CyberKnife Treatment
Comments
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mlevygmmlevygm said:Cyberknife - Kaiser So. San Francisco
Hi there, I have seen you on numerous posts dating back quite some time. I was diagnosed Mid May. PSA - 7.4 in April - In July - 6.9. Out of 14 snips - Gleason - 3+3 in 3 and Gleason 4+3 in the other. My diagnosis is intermediate risk.
I did want you to know that Kaiser is offering Cyberknife for Prostate at their Cancer Center in So. San Francisco. I am a candidate for Brachytherapy as well. I am leaining towards Cyberknife and have actually reached out to both Dr. Katz and Dr. Fuller. Their opinion is Cyberknife is an excellent choice for my condition.
My only concern is I will be one of a very few patients that Kaiser So. San Francisco will treat using Cyberknife or Trilogy.
Just wanted to get your thoughts or anyone else who wants to chime in.
Congratulations on your recovery. I look forward to hearing from you.
Good idea to have a Tesla 3.0 MRI before receiving treatment, since MRI can effectively identify seminal vesicle invasion, extracapsular extension and pelvic lymph node involvement.
P.S. I know a man who had SBRT, did not have an MRI before, and as it turns our had extracapsular extension. He is now being treated by a medical oncologist.
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Mlevygm: Were you speaking to me?mlevygm said:Cyberknife - Kaiser So. San Francisco
Hi there, I have seen you on numerous posts dating back quite some time. I was diagnosed Mid May. PSA - 7.4 in April - In July - 6.9. Out of 14 snips - Gleason - 3+3 in 3 and Gleason 4+3 in the other. My diagnosis is intermediate risk.
I did want you to know that Kaiser is offering Cyberknife for Prostate at their Cancer Center in So. San Francisco. I am a candidate for Brachytherapy as well. I am leaining towards Cyberknife and have actually reached out to both Dr. Katz and Dr. Fuller. Their opinion is Cyberknife is an excellent choice for my condition.
My only concern is I will be one of a very few patients that Kaiser So. San Francisco will treat using Cyberknife or Trilogy.
Just wanted to get your thoughts or anyone else who wants to chime in.
Congratulations on your recovery. I look forward to hearing from you.
If so, I am aware that Kaiser NorCal is apparently now using CK to treat PCa. It wasn't when I was 1st diagnosed back in 2010, which is the reason I switched carriers to Blue Shield so that I could get CK at UCSF instead.
While experience is essential in choosing a urologist/surgeon, I don't think it's as critical w/CK because the computer program basically does all the modeling and planning. Dr. Gottshalk, who is the head of the CK treatment center at UCSF, had only supervised around 50 PCa treatments before he did mine and there wasn't enough of a track record to determine a long term "success" rate. He has since done over 200 CK PCa treatments w/no PCa recurrence but 4 patient experienced cancer that spread beyond the prostate despite the treatment. However, he gave me enough info at the time for me to decide that it was worth the risk when compared w/surgery.
That said, the radiologist and technicians do need to have some experience in setting up and administering the treatment because it is NOT an entirely automated process. For example, when I was being treated, the technician actually stopped the treatment when he SAW gas passing through my intestines which he decided would alter the course of treatment; he resumed the treatment after the gas passed farther down the GI tract.
So, I'd ask the CK radiologist how many procedures they have done and what their track record has been to date but, if they haven't done many procedures, you'll just have to decide whether to "trust" them or not. FWIW, when compared w/surgery (open or robotic), I think the risks you face undergoing CK are much smaller and would be worth the risk regardless.
Good luck!
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Welcomemlevygm said:Cyberknife - Kaiser So. San Francisco
Hi there, I have seen you on numerous posts dating back quite some time. I was diagnosed Mid May. PSA - 7.4 in April - In July - 6.9. Out of 14 snips - Gleason - 3+3 in 3 and Gleason 4+3 in the other. My diagnosis is intermediate risk.
I did want you to know that Kaiser is offering Cyberknife for Prostate at their Cancer Center in So. San Francisco. I am a candidate for Brachytherapy as well. I am leaining towards Cyberknife and have actually reached out to both Dr. Katz and Dr. Fuller. Their opinion is Cyberknife is an excellent choice for my condition.
