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vam4710
Regular Member


Date Joined May 2010
Total Posts : 89
   Posted 6/8/2010 9:19 PM (GMT -6)   
Hi Guys,
 
Just had my results come back negative for my CT and Bone scan.... I figured it would, so did my Uro. 
 
I've been doing some research on CyberKnife.  Has anyone had or know anyone who's had any experience with it and what the long term outlook is with this procedure??

Diagnosis June 1, 2010 @ age 50
PSA 2.75 (April 2010)  - 2.14  (Sept. 2009) - 1.7 (Sept 2008)
Biopsy May 25, 2010
1 of 12 cores positive;  Gleason 3+4 = 7  25%;   Stage T1c
June 4, 2010
CT and Bone scan - All Negative
 
Da Vinci Surgery  - TBA 


Tudpock18
Forum Moderator


Date Joined Sep 2008
Total Posts : 4157
   Posted 6/9/2010 6:22 AM (GMT -6)   

Vam, I looked at Cyberknife when I was researching my options especially because its' promoters promised better QOL.  However I ultimately eliminated it because of the lack of data on either cure rate or QOL.  I ended up choosing brachytherapy which had a proven track record on both and lots of statistical data to back it up.  My treatment was 1 1/2 years ago so there may be more info available now but I was turned off by both the hype and lack of data.

Tudpock (Jim)


Age 62, Gleason 3 + 4 = 7, T1C, PSA 4.2, 2 of 16 cores cancerous, 27cc
Brachytherapy December 9, 2008.  73 Iodine-125 seeds.  Procedure went great, catheter out before I went home, only minor discomfort.  Regular activities resumed, everything continues to function normally as of 4/10/10.  6 month PSA 1.4 and now 1 year PSA at 1.0.  My docs are "delighted"!

lewvino
Regular Member


Date Joined Jul 2009
Total Posts : 384
   Posted 6/9/2010 6:50 AM (GMT -6)   
I'm not 100% positive but I think they like it for Gleason 6 or below. I see you have a Gleason 7.

Larry
Age 55 / age at diagnosis 54, PSA 5.1
Robotic surgery 08/12/09 at Vanderbilt, Nashville TN. 
Final Path report:
20% of the prostate Involved
Tumor graded at T2C
Overall Gleason 3+4 (7)
Lymph Glands Clear, Positive Margin Noted in Right Apex
 
First post Surgery PSA - 0
Six month PSA - 0


Casey59
Veteran Member


Date Joined Sep 2009
Total Posts : 3172
   Posted 6/9/2010 7:53 AM (GMT -6)   
lewvino said...
I'm not 100% positive but I think they like it for Gleason 6 or below. I see you have a Gleason 7.
 
Cyberknife is for treating Gleason scores of less than or equal to 7.  (Google it.)
 
It has a lot of promise for the future as a targetted treatment, but you've got to have a bit of "pioneer's spirit" to go for it now...especially if you're a "younger" guy (I see you are 50...I'd call that young).  If you are a younger guy, I would think you would want to feel comfortable with the long-term fallout...which is unknown at this time.  I read that the 1,000th prostate cancer patient was treated by Cyberknife in 2007.
 
 

John T
Veteran Member


Date Joined Nov 2008
Total Posts : 4229
   Posted 6/9/2010 8:11 PM (GMT -6)   
Cyberknife is a good focal therapy. If you can identify that you only have pc in one small spot it may be an effective treatment. I would not have cyberknife untill I had a saturation biopsy to confirm that the disease was not multifocal.
JohnT

64 years old.

PSA rising for 10 years to 40, free psa 10-15. Had 5 urologists, 12 biopsies and MRIS all neg. Doctors DXed BPH and continue to get biopsies yearly. 13th biopsy positive in 10-08, 2 cores of 25, G6 less than 5%. Scheduled for surgery as recommended by Urological Oncologist.

2nd Opinion from Dr Sholtz, a Prostate Oncologist, said DX wrong, pathology shows indolant cancer, but psa history indicates large cancer or metastasis. Futher tests and Color Doppler confirmed large transition zone tumor that 13 biopsies and MRIS missed. G7, 4+3, approx 16mmX18mm.

