from prostate cancer have significantly decreased in the last two decades as a result of early treatment of these cases. While AS may potentially offer the least amount of potential side effects, we don't know, with the technology today, which of these low risk cancers will progress. All advanced cancers started out at some point as low risk.

The other thing that is "special" here is that this study shows a very high percentage of men who are free of biochemical recurrence or progression at five years. About a third of surgery patients see a biochemical recurrence and require follow-on treatment of one sort or another. While five years is not forever, it's a strong indication of this trend will continue.

So to me at least, the point of the promising results of these new technologies to treat early stage prostate cancer is that men have more and better choices to minimize the potential side effects of their treatment, improve their quality of life for however long they have left, and have an excellent probability that their cancer will never return. In my decision process, it came down to choosing a treatment method that minimized side effects while maximizing the potential for a long term cancer free life.

There are other benefits here as well that the abstract Vasco posted does not touch upon that I feel are noteworthy which involve the cost and convenience of this treatment. CK is significantly less expensive than either surgery or IMRT, recovery time is not a factor, and treatments are completed within a few days rather than over a few months. Since this procedure also has fewer and less severe side effects than other treatments, the long term costs over the life of the patient are also significantly reduced. As a nation facing exponentially rising health care costs in general and prostate cancer costs specifically, we should be embracing new treatment options that successfully treat cancer, reduce side effects, and lower overall insurance and Medicare costs.

One thing to be aware of regarding this study. It is only the first one with a 5-year median follow-up and has a relatively small number of patients. The CK treatments common today use a protocol that has evolved from what was used in this first study in terms of how the dosage is delivered, schedule of fraction treatment, and so forth. For example, the Stanford study found that giving the five fractional doses every other day instead of consecutively greatly reduced near term urinary issues that involved urgency and frequent urination. As a result of the improved protocols as a result of early results from this study, future trial results which should be forthcoming in the next year or so are promising to be even more impressive with respect to side effects.

As recently as a few years ago many naysayers downplayed SBRT as too new, "experimental," and without long term results. As more and more of these types of results emerge and awareness increases among the medical community and newly diagnosed patients, I expect that it will become an increasingly more frequent choice for men who are fortunate enough to have a pathology that this treatment can well address. Ongoing research may also afford men with more advanced cancers the opportunity for more treatment choices as well.

K

as always...
excellent reply and so thorough, Kongoman. I enjoy your posts. Honestly, I wish my husband had considered cyberknife; I wanted him to check it out, but he has been exposed to many different kinds of dangerous chemicals and radiation in his career as an industrial electrician, and he wanted no part of any sort of radiation therapy. So he eventually chose DaVinci, as you know. I always read your posts about Cyberknife because I think had it been me facing the decision, that was what I personally would have chosen.
In our 'neck of the woods', there are a few doctors down this way who have provided some less than optimal outcomes in their patients, one in particular I ran across last week with horrendous side effects from brachytherapy gone awry, that makes Trew's unfortunate story look almost good. Seriously. (want details you'll have to email me privately at snooksmama@insightbb.com).
It all boils down to RESEARCH RESEARCH RESEARCH on the part of the patient. Check out your your options and your provider thoroughly, go on boards such as this one, and keep talking to whoever has info and perspective from a variety of different approaches. It seems to be then that you can make your most educated decision that you will feel comfortable with. No one can make the decision for you. And you are the one that has to live with that decision.