My only concern is I will be one of a very few patients that Kaiser So. San Francisco will treat using Cyberknife or Trilogy.
Just wanted to get your thoughts or anyone else who wants to chime in.
Congratulations on your recovery. I look forward to hearing from you.
Greetings mle, thanks for your post. I'm sorry you've had to find us here, but please take advantage of the wealth of knowledge and personal experience of the members of this forum.
I can't help you with the specifics of CK treatment in SF, but it seems Swing has some local knowledge.
I am fortunate to live on the east coast and have many treatment options available. I do believe that the technology (computer administered treatment once your specific plan has been developed by your RO and team) related to CK treatment limits the risk involved. And Swing is correct about the techs ability to interupt a session. Once you are positioned on the table for treatment (no restraint except across my ankles), you have to remain still. As the machine was repositioning for the next "shot", I felt the table move slightly. No word from the tech until afterward when I mentioned it, and she said I had moved. Might have been gas
?Continue to research and self educate. That is key to understanding what will work best for you.
Sincere best wishes as you move along,
CC
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CyberknifeSwingshiftworker said:Mlevygm: Were you speaking to me?
If so, I am aware that Kaiser NorCal is apparently now using CK to treat PCa. It wasn't when I was 1st diagnosed back in 2010, which is the reason I switched carriers to Blue Shield so that I could get CK at UCSF instead.
While experience is essential in choosing a urologist/surgeon, I don't think it's as critical w/CK because the computer program basically does all the modeling and planning. Dr. Gottshalk, who is the head of the CK treatment center at UCSF, had only supervised around 50 PCa treatments before he did mine and there wasn't enough of a track record to determine a long term "success" rate. He has since done over 200 CK PCa treatments w/no PCa recurrence but 4 patient experienced cancer that spread beyond the prostate despite the treatment. However, he gave me enough info at the time for me to decide that it was worth the risk when compared w/surgery.
That said, the radiologist and technicians do need to have some experience in setting up and administering the treatment because it is NOT an entirely automated process. For example, when I was being treated, the technician actually stopped the treatment when he SAW gas passing through my intestines which he decided would alter the course of treatment; he resumed the treatment after the gas passed farther down the GI tract.
So, I'd ask the CK radiologist how many procedures they have done and what their track record has been to date but, if they haven't done many procedures, you'll just have to decide whether to "trust" them or not. FWIW, when compared w/surgery (open or robotic), I think the risks you face undergoing CK are much smaller and would be worth the risk regardless.
Good luck!
Yes I was speaking to you. Thank you for reply and insight. I have decided to move forward with Cyberknife and will do it with DR. Millender at Kaiser So San Francisco.
As mentioned I was able to speak with Dr. Fuller who has met Dr. Millender and the team. He had very high praise for them. I am confident in my decision and Dr. Millender.
First ste is to schedule the gold implants, then the CT and MRi and then treatment. I anticipate treatment to begin the week of August 24th. I will keep you posted. Thank you again.
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Good luck!mlevygm said:Cyberknife
Yes I was speaking to you. Thank you for reply and insight. I have decided to move forward with Cyberknife and will do it with DR. Millender at Kaiser So San Francisco.
As mentioned I was able to speak with Dr. Fuller who has met Dr. Millender and the team. He had very high praise for them. I am confident in my decision and Dr. Millender.
First ste is to schedule the gold implants, then the CT and MRi and then treatment. I anticipate treatment to begin the week of August 24th. I will keep you posted. Thank you again.
Sounds good, Melvygm. Looking forward to hearing from you again w/a report following the treatment. Good luck!
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TreatmentSwingshiftworker said:Mlevygm: Were you speaking to me?
If so, I am aware that Kaiser NorCal is apparently now using CK to treat PCa. It wasn't when I was 1st diagnosed back in 2010, which is the reason I switched carriers to Blue Shield so that I could get CK at UCSF instead.
While experience is essential in choosing a urologist/surgeon, I don't think it's as critical w/CK because the computer program basically does all the modeling and planning. Dr. Gottshalk, who is the head of the CK treatment center at UCSF, had only supervised around 50 PCa treatments before he did mine and there wasn't enough of a track record to determine a long term "success" rate. He has since done over 200 CK PCa treatments w/no PCa recurrence but 4 patient experienced cancer that spread beyond the prostate despite the treatment. However, he gave me enough info at the time for me to decide that it was worth the risk when compared w/surgery.
That said, the radiologist and technicians do need to have some experience in setting up and administering the treatment because it is NOT an entirely automated process. For example, when I was being treated, the technician actually stopped the treatment when he SAW gas passing through my intestines which he decided would alter the course of treatment; he resumed the treatment after the gas passed farther down the GI tract.
So, I'd ask the CK radiologist how many procedures they have done and what their track record has been to date but, if they haven't done many procedures, you'll just have to decide whether to "trust" them or not. FWIW, when compared w/surgery (open or robotic), I think the risks you face undergoing CK are much smaller and would be worth the risk regardless.
Good luck!
I wanted to update you on the treatments I've received.
My final one is Tuesday the 8th. I receved a total of 4 so far. I must tell you the staff at Kaiser So. San Francisco are tremndous. I have also found out that they have done numeorus prostate/cyberknife treatments while they were at Stanford. So excellent staff.
For anyone else considering Cyberknife...
There is daily prep during the treatment time. It's a No Gas Diet. Lean Meats - No Fiberous foods or anything that would cause Gas. I have been very diligent in this and so far so good.
The only current occurence is burning when i urine. I do not get up at night however urinate frequently during the day. I also am drinking plenty of water.
Thank you again for your support. I will continue to keep you posted.
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Study, results of SBRT using Cyberknife, 7 years, Dr. Katz
http://csn.cancer.org/node/291691
Dr. Katz, author of this study does 5 fractions for a total of 35- 36.25 Gy's There is some difference between practitioners , with reference to GY, who administer SBRT; most do five fractions, while some do four.
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How many treatments?mlevygm said:Treatment
I wanted to update you on the treatments I've received.
My final one is Tuesday the 8th. I receved a total of 4 so far. I must tell you the staff at Kaiser So. San Francisco are tremndous. I have also found out that they have done numeorus prostate/cyberknife treatments while they were at Stanford. So excellent staff.
For anyone else considering Cyberknife...
There is daily prep during the treatment time. It's a No Gas Diet. Lean Meats - No Fiberous foods or anything that would cause Gas. I have been very diligent in this and so far so good.
The only current occurence is burning when i urine. I do not get up at night however urinate frequently during the day. I also am drinking plenty of water.
Thank you again for your support. I will continue to keep you posted.
Mlevygm: Are you receving more than 4 treatments? If so that's a bit unusual for CK. How many treatments in total will you receive?
After you're done, let us know what your post-treatment progress results (PSA test results) are. Best of luck!!!
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9 months since CK with Dr. Katzhopeful and optimistic said:Study, results of SBRT using Cyberknife, 7 years, Dr. Katz
http://csn.cancer.org/node/291691
Dr. Katz, author of this study does 5 fractions for a total of 35- 36.25 Gy's There is some difference between practitioners , with reference to GY, who administer SBRT; most do five fractions, while some do four.
I am now 9 months out from 5 CK fractions with Dr. Katz. My PSA is down to 2.9 from 6.5, and I still have absolutely no side-effects whatsoever.
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schin, glad to read about your good results.schin said:9 months since CK with Dr. Katz
I am now 9 months out from 5 CK fractions with Dr. Katz. My PSA is down to 2.9 from 6.5, and I still have absolutely no side-effects whatsoever.
Of course a toast to you. Caifornia Red. Great numbers! Please keep on posting.
.........
Here is the thread that you previously posted.
http://csn.cancer.org/node/286579
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Slowing Declining PSA w/CKschin said:9 months since CK with Dr. Katz
I am now 9 months out from 5 CK fractions with Dr. Katz. My PSA is down to 2.9 from 6.5, and I still have absolutely no side-effects whatsoever.
Schin: Glad to hear your CK treatment went well but it sounds like you have may have a slowing declining post-treatment PSA as I did.
Took me 3 years after treatment (with some irregularities in between) for my PSA level to finally drop from 9.48 (3 months after treatment) to .995 (in June 2013). It has continued to drop consistently for the past 2 years since then and is now at 0.232 (last test in June 2015). Total of 5 years to reach this point.
