Who Is Suitable For Treatment With The Cyberknife
CyberKnife is suitable for the following patients with prostate cancer:
- Localised prostate cancer .
- Gleason score up to seven and PSA less than 20.
- No severe urinary symptoms or previous TURP . If you are unsure how severe your urinary symptoms are, try this IPSS symptom score. Men scoring more than 20 would be considered severe and not suitable for CyberKnife treatment.
- Small to medium size of prostate.
CyberKnife is not suitable if:
- you have artificial hips on both sides, but may be possible if on one side only
- you have any medical condition or an implant that prohibits having a MRI scan.
Common Short Term Side Effects
- Urinary bother: frequent urination, some burning, getting out of bed frequently to urinate, weak stream, dribbling
- Rectal irritation: more frequent bowel movements, some rectal mucous, hemorrhoid irritation
- Small amounts of blood in the urine
- Some blood and discomfort occurring during sex / ejaculation
What To Expect With Prostate Cancer Radiation Therapy
With each of these treatments, there are often side effects that can include short-term complications including urinary and bowel problems. However, depending on the treatment, side effects can be minimized.
The Risk of Long-Term Complications with Radiation Therapy is Low Less Than 5% According to the Prostate Cancer Foundation.
The risk of cancer recurring after receiving radiation treatment for prostate cancer is less than 1%.
With more precise treatments, side effects are lower than ever, but you must make sure the treatment center you choose has highly-skilled radiation oncologists, physicists, and radiation therapists like those at the CyberKnife Center of Miami.
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Hdr Brachytherapy: What It Is
This technology does away with entrance and exit doses because the radiation is released after a pellet is placed inside of, or very near to, the prostate cancer mass. This is why this form of treatment is often called seed.
HDR brachytherapy is tightly focused on tumors to minimize serious side effects, says the CTCA site.
Exposure of radiation to the surrounding benign tissue is minimized, while the maximum dose is delivered to malignant cells.
Who Is A Candidate For Cyberknife
CyberKnife can be used as a first-line treatment for early-stage prostate cancer. It can be combined with hormone therapy for cancer that has spread into nearby tissues. It can also be used to slow progression in advanced cancer or cancer that has recurred after previous treatment.
Prostate cancer treatment is not the same for everyone. Surgery, radiation therapy, chemotherapy, and hormone therapy are designed to do different things.
There are a few benefits of CyberKnife when compared to other treatments:
- Theres no incision or pain, as you might have from surgery.
- Theres no need for anesthesia or a hospital stay.
- As soon as its over, you can get up and return to your normal activities.
- Its a lot less time-consuming than conventional radiation or chemotherapy.
- Theres no extended recovery period.
Another type of radiation used for prostate surgery is brachytherapy. It involves implanting radioactive pellets in your prostate. The pellets release radiation over a period of days or weeks. Its a good option for early-stage or low-grade prostate cancer. CyberKnife may be a better choice if you cant have anesthesia or if your anatomy makes brachytherapy difficult.
If you have treatment with CyberKnife, you may need other therapies as well. Your doctor will make a recommendation based on variables such as the stage and grade of the cancer, as well as your age and any other health conditions you may have.
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External Beam Radiation Therapy
In EBRT, beams of radiation are focused on the prostate gland from a machine outside the body. This type of radiation can be used to try to cure earlier stage cancers, or to help relieve symptoms such as bone pain if the cancer has spread to a specific area of bone.
You will usually go for treatment 5 days a week in an outpatient center for at least several weeks, depending on why the radiation is being given. Each treatment is much like getting an x-ray. The radiation is stronger than that used for an x-ray, but the procedure typically is painless. Each treatment lasts only a few minutes, although the setup time getting you into place for treatment takes longer.
Newer EBRT techniques focus the radiation more precisely on the tumor. This lets doctors give higher doses of radiation to the tumor while reducing the radiation exposure to nearby healthy tissues.
How Do You Prepare For Cyberknife
Youll need to go through a few steps before treatment can begin.
With ultrasound as a guide, a urologist will use long needles to place gold markers in your prostate. This will be similar to when you had your biopsy. CyberKnife will use the markers to track the tumor during treatment.
