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.
DX PSA: 4.3
Pathology: 1 of 12 biopsy cores showed 15% invovlement of adenocarcinoma with no evidence of perineural invasion.
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