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
Long-term CyberKnife® and prostate cancer radiation side effects may include:
Treatment Options For Urinary Incontinence Can Include:
- Pelvic floor physical therapy. These specialized physical therapists are trained to help men strengthen their pelvic floor muscles. These muscles help you control the flow of urine. The exercises are called Kegel exercises just as you might do bicep curls to strengthen your arm muscles Kegel exercises help you learn to tighten and relax the muscles that control your flow.
- Bladder training. The bladder is a muscular organ that can be trained. A pelvic floor physical therapist or your urologist will provide simple behavioral changes to help retrain your bladder.
- Medication. Prescription medicines help the muscles in your bladder and sphincter . These medications work well for men with urge incontinence.
- Surgery. Surgery may be scheduled if you have a blockage. Other surgical procedures include injecting collagen to strengthen the urinary sphincter that controls urine release or implanting an artificial urinary sphincter.
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‘it’s Amazing How Easy It Is’ Says Prostate Cancer Patient Of Cyberknife Treatment
Fortunately for the now 67-year-old, his urologist recommended “active surveillance,” allowing him to avoid possible side effects from treatment and potentially benefit down the road as new technology and options emerged.
Last summer, a biopsy indicated that his condition had progressed and he was referred to a Kansas City-area radiation oncologist, who prescribed a course of 43 doses of standard radiation delivered over a period of eight and a half weeks.
But fortunately for Don, he had heard about CyberKnife from his nephew, who works for the manufacturer of the non-surgical, non-invasive radiation therapy system.
Don liked the idea of a high-dose prostate cancer treatment so precise that it could be delivered in just five treatments. If he were to need treatment, he decided, he would want it done with CyberKnife, the first and only fully robotic radiotherapy device that uses speed, precision and motion synchronization technology to treat tumors and benign lesions throughout the body.
“I wanted to come out of this as normal as I possibly could and I felt like this was my best chance to do that,” he says.
So after learning that CyberKnife wasn’t available in the Kansas City area, he reached out to his nephew, who sent him a video about the new CyberKnife ® S7 System recently installed on Ascension Via Christi’s St. Francis hospital campus.
“I said, ‘Yeah, that’s the one I want.'”
“That’s very reassuring,” says Don.
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What Happens During The Procedure
Youll be placed in the proper position on a table. Then, a computer-controlled robot will move slowly around the table, targeting radiation where its needed. The software will adjust radiation for your breathing pattern and any movement of the tumor.
This is a noninvasive, painless procedure. Each session will last anywhere from 30 to 90 minutes. Once its over, you should be able to get up and resume your normal activities right away.
The Importance Of Prostate Massage
Prostate massage is a treatment that addresses the root cause of most prostate issues. Treatments like surgery and medications only provide temporary relief by treating the symptoms and not the cause.
> > > Prostate Massage for Optimal Prostate Health
On the other hand, regular prostate massages encourage the gland to work without problems. A man will not be subjected to dangerous side effects from medication or complications from surgery. Massage also helps make the prostate stronger and more resistant from disease and infection.
Advantages Of Prostate Massage
Although regular prostate massage can help to eliminate or reduce the severity of any symptoms a man may have, it can also offer other benefits especially with improved sexual enjoyment and function.
It is a fact that modern medicine has not been able to determine the causes and treatments for many conditions related to the prostate. Even though prevention is the best medicine, prostate massage will help improve your prostateâs health and prevent existing conditions from becoming worse.
However, in the case of bacterial prostatitis, left untreated, can cause intense inflammation and increased bacterial growth.
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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.
What Is The Cyberknife System And How Does It Treat Prostate Cancer
Despite its name, the CyberKnife System is not a surgical procedure. In fact, there is no cutting involved. The CyberKnife System precisely delivers high doses of radiation in a process called stereotactic body radiation therapy directly to the prostate tumor. With SBRT, prostate cancer patients typically have to undergo one treatment or fraction per day for five days or less, compared to 43 days of treatment or more using conventional radiation radiation systems.s.
The CyberKnife System has a linear accelerator mounted to a robotic arm, which enables it deliver radiation from hundreds of different angles. With this extreme maneuverability, the CyberKnife System allows doctors to deliver high doses of radiation directly to the prostate tumor, sparing healthy tissue and minimizing side effects.
Each CyberKnife treatment fraction takes approximately 20 to 45 minutes, depending on movement, and is completed in one to five sessions over the course of consecutive days. Side effects are typically minimal, and success rates are high.
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Getting Proton Therapy Covered By Insurance
The New York Proton Center accepts both Medicare & Medicaid and is currently in-network with many commercial insurers. We are committed to working with ALL insurance companies to help patients secure approval. We will provide your insurer with supporting clinical evidence about your case. We will work with you to complete all the paperwork, explain to your insurance company the reasoning behind your treatment plan and assist you throughout the process.Please contact us so we can discuss your particular situation and provide support to help you secure coverage.
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Advantages Of Cyberknife For Prostate Cancer
- With CyberKnife® radiosurgery for prostate cancer, the majority of patients can continue normal activity during and immediately following treatment. With traditional prostate cancer surgery, patients must limit normal activity for 3-5 weeks.
- In a recent clinical study of patients treated with CyberKnife® radiosurgery for prostate cancer, the majority of these patients maintained sexual function.
- Patients treated with the CyberKnife® System for prostate cancer reported a return to normal urinary and bowel function by 6 months post-procedure.1
- Prostate cancer treatment with the CyberKnife® System is completed in 4-5 treatment sessions, over the course of a week. Conventional radiation therapy typically requires 30-40 treatment sessions, over the course of several weeks.
- The CyberKnife® System delivers the required radiation dose to the prostate with pinpoint precision, thereby minimizing the radiation that is delivered to the bowel and urinary tract.
This video is used with permission from Accuray Incorporated.
King et al. International Journal of Radiation Oncology.2013. Health-Related Quality of Life After Sterotactic Body Radiation Therapy for Localized Prostate Cancer: Results from a Multi-institutional Consortium of Prospective Trials
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It was once a week for five weeks and then it was done total recovery
David
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Cyberknife is very non-intrusive, it allows you to go on with your everyday life.
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What Is The Cyberknife Vsi Treatment Process
Pasadena Cyberknife® robotic treatments involve a team approach in which several specialists from our oncology center participate.Prior to the procedure, the patient is imaged using a high-resolution CT scanner, to determine the size, shape, and location of the tumor. Following the CT scan, the image data is digitally transferred to the Pasadena CyberKnife VSI Systems workstation, where the treatment planning begins.
Your Board Certified physician then uses the CyberKnife VSI software to generate your specific treatment plan. The plan is used to match the desired radiation dose to the identified tumor location while limiting radiation exposure to the surrounding healthy tissue. Once the treatment plan has been developed, you are ready to undergo treatment.
The process of prostate cancer radiation treatment with CyberKnife begins by placing the fiducial markers. These tiny golden seeds help the CyberKnife system locate your tumor and track its movements.
Next, your treatment team creates your treatment cradle. The cradle is made from soft material that conforms to your shape. Youll lie in the treatment cradle during each session. It will help you maintