hopeful and optimistic said:

swingshift

My research indicates that SBRT is given in 4 or 5 sessions; not 3 or 4 sessions. I never heard of SBRT given in 3 sessions, so, I would appreciate if you can increase my knowledge and document the 3 session protocol...............thanks

PS Here is an example of SBRT given in five fractions.

cancer: disease control and quality of life at 6 years

Alan J Katz, Michael Santoro, Fred Diblasio and Richard Ashley

For all author emails, please log on.

Radiation Oncology 2013, 8:118 doi:10.1186/1748-717X-8-118

Published: 13 May 2013

Abstract (provisional)

Background

Stereotactic body radiotherapy (SBRT) may yield disease control for prostate cancer in a brief, hypofractionated treatment regimen without increasing treatment toxicity. Our report presents a 6-year update from 304 low- (n = 211), intermediate- (n = 81), and high-risk (n = 12) prostate cancer patients who received CyberKnife SBRT.

Methods

The median PSA at presentation was 5.8 ng/ml. Fifty-seven patients received neoadjuvant hormonal therapy for up to one year. The first 50 patients received a total dose of 35 Gy in 5 fractions of 7 Gy. The subsequent 254 patients received a total dose of 36.25 Gy in 5 fractions of 7.25 Gy. Toxicity was assessed with the Expanded Prostate Cancer Index Composite questionnaire and the Radiation Therapy Oncology Group urinary and rectal toxicity scale. Biochemical failure was assessed using the nadir + 2 definition.

Results

No patients experienced Grade III or IV acute complications. Fewer than 5% of patients experienced any acute Grade II urinary or rectal toxicities. Late urinary Grade II complications were observed in 4% of patients treated to 35 Gy and 9% of patients treated to 36.25 Gy. Five (2%) late Grade III urinary toxicities occurred in patients who were treated with 36.25 Gy. Late Grade II rectal complications were observed in 2% of patients treated to 35 Gy and 5% of patients treated to 36.25 Gy. Bowel and urinary quality of life (QOL) scores initially decreased, but later returned to baseline values. An overall decrease of 20% in the sexual QOL score was observed. QOL in each domain was not differentially affected by dose. For patients that were potent prior to treatment, 75% stated that they remained sexually potent. Actuarial 5-year biochemical recurrence-free survival was 97% for low-risk, 90.7% for intermediate-risk, and 74.1% for high-risk patients. PSA fell to a median of 0.12 ng/ml at 5 years; dose did not influence median PSA levels.

Conclusions

In this large series with long-term follow-up, we found excellent biochemical control rates and low and acceptable toxicity, outcomes consistent with those reported for from high dose rate brachytherapy (HDR BT). Provided that measures are taken to account for prostate motion, SBRT's distinct advantages over HDR BT include its noninvasiveness and delivery to patients without anesthesia or hospitalization.

Hopeful:  My menory of how many treatment I got is actually quite hazy.  It could have been 5 over every other day over 2 weeks.  Frankly, I don't remember.  I'd go w/the info that you have, not my poor recollection of it. 

It has been three years since I went through cyberknife for prostate cancer.  All is well and my PSA has dropped to acceptable levels almost immediately after the procedures.  Since then I have always encountered a burning sensation while urinating.  The doctors have never shown much concern and it is certainly not debilitating.  I took Flomax for a short time and was switched to Rapaflo soon after when the Flomax made me dizzy upon standing.  I am still taking Rapaflo and see no end in sight as it makes it easier to relieve myself.

I am usually up 2-3 times a night to go.

Has anyone else had the problem of the burning pain?  I am due to see my doctor soon as it has been almost a year and that is the cycle I am now on.  It would be nice to find some relief and possibly even be able to quit needing the Rapaflo.

finished 6 weeks ago and feeling great. First two weeks after treatment a bit of urgency but not now. Feeling good about my decision for Cyberknife treatment! Still not taking antioxidants and probably won’t start them for a few more months. Don’t want to hinder the radiation cancer killing. 

Billdonaldson said:

Cyberknife after week 6

finished 6 weeks ago and feeling great. First two weeks after treatment a bit of urgency but not now. Feeling good about my decision for Cyberknife treatment! Still not taking antioxidants and probably won’t start them for a few more months. Don’t want to hinder the radiation cancer killing. 

Glad to hear that your CK treatment seems to have gone well.  If you want to discuss your treatment and any other issues, it would be better if you started a new thread rather than tack onto the end of this very old tread to do so.

