Cyberknife Procedure Update

2ndBase said:

Wow
I read this thread and have to say just let it it go already. If not there may be a cure for cancer before this thread ends. I am dying a little more each day and working at my job and in the garden and playing golf and spending time with my wife and friends is what keeps me going. Much of my long survival is due to getting the stress out of my life and it pains me to read all the stressfull posts in this thread. You should all be so happy you got treated in time to save your lives and stop trying to one up each other. You would understand this if you knew your life was to be cut off in a few weeks. I will let his be my very last post and wih you all the best. Be kind to others and perform a random act of kindness every day. Peace, Mark

Kongo said:

Marge
Marge, thanks for the encouragement.

One thing about all of these studies which I find enormously frustrating is that most never seem to make head-to-head comparisons of treatment options, as indicated in the conclusion for the study you referenced. In the study you cite, for example, you can’t really draw a relevant conclusion because we don’t know the experience level of the surgeon, the state of urinary or ED functionality before treatment, the age of the patient, the staging of the cancer, and so forth. We can’t statistically normalize the study. What we have is basically: A bunch of guys had many different forms of treatment someplace and there were differing results with respect to side effects.

Randy has cited a study in this thread that shows a much different outcome for RP side effects out of NY Presbyterian done in 2007 where the patient cohort had a continence rate of over 90% and sexual function of nearly 80 percent. The caveat is that these were highly experienced surgeons using the Da Vinci machine. Of course, we really don’t know how they defined continence or sexual function but giving them the benefit of the doubt, those are certainly encouraging results for those considering RP.

Outside of NY Presbyterian, some of the large studies that draw upon the VA or Medicare databases show higher rates of RP side effects with respect to incontinence and ED. My personal belief on this is that the experience of the surgeon is the critical factor. As RP has only been approved for PCa treatment for about five years and the number of facilities offering it is growing dramatically, there is obviously a learning curve that comes into play, and Randy has always maintained that a man considering Da Vinci should seek out the most experienced surgeon available. (I heard a commercial on the radio this morning on the way to work touting a new Da Vinci machine at a local hospital – I wondered to myself how much experience the surgeon who fires that baby up for the first time will have had.) If I was going the RP route, I would be on a plane to the most expensive, most highly acknowledged, and most experienced surgeon I could find.

In Cyberknife, for example, my doctor took great pains to tell me that men who have poor sexual function before treatment will have ED issues afterward and those men with enlarged prostates or urinary issues before radiation will have a more difficult recovery than men without symptoms. I suspect there is a similar analog to RP. So, if you look at a VA or Medicare study with men at a more advanced age possessing incumbent ED and urinary issues, the study will report more side effects. I think the studies should pay much more attention to pre-treatment diet, health, and vitality and the impact it has on successful outcomes. BDHilton has made some good points on the importance of diet and exercise to recovery in other threads.

Just about any personal opinion about PCa or treatment options can cite some study or another for justification. I personally believe that flaming someone who cites a particular study that doesn’t fit your personal view of the world is unproductive and stymies the free exchange of information about subjects which many are seeking. A more civilized approach, in my opinion, would be to tactfully disagree and cite your own study and explain why you think it may be more relevant to a particular cancer situation. Personal attacks are not only against website rules; they tend dampen the free exchange of information which might turn out to be instrumental in helping someone find the right path for them. And at the end of the day, I don’t think any specific study is totally authorative by itself -- It’s just another piece of the puzzle we all have to put together as we sift through the myths, folklore, lies, and damn lies on the road to recovery.

I’ve completed all of my preparatory work and start Cyberknife treatment on June 21.

Kongo said:

Swing
Hope you had a good trip! I start my treatment Monday morning and will let you know how it goes. So far, I've impressed with the treatment I've received, the education on what to expect, and the professionalism of the staff.

One thing you might want to consider when you get to the point where you're talking about the treatment schedule. After reading a recent study out of Stanford I elected to have my radiation treatments every other day instead of consecutively. The Stanford study showed that there were fewer incidents of urinary urgency issues when they gave the urethera a day to recover. Anyway, something to ask the doctor about.

Hope your process goes as smoothly as mine has.

Keep in touch.