External radiation/hormone Therapy folowed by Cyberknife treatment

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mb acoreano
New Member

Date Joined Feb 2009
Total Posts : 12
   Posted 2/7/2009 1:54 PM (GMT -6)   
 I was diagnosed with prostate cancer Dec. 12, 2008, My PSA was 9 and two weeks later it was at 12. My gleason grade was 8, my biopsy showed 7 out of 8 samples positive raging from 35 to 80% cancerous Stage T2C. Because of these results the Oncology team at UCSF recomends external radiation/hormone therapy followed with cyberknife therapy. I am considered a high risk patient amd these are the reason for the recomendations.
Can anyone enlighten me with these procedures?

Post Edited (mb acoreano) : 2/7/2009 12:20:03 PM (GMT-7)

Tony Crispino
Veteran Member

Date Joined Dec 2006
Total Posts : 8128
   Posted 2/7/2009 2:41 PM (GMT -6)   
Hi mb,
Welcome to HealingWell. Cyberknife is new, but exciting. The intent is to deliver a high dosage of radiation in a short time frame. Some radiation oncologists still consider it experimental, but if I were to do an experimental treatment, UCSF is a great facility to consider. Have you spoken to Dr. Peter Carroll there? He is a well known surgeon. I would be curious what his take is. He is in charge of the Urologic Oncology at UCSF.

External beam radiation in combination with Cyberknife is strikingly similar to external beam with Proton Therapy, just less visits to the clinic. It is a good therapy alternative when it is felt precision radio therapy won't be enough. The hormonal therapy should be started ahead of the radiation by a month or so in high risk cases. I too am a high risk case, and I was able to get the prostate out with surgery first then add the hormone and radiation therapies. My understanding is that I improved my relapse time frames greatly. I will take it. I believe you have a good plan. Stay with us and ask any question that may arise. We have a great group here, and many that have been down your road. Again, welcome...

Age 46 (44 when Dx)
Pre-op PSA was 19.8 : Surgery at The City of Hope on February 15, 2007
Geason 4+3=7, Stage pT3b, N0, Mx
Positive Margins (PM), Extra Prostatic Extension (EPE) : Bilateral Seminal vesicle invasion (SVI)
HT began in May, '07 with Lupron and Casodex 50mg (2 Year ADT)
IMRT radiation for 38 Treatments ending August 3, '07
Current PSA (January 13, 2009): <0.1
My Journal is at Tony's Blog  

Elite Member

Date Joined Oct 2008
Total Posts : 25393
   Posted 2/7/2009 3:40 PM (GMT -6)   
MB, welcome here, sorry you need to be here, but we will do all we can to help you through your journey. Many experienced people here, involved in most every type of treatment. We are here for you, hope we can help.

David in SC
Age 56, 56 at DX, PSA 7/7 5.8, 7/8 12.3
3rd Biopsy 9/8 Positive 7 of 7 cores pos, 40-90%, Gleason 7
Open RP surgery 11/14/8, Non-nerve sparing, 4 days hospital, staples out 11/24/8, 5th cath out on 1/19/9
Post-surgery Pathlogy Report:Gleason 3+4=7, pT2c, 42 grm, tumor 20%, Contained in capsular, clear margins, clear lymph nodes 
First PSA Post Surgery   2/9/9

Veteran Member

Date Joined May 2008
Total Posts : 1010
   Posted 2/7/2009 6:26 PM (GMT -6)   

Hello MB,

When I was first diagnosed I investigated the Cyberknife. I am considered a high risk case as well. Cybeknife has a patient website and there are two doctors there who will answer your questions. I posted my statistics and asked if the CK was appropriate for my case. I had a reply within 24 hours. Both said it was not appropriate as a primary but might be used as a "boost". What you have described as your recomendation thus far sounds very much like the "boost" option. You may want to try googling "cyberknife patient support". I can't find the address or I would give you a link.

Good luck with whatever choice you make.


Diagnosed 04/10/08 Age 58 at the time
Gleason 4 + 3
DRE palpable tumor on left side
100% of 12 cores positive for PCa range 35% to 85%
Bone scan clear and chest x ray clear
CT scan shows potential lymph node involvement in pelvic region
Started Casodex on May 2 and stopped on June 1, 2008
Lupron injection on May 15 and every four months for next two years
Started IMRT/IGRT on July 10, 2008. 45 treatments scheduled
First 25 to be full pelvic for a total dose of 45 Gray to lymph nodes.
Last 20 to prostate only. Total dose to prostate 81 Gray.
Completed IMRT/IGRT 09/11/08.
PSA 02/08 21.5 at diagnosis
PSA 07/08 .82 after 8 wks of hormones
PSA 10/08 .642 one month after completion of IMRT, 6 months hormone

Veteran Member

Date Joined Dec 2008
Total Posts : 3149
   Posted 2/7/2009 7:51 PM (GMT -6)   
Cyberknife sounds great, I have not looked closely at it, but seems like another great radiation method. Google search Bolla study on radiations and read the abstract info. Hormone therapy followed by radiations (perhaps various methods of radiations) is a decent protocol for high risk patients with PCa.
Study and look at everything and anything, compare all you can and then perhaps be comfortable with what you wish to sign on for and then don't look back, but look ahead.


mb acoreano
New Member

Date Joined Feb 2009
Total Posts : 12
   Posted 2/9/2009 12:22 AM (GMT -6)   

Thanks all of you for advise I a 57 years old and still new to the process, all you comments are deeply appreciated.


mb acoreano
New Member

Date Joined Feb 2009
Total Posts : 12
   Posted 2/10/2009 9:02 AM (GMT -6)   
The insurance company is turning nose up on cyber knife, looking at brachy as alternative, can anyone share info on this procedure.
Age 57
DX 12/12/08
PSA 9 Second PSA 12
Biopsy 12/04/08 7 out of 8 cores positive 35-80% cancerous
Gleason Grade 8
Stage T2C
High Risk Patient

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