So, if your PSA does not drop quickly; don't despair. Give it time and it should all work out well in the end. Good luck!!!
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Congrats/Question/Almost on year
Comments/thoughts:
Schin - that's great news for you. Slow and steady progress with declining PSA is a good thing.
Mle - by the time you read this, you will have completed your final treatment. I trust that all went well, and that now you can relax and anticipate a positive outcome.
SSW - In regard to your question about the number of treatments, I was under the impression that five was the normal amount. That's what I had, and it seems that others treated with SRBT always had five sessions. Did you have four? And what would be the determining factors for the RO to consider between four or five?
Update on my progress - I am nearing one year since completing my treatment. A bit of an issue has developed over the past several months is increased difficulty with urination, particularly at night and with a full bladder. Also more frequent urination (every 2 hours) and mild discomfort (burning sensation and pressure) upon peeing. With this, I have difficulty getting flow started, but slowly improves as the bladder empties. Seems very similar to what CJ613 reported in earlier posts. I will certainly talk with my Dr. when I see him in a couple weeks.
Take care all, I'll check in after my appointment - CC
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MedicationCC52 said:Congrats/Question/Almost on year
Comments/thoughts:
Schin - that's great news for you. Slow and steady progress with declining PSA is a good thing.
Mle - by the time you read this, you will have completed your final treatment. I trust that all went well, and that now you can relax and anticipate a positive outcome.
SSW - In regard to your question about the number of treatments, I was under the impression that five was the normal amount. That's what I had, and it seems that others treated with SRBT always had five sessions. Did you have four? And what would be the determining factors for the RO to consider between four or five?
Update on my progress - I am nearing one year since completing my treatment. A bit of an issue has developed over the past several months is increased difficulty with urination, particularly at night and with a full bladder. Also more frequent urination (every 2 hours) and mild discomfort (burning sensation and pressure) upon peeing. With this, I have difficulty getting flow started, but slowly improves as the bladder empties. Seems very similar to what CJ613 reported in earlier posts. I will certainly talk with my Dr. when I see him in a couple weeks.
Take care all, I'll check in after my appointment - CC
CC52, Are you currently king any medication to help with urinary flow?
EDIT: I note from this thread that you had been taking Flomax. http://csn.cancer.org/node/264905?page=1
What was the size of your prostate before treatment?, was it large?
Could be temporary side effects from the radiation, but your doc is the one to speak with.
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Flomaxhopeful and optimistic said:Medication
CC52, Are you currently king any medication to help with urinary flow?
EDIT: I note from this thread that you had been taking Flomax. http://csn.cancer.org/node/264905?page=1
What was the size of your prostate before treatment?, was it large?
Could be temporary side effects from the radiation, but your doc is the one to speak with.
H&O,
I stopped taking Flomax around the 1st of the year. Had no problems, things seemed normal. Up once per night to go. The recent changes of 2-3 times per night (every 2-3 hours) and the feeling of a very full bladder, difficulty with starting and emptying have sent me back for 4mg Flomax per day to see if that helps. I try to limit my liquid intake after dinner, which is around 6pm or so. Bedtime between 10-11p. Might be a bit early (3 days now) but the Flomax seems to have helped.
Prostate was measured at 4x5.6x4.8cm w/ volume of 53.2g.
I see the Dr in two weeks, and will discuss.
Thanks for checking in,
CC
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CyberknifeSwingshiftworker said:Why Not?
FWIW, I see no problem in advocating CK, if it's appropriate to the patient's circumstances, and I've had NO problem advocating CK when I thought it was appropriate to do so. Ultimately, it's the patient's choice and, if they don't know about CK, we'd be remiss in not pointing it out.
Swingshift,
Hi there I hope all is well.
I wanted to follow up and share with the group that I completed my last Cyberknife treatment Tuesday September 8th. So far all is well. No real side effects except burning when I urinate however that was only early in the treatment.
I occasionaly feel a little fatigued, other than that life is very normal. I wanted to thank all of you for your knowledge, wisdom and encouragement. Your posts led me to do more research with regard the best treatment for me. Please continue.
If I can help anyone with their decision or provide some personal advice I am more than honored. Thank you so very much.
I will report back and let you know my latest PSA results. FYI - My last PSA in late May this year was - 6.8.
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Very goodmlevygm said:Cyberknife
Swingshift,
Hi there I hope all is well.
I wanted to follow up and share with the group that I completed my last Cyberknife treatment Tuesday September 8th. So far all is well. No real side effects except burning when I urinate however that was only early in the treatment.
I occasionaly feel a little fatigued, other than that life is very normal. I wanted to thank all of you for your knowledge, wisdom and encouragement. Your posts led me to do more research with regard the best treatment for me. Please continue.
If I can help anyone with their decision or provide some personal advice I am more than honored. Thank you so very much.
I will report back and let you know my latest PSA results. FYI - My last PSA in late May this year was - 6.8.
So far so good..........please post your PSA's, remember that there will be a bump, about 18 to 24 montrhs out.
As the vet that you are now, please continue to post for the newbee's
H
PS. I wonder if being fatigued is side effect of SBRT.
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Good luck!mlevygm said:Cyberknife
Swingshift,
Hi there I hope all is well.
I wanted to follow up and share with the group that I completed my last Cyberknife treatment Tuesday September 8th. So far all is well. No real side effects except burning when I urinate however that was only early in the treatment.
I occasionaly feel a little fatigued, other than that life is very normal. I wanted to thank all of you for your knowledge, wisdom and encouragement. Your posts led me to do more research with regard the best treatment for me. Please continue.
If I can help anyone with their decision or provide some personal advice I am more than honored. Thank you so very much.
I will report back and let you know my latest PSA results. FYI - My last PSA in late May this year was - 6.8.
It's early yet, but I'm glad to hear "so far so good" with your CK treatment. Please keep us up to date on your post--treatment progress. Good luck & best wishes!!!
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Treatmenthopeful and optimistic said:Very good
So far so good..........please post your PSA's, remember that there will be a bump, about 18 to 24 montrhs out.
As the vet that you are now, please continue to post for the newbee's
H
PS. I wonder if being fatigued is side effect of SBRT.
They did indicate that there could be some fatigue. With my work I drive alot and sometimes late hours. I usualy get through it well however just a little fatigue recently. No big deal. Feel better and better everyday. Hope this helps.
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Fatigue is commonhopeful and optimistic said:Very good
So far so good..........please post your PSA's, remember that there will be a bump, about 18 to 24 montrhs out.
As the vet that you are now, please continue to post for the newbee's
H
PS. I wonder if being fatigued is side effect of SBRT.
My RO told me that I would be tired for several days after the Cyberknife sessions.
And I was; no big deal...
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One YearCC52 said:Flomax
H&O,
I stopped taking Flomax around the 1st of the year. Had no problems, things seemed normal. Up once per night to go. The recent changes of 2-3 times per night (every 2-3 hours) and the feeling of a very full bladder, difficulty with starting and emptying have sent me back for 4mg Flomax per day to see if that helps. I try to limit my liquid intake after dinner, which is around 6pm or so. Bedtime between 10-11p. Might be a bit early (3 days now) but the Flomax seems to have helped.
Prostate was measured at 4x5.6x4.8cm w/ volume of 53.2g.
I see the Dr in two weeks, and will discuss.
Thanks for checking in,
CC
My one year check-up on 9/25 went well... at least as far as the numbers go:
PSA came back at .4 ng/mL (.421 ultra sensative), and testosterone was 449 ng/dL . Definitely pleased about that.
Still having some issues with urination though. During the day, starting and flow is good, but with more frequency than usual. Sometimes, an hour or two between visits to the bathroom. Don't feel like I'm completely emptying every time.
Consultation with my RO is this can happen at about the one year mark, and I mentioned to the Dr. that I had already put myself back on Flomax. He agreed with that, and offered a steroid if I felt it necessary. I declined. I've upped my doseage now to two pills per day, so I'll see if that helps. I've also had some serious pain around the tip (shooting needle like symptoms) at times - mostly as I settle into bed at night. That really gets my attention!
I trust my RO's advice on what I'm experiencing - that it's not at all unusual, and that with more time (2-3 months) things should begin to settle out with a return to more normal habits.
CC
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