Then youll need some imaging tests to assess the location, size, and shape of the tumor. This data is sent to the CyberKnife software, so the proper dose, exact location, and number of treatments can be determined.
Your doctor will fill you in on details before you begin so you can plan accordingly.
Youll likely need one to five treatments on consecutive days. This can all be accomplished on an outpatient basis.
Theres no need for anesthesia or other medications, so you can eat and take medications as usual. Avoid lotions and powders on the area to be treated, and wear comfortable clothing. No further preparation is needed.
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Q: How Does Cyberknife Robotic Radiosurgery Differ From Robotic Prostatectomy Surgery And Radiation
CyberKnife® Robotic Radiosurgery is not robot-assisted surgery it is simply another form of prostate cancer radiation such as external beam radiation therapy or brachytherapy. CyberKnife® is FDA-approved radiation therapy for the treatment of cancer, though the procedure is very new.
During robotic prostatectomy surgery, Dr. Samadi uses real-time, first-hand visualization to assess the prostate cancer scope and remove the tumor. This proven, minimally invasive procedure integrates the precision and visualization of robot-assisted surgery with the expertise of Dr. Samadis vast surgical background. With appropriate follow-up and post-surgery care, PSA level should drop to an undetectable level after robotic prostatectomy surgery.
Radiation such as CyberKnife® can be an effective secondary measure for men with high-risk, recurring prostate cancer.
Follow Dr. David Samadis appearance on Fox News for a detailed explanation of the differences between CyberKnife®, Robotic Prostatectomy and Radiaton.
The negative side effects of CyberKnife® can be expected to mirror those of other targeted radiation therapies.
Over the short term, radiation therapy for prostate cancer can cause:
- Urination problems including burning and blood in the urine
- Urinary urgency and frequency
- Incomplete emptying of the bladder
- Anal and rectal irritation, rectal bleeding, hemorrhoids, and stool problems
- Fatigue and nausea
Long-term CyberKnife® and prostate cancer radiation side effects may include:
Fewer Treatments In Less Time
Compared with standard radiation treatment, CyberKnife delivers 4 times the usual dose of radiation per day, but with half the overall radiation dose over the full course of treatment. Thats because CyberKnife allows the higher dose to be more accurately delivered to hug the prostate tumor and spare the surrounding healthy tissue.
That means each CyberKnife treatment only takes about 45 minutes per day for about five days. Normal radiation treatment takes longer per session and sessions go on from 6-8 weeks. For younger men 50-60, who are likely to be working still, this is a valuable convenience.
I urge all men with prostate cancer to consider CyberKnife for treatment. Its not for every man with prostate cancer that needs to be treated, but its a great option for a lot of them.
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Radiation Therapy For Prostate Cancer
Radiation therapy uses high-energy rays or particles to kill cancer cells. Depending on the stage of the prostate cancer and other factors, radiation therapy might be used:
- As the first treatment for cancer that is still just in the prostate gland and is low grade. Cure rates for men with these types of cancers are about the same as those for men treated with radical prostatectomy.
- As part of the first treatment for cancers that have grown outside the prostate gland and into nearby tissues.
- If the cancer is not removed completely or comes back in the area of the prostate after surgery.
- If the cancer is advanced, to help keep the cancer under control for as long as possible and to help prevent or relieve symptoms.
How Does Cyberknife Work
One of the major obstacles to treating prostate cancer is the fact that the tumors in and around the prostate can involuntarily and unpredictably move throughout treatment as much as 5 mm in as little as 30 seconds. These movements can be due to natural occurrences such as the bladder filling and gas in the bowel. The CyberKnife hurdles these obstacles. The CyberKnife System works by combining a robotic arm with an imaging system. The robotic arm is flexible and moves around the body ensuring precision by reaching your tumor at hundreds of different angles with its beams of high-dose radiation. The imaging system tracks your tumor during the entire treatment process and sends the information to the robotic arm to guide its every movement. With this range of motion, the CyberKnife System is able to avoid healthy tissue and form its emitted radiation to the exact shape of the patients prostate tumor.
