CyberKnife Treatment

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!

Swingshiftworker 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.

Swingshiftworker 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.

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!!!

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

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.

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.

hopeful 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.