Cyberknife providers

I was diagnosed with PCa in April 2015 at Johns Hopkins, with a Gleason score of 3+4=7 involving 40% of one core out of 15.  I chose not to do RP or radiation, in favor of another provider doing Focal Laser Ablation , and was treated in November 2015, December 2017 and June 2019 using this modality.  Each time the Gleason score was 3+4+7.  In January 2020, after the most recent FLA, my PSA was 3.93, the lowest reading in 13 years.  A 3t MRI scan in February 2020 showed no suspicious lesions.  In July, my PSA was back up to 6.43 and in September to 7.11.  A second MRI in October showed questionable areas and I was invited back by my FLA doctor to do another biopsy.  Because of Covid concerns, this did not happen until last week, on February 22, when the biopsy report showed that all six of the cores from different parts of the prostate were affected, with anywhere from 25% to 85% of prostatic tissue involved by the tumor.  The Gleason score had risen to 4+3=7 in five of the cores, but there was no indication of spread outside the prostate. My doctor said that another FLA treatment would not be productive, and recommended that I consider Cyberknife.

I have read many postings from this site from the past 10 years and believe I am well equipped to ask the right questions.  I am impressed with the advice from several respondents that the experience of the provider is critical to a successful outcome.  It would be of great help to me to know which of the institutions (and doctors) have the best reputation and the most extensive experience in providing Cyberknife treatment. I am currently 81 years old and in excellent physical condition, with at least five days a week working out on my Pilates equipment, hiking, or trimming roadside trees in our community.  Except for increasing slowness in my urinary stream, which I treat with Flomax, Cialis and Saw Palmetto, I have experienced no Quality of Life issues that could not otherwise be attributable to advancing age. I have full sexual function as of this posting.




  • Old Salt
    Old Salt Member Posts: 1,261 Member
    edited March 2021 #2

    and how far are you willing to travel?

     Sorry to read about your experience(s) with FLA.

  • hopeful and optimistic
    hopeful and optimistic Member Posts: 2,339 Member
    edited March 2021 #3

    As you may be aware saw palmetto masks the psa, so your psa is actually higher. 

    A t3MRI may show if there is extracapsulat extension, that is if the cancer escaped the capsule. Strongly recommend that you have one before any treatment.  

    You did not indicate how much of each of the five cores were cancerous. Please note that a bone scan is indicated with extensive 4's. 

      cyberknife is one of the platforms that deliver SBRT. There are also other platforms in use. ie novalis. There is a dr katz in nyc that did a lot of them and published a 10 year study of his patients that discusses cure rate and side effects. You can google  


    If your cancer turns out to be more extensive you may wish to consider a combination of bracky and IMRT for better cure results with also more side effects