This advanced stereotactic radiosurgery system is the most precise available. Instead of surgery, or targeting general regions with large doses of radiation, we are able to use pin-point accuracy within the thickness of a dime. CyberKnife also provides treatment without invasive surgery, within a weeks time and with minimal side effects. Our Orange County radiation oncology experts can work closely with your medical team to use the CyberKnife system for stand alone treatment as well as for treatment that complements other treatment options including surgery and/or chemotherapy.
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Stereotactic Body Radiation Therapy Delivered By Cyberknife Has Distinct Advantages Over Other Treatments
Having performed more than 1,500 CyberKnife prostate cancer treatments, if I didnt know better I would think that this technology was created specifically to treat this disease. It is completely suited to the specific challenges of prostate cancer treatment. Yet CyberKnife was first used mostly as a treatment for head, neck and spine tumors that were very difficult to reach.
The Food and Drug Administration opened the door in 2001 to the use of CyberKnife to treat other cancers in the body. Since then urologists and oncologists are turning more and more to CyberKnife, as are patients.
CyberKnifes primary advantages relate to reduced damage to healthy tissue surrounding the cancerous prostate tissues. This is largely due to CyberKnifes ability to precisely target a tumor in the prostate without radiating healthy tissue. Damaging healthy tissue is the leading cause of side effects from radiation treatment.
Orange County Cyberknife Treatment Process For Prostate Cancer
CyberKnife Treatment is completely non-invasive and is performed on an outpatient basis in our welcoming Southern California treatment center. Treatment at Orange County CyberKnife and Radiation Oncology Center includes treatment planning, treatment sessions, and post-treatment follow-up appointments.
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What Are The Side Effects Of Cyberknife Treatment
At Orange County CyberKnife, were proud to be one of the premier providers of radiation therapy treatments in the Orange County area. Our flagship treatment is CyberKnife: a revolutionary cancer treatment system that uses high-dose radiation to eliminate cancer cells and tumors. In many patients, CyberKnife produces almost no side effects but as with any radiation therapy treatment, side effects are possible. If youre curious to learn the side effects of CyberKnife, we can help.
Cyberknife May Reduce Side Effects Of Prostate Cancer Treatment
Stereotactic body radiation therapy is a type of external beam radiation therapy in which the radiation therapy is given in five or fewer treatments. Conventional radiation treatment for prostate cancer consists of 39 to 45 treatments. With SBRT, a higher radiation dose is delivered with each treatment compared to conventional treatment.
The Power of CyberKnife
External beam radiation therapy consists of high energy X-rays delivered from a linear accelerator targeting the tumor. The CyberKnife machine at UofL Brown Cancer Center is a lightweight linear accelerator with a robotic arm that delivers radiation to the tumor precisely and accurately. Additionally, the CyberKnife can track the motion of the tumor during the treatment delivery, which allows for a higher amount of radiation to the tumor and less to the surrounding normal tissue.
CyberKnife technology can be used to treat several types of cancer while minimizing side effects for eligible patients including brain, kidney, liver, lung, ocular/orbital, prostate, pancreatic and spinal tumors, as well as metastatic cancer. It is also used to treat acoustic neuroma, arteriovenous malformation and trigeminal neuralgia. For more information about CyberKnife, visit www.louisvilleck.com.
Lets take a closer look at using CyberKnife for prostate cancer.
Prostate cancer patient eligibility
Technology to reduce side effects
PSA levels after treatment
Side effects of SBRT with CyberKnife for prostate cancer
External Beam Radiation Therapy :
Radiation focused on the prostate gland from outside the body. EBRT is often used for earlier staged cancers or to help relieve symptoms like bone pain if the cancer has spread.
Within the EBRT category there are four types of external radiation:
Three-Dimensional Conformal Radiation Therapy : High energy photon radiation delivered typically in 42 treatments.
Intensity Modulated Radiation Therapy : An advanced form of 3D-CRT. Also typically delivered in 42 treatments.
Proton Beam Radiation Therapy: This therapy focuses beams of protons instead of photon beam. Typically delivered in 40 treatments.
Stereotactic Body Radiation Therapy : This therapy uses advanced image-guided techniques to deliver larger doses of radiation to a very precise area. Since the dose of radiation is larger, only five treatments are required over a few days as opposed to many more treatment sessions with other forms of radiation.