Combidex MRI in Holland eliminated lymphnode mets. Casodex and Proscar reduced psa to 0.6 and prostate from 60mm to 32mm. Changed diet, no meat and dairy. All staging tests indicate that tumor is local and non agressive. (PAP, PCA3, MRIS, Color Doppler, Combidex, tumor reaction to diet and Casodex, and tumor location in transition zone). Surgery a poor option because tumor is located next to the urethea and positive margin is very likely; permanent incontenance is also high probability with surgery.

Seed implants on 5-19-09, 3 hours door to door, no pain, minor side affects are frequency and urgency; very controlable with Flowmax and lasted 4 weeks. Daily activities resumed day after implants with no restrictions. Gold markers implanted with seeds to guide IMRT.

25 treatments of IMRT 6 weeks after seed implants. No side affects at all.

PSA at end of treatment 0.02 mostly the result of Casodex. When I stop Casodex next week expect PSA to rise. Next PSA in November. Treatments and side affects have greatly exceeded my expectations. Glad to have this 11 year journey finally conclude.

JohnT


Kongo
Regular Member


Date Joined May 2010
Total Posts : 36
   Posted 6/10/2010 6:50 PM (GMT -6)   
Vam,
 
Cyberknife will treat a Gleason 7.  To be in a study protocol you have to have a Gleason <7, PSA at DX < 10, and relatively minor biopsy involvement.  I was diagnosed in March and went through an extensive research process that included RP, proton, AS, Cryro, hormone therapy, seeds, IMRT, XBRT, HDR Brachy, and Cyberknife.
 
I've elected Cyberknife and will start my radiation treatment the week after next.  All the prep work (CT scans, MRI, gold fiducial implants) are complete.
 
Sure there's some marketing hype with Cyberknife...just like there is with Da Vinci, proton treatment, and others.  PCa is big business in this country.  You have to sift through the hype, myths, folklore, lies, and darn lies.  Besides reading 9 books and going through dozens of clinical studies, I personally met and consulted with different urologists, open surgeions, Da Vinci surgeons, Loma Linda (for proton), and AS (active surveillance) specialist, and Cyberknife.  All of the individual doctors I met with were highly professional, dedicated, and provided excellent information and perspective. 
 
Not surprisingly, over 90% of urologists suggest RP as a solution, over 80% of radiologists suggest radiation. 
 
There's no easy solution and you have to figure out what is best for yourself given your situation, insurance, lifestyle, and tolerance for potential side effects.
 
Cyberknife was approved for cancer treatment by the FDA in 2000 and has been used to treat PCa since 2003.  Da Vinci was also approved by FDA in 2000 but was not approved for PCa treatment until 2005.   Some will say that there are no long term numbers for these procedures and they are right...but you can infer from the many, many studies that are out there about the liklihood of success given your conditions.  On the other hand, a procedure with 20 year statistics is using 20-year old technology.
 
Cyberknife to date (more than 4000 patients) typically experience a very low rate of urinary, fecal, or ED issues.  If you can get it up before treatment you will have a better than 80% chance of getting it up afterwards.  For those that have difficulties, Viagra or Cialis seem to work great.  Men wth very enlarged prostates and urinary difficulties before Cyberknife will likely have some discomfort afterwards which is characterized as frequent urination or a sense of urgency.  Men in the studies I have read do not have complete incontinence requiring artifical sphincters, slings, diapers, or pads.  Symptoms usually resolve within a few weeks to a month if the emerge.
 
Vam, do your homework and check out a Cyberknife center near you.  Like Da Vinci, Cyberknife is at MD Anderson, Stanford, Harvard, Georgetown etc.  In other words, some of the finest medical institutions in the world.  Don't trust anybody on a discussion board for something as critical as this.  Find out yourself.  Even if you have to pay the consulting fee out of pocket, it's well worth it.  We don't get any mulligans on this decision.
 
From what I've read, if you decide to go the RP route using Da Vinci, make sure you hire the most experienced surgeon...many who post can give you advice on this.  Most of the studies show there is a learning curve on using the robot and there is a much higher incidence of side effects for those with less than 100 operations compared to those with more.
 
Good luck!
 
=======================
Age:  59
DX PSA:  4.3
Gleason:  3+3=6
Pathology:  1 of 12 biopsy cores showed 15% invovlement of adenocarcinoma with no evidence of perineural invasion.
Stage:  T1C
Pre Treatment PSA:  2.8 (Decrease attributed to elimination of dairy products from diet)
Prostate Volume:  47 cc
PSA Doubling Time:  > 10 years
Treatment:  Start Cyberknife June 21
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