Cyberknife v. RP
Comments
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Why is treatment being
Why is treatment being discussed for a man with two cores of low percentage Gleason 3+3?
The NCCN guidelines state that active surveillance is the default course for such a case. I recently attended a support group and heard a urologist who does a lot of prostatectomies say that he doesn't want to do any more on men with small amounts of G6. It is simply overtreatment.
Instead of debating Cyberknife versus surgery (I would take Cyberknife without hesitation if it came to that), his direction should be advised towards the least damaging but still safe action, which would be a formal AS progran with all its mandatory follow-up testing.
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Yes
AS, in my opinion, is the wisest course whenever available. That leaves your options open to adapt to your changing profile. As your condition evolves, you can choose the procedure commensurate with your evolving condition.
I keep stressing that I am not an evangelist for RP. I am an evangelist for the procedure that best matches your profile. Earlier, MK noted that he had a TURP procedure six months prior to his RP. Was RP the best procedure for his profile six months after a TURP? Read his account for the answer to that.
We tend to forget other factors may evolve involving your prostate. You may have to switch gears with these changing conditions. AS will allow you to adapt to the changes.
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Look for the best SBRT docjc7908 said:CK doctor
Swingshiftworker,
I read on another post that you had your CK procedure at UCSF. Would you mind sharing the name of your doctor? I am in the Bay Area and I was recently diagnosed with low risk PCa, as explained in another post. I am conisdering SBRT and would like to speak with a local specialist. Thanks.
You should really start a new thread, but in the meantime, Dr Chris King is one of the best for SBRT and other modes of radiation. But he is at UCLA and to my knowledge, uses the Varian instrument (not CyberKnife).
UCSF and Stanford should have great docs as well. I hope that Swingshiftworker will follow up. And, as an aside, SBRT was 'invented' at Stanford.
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It's been a while since I've
It's been a while since I've posted, and it's not surprising that the "debate" continues. As my Dad would say - ain't that why they make chocolate and vanilla? And strawberry, etc, etc?
With those numbers, it seems like the OP would be a posterchild for AS. Any other option would be off the table. But that's just me.
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AS vs CK
As a CK patient myself (15 months post treatment, PSA under .6), I would also recommend AS be considered IF it is determined that the cancer is contained in the prostate and not along the periphery as it was in my case. Because of the location of the cancer I did not want to risk it spreading outside the prostate and also knew that IF the cancer was outside the prostate, I would still have to deal with radiation post RP which was one of the primary reasons I did not seriously consider RP. I am happy with my decision and I hope that you are able to find doctors who can fairly represent the options to you in a manner that allows you to make a decision you are most comfortable with. I recommend Cyberknife is asked. I appreciate my PCP who gave me a list of options to consider including CK AND SSW who's tireless pitch for CK encouraged me to check it out. Indeed, the Uroligists and regular radiation oncologists tried to steer me away from CK and somewhat bashed that option even though it is in fact on line with RP in terms of cure when it is an appropriate option. It is not always appropriate as those with larger prostates or cancer that is wide spread can attest.
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