Sbrt Demonstrates Better Quality Of Life Than Imrt Or Brachytherapy For Prostate Cancer Treatment
For patients who choose to proceed with radiation therapy for the treatment of their prostate cancer, stereotactic body radiotherapy , intensity modulated radiotherapy and brachytherapy are the potential treatment options. With advancements in technology, SBRT has become used more popular due to its effectiveness, convenience and lower risk of side effects.
A large multi-institutional study of 803 patients with prostate cancer treated with SBRT, IMRT and brachytherapy compared the patient-reported quality of life outcomes of the three treatment options . The study found that SBRT had a lower risk of gastrointestinal side effects than either IMRT or brachytherapy. Another key finding of the study was that brachytherapy had the highest risk of urinary side effects and that both SBRT and IMRT had a low risk of causing urinary dysfunction. There were no differences in sexual dysfunction between the three treatments.
While SBRT, IMRT and brachytherapy are all effective treatment options, more patients are choosing SBRT due to the effectiveness, convenience and lower risk of side effects with CyberKnife.
For further information, please contact our office at 212-3186 to schedule a consultation with one of our Radiation Oncologists.
How Effective Is The Cyberknife And What Are The Possible Side
Several clinical studies have shown that CyberKnife is as effective as standard radiotherapy. CyberKnife is one of the recommended treatment options for the treatment of localised prostate cancer by the American Society of Radiation Oncology . Read the results of a study in full.
Possible side effects during treatment
Mild to moderate urinary problems and mild fatigue for 12 months about 1% of patients need catheterization for urinary retention resume normal activity immediately after treatment.
Possible long-term side effects
Despite receiving high doses of radiation, long-term urinary effects are not common and rectal injury is rare 2030% patients develop erectile dysfunction.
There Is One Marked Difference Between Proton Beam Radiation And Cyberknife
men with prostate cancer are understandably concerned over which treatment modality will be most effective.
Both protons and cyberknife involve precision delivery of radiation therapy, says Sean Cavanaugh, MD, Chief of Radiation Oncology, Cancer Treatment Centers of America at Southeastern Regional Medical Center.
In general, radiation therapy involves delivering the desired target dose to the tumor as well as undesired entrance and exit dose across healthy tissue, continues Dr. Cavanaugh.
In other words, more conventional radiation causes a so-called collateral damage. Think of a bomb being set off in a little town to get rid of dangerous criminals but the good guys will get blasted too.
Will My Diet Affect My Treatment
Yes. Good nutrition is an important part of recovering from the side effects of radiation therapy. When you are eating well, you have the energy to do the activities you want to do, and your body is able to heal and fight infection. Most important, good nutrition can give you a sense of well-being.
Since eating when you don’t feel well can be difficult, consider working with a dietitian. They can help make sure that you are getting adequate nutrition during your radiation therapy.
Long Term Urinary Symptoms
Flomax can be taken long-term if needed. If the long-term symptoms are very troubling, then sometimes a TURP is performed. The urologist places an instrument up the penis and widens the urine passage as it passes through the prostate. It is important that as little tissue be removed as possible, as doing a TURP after radiation therapy can increase the chance of urine leakage. Other options are to try to stretch the urethra with a procedure called dilatation. Self catheterization, I.e learning to insert a catheter through the penis and up to the bladder, is also an option for the most severe cases.
Prostate Cancer Causes & Symptoms
Unfortunately, the exact cause of prostate cancer is not always known. Some recent discoveries have linked prostate cancer to changes in DNA and also to high levels of certain male hormones.
Prostate cancer is not, however, linked to an enlarged prostate gland, a condition also called benign prostatic hyperplasia or benign prostatic hypertrophy. An enlarged prostate gland is not cancer and does not cause cancer.
The symptoms of prostate cancer are also the same type of symptoms shared by many non-cancerous conditions. Therefore, it is very important to have a doctor determine the source of the problem for men who experience changes in their urinary functions.
It is also possible to have prostate cancer and not have prostate cancer symptoms.
Prostate Cancer Symptoms may include:
- Problems with urination
- Blood in your urine
- Anemia