BTW, I never took finesteride after treatment w/CK and don't know any one else who did.  If you start a thread mentioning CK and finesteride in it, you may get a response from someone who did or still does.

question, what is your lowest psa after a few years from Cyberknife treatment? Thanks 

Swingshiftworker said:

Poor Recollection

Hopeful:  My menory of how many treatment I got is actually quite hazy.  It could have been 5 over every other day over 2 weeks.  Frankly, I don't remember.  I'd go w/the info that you have, not my poor recollection of it. 

just saw dr gotschaulk today its 4 treatments  2 aweek for 2 weeks  at least thats what it is in 2018

Dr. Gottshalk was my supervising radiation oncologist when I was treated w/CK in Sept 2010.  I doubt that he would authorize the treatment if there was any doubt that the cancer was contained w/in the prostate.

The only way you'll know w/reasonable certainty if the cancer is contained or not is to get an MRI/MRSI which is a spectrographic scan of the prostate done w/a 3T coil and dye.  I had this done when my PSA bounced in 2013 and rose 3 times in a row (an indicator of recurrence).  The scan came up completely negative (a relief) and my PSA has dropped consistently ever since. 

The procedure is very expensive and I doubt it would be approved by your insurer pre-treatment but you won't know unless you ask.  Good luck!

Kongo said:

CK Side Effects
Welcome to the forum. I had CyberKnife treatment in June and have had zero side effects. After CK, some men (about 4%) experience a mild degree of bowel toxicity (they have loose stools) and urinary urgency (they feel like they have to go to the toilet frequently). Both of these symptoms tend to pass within a few days or weeks of treatment. Urinary urgency can be treated with Flomax or in mild cases, Advil.

"Nerve sparing" is not really a term used with CyberKnife. I assume you're wondering if you can still have sex afterward. The nerves really don't come into play with CK, although very long term effects of SBRT on the nerve bundles that encase the prostate is unknown, other forms of radiation frequently have the effect of damaging these nerve bundles several months to years after being irradiated. They typical radiation dose pattern for the prostate using CK avoids concentrating radiation dosages at or near the nerve bundles, but since it is an external source of radiation there is some exposure as the entire prostate is radiated. Over 85% of men with no ED issues before treatment have no ED issues after treatment. Of all forms of radiation used to treat prostate cancer, SBRT (which CK is one method of delivery) has the least amount of side effects. Age, of course, also affects the level of potency. The good news is that even if there is a decrease in potency as a long term side effect of radiation, it is a condition easily corrected by Viagra like drugs.

If you scroll through two or three pages of posts you will see several threads (some have sparked heated debates) pertaining to CyberKnife that pretty much plumb the depths of the pros, cons, and technical aspects of this treatment protocol. I would suggest you read the previous posts and I'm sure any of the men who have undergone this treatment would be happy to address any further technical questions you might have.

As you may know, CK is pretty much for low risk prostate cancer and is not appropriate for intermediate or advanced stages.

Best to you.

=====================

Diagnosed in March 2010 at age 59 with an elevated PSA of 4.3. Biopsy revealed 1 of 12 cores positive with 15% involvement. Gleason 3+3=6. Confirmed with second pathology reading. DRE negative. No physical symptoms and no family history of prostate cancer.

Treatment: 5 fractions of SBRT using CyberKnife. No side effects. 3 month PSA level was 1.3.

Hi, I was diagnosed with PC and I am presently thinking of my options. I have heard alot about CK and I know that it is relatively new compered to other methods. Pleade I was woundering if you can just tell me if you are experiencing any other side effect since it has been over 7 yrs since you had your last intervention.

I look forward to hearing from you

Thank you

hopeful and optimistic said:

jmadison has not posted since march 2011

Best for you to start a new thread with your medical information pertaining to prostate cancer, PSA results, image tests, biopsy results, age, etc etc so you can receive individualized attention

Several of us (frequent responders) have gone the SBRT route and may be able to give reasonable responses to focussed questions.

SO STANFORD BRACHYTHERAPY MAN SAYS THATS USING CYBERKNIFE IS A GAMBLE ONLY BECAUSE THEY USE THE RADIATION  USEDIN THE  40 TREATMENT COURSE IS THE SAME AS CYBERKNIFE BUT  CONDENSE IT INTO 4 TREATMENTS..THE PROBLEM IS THEY HAVENT PERFECTED THE DOSE TO USE..THEY SAY IT ISNT AS SIMPLE AS DIVIDING 40 BY 4..SO THEY ARE MOST LIKLEY UNDER RADIATING THAN  OVER RADIATION BECAUSE THEY WOULD NEVER TAKE THE RISK OF OVER READIATING.....SO I ASKED THE CYBERKNIFE MAN AT UCSF IF THIS IS TRUE  AND HOW DO THEY CALCULATE HOW MUCH RTADIAITION TO GIVE AND IS THE AMOUNT DIFFERENT FOR EACH PATIENT.....WILL LET YOU ...SO DAMN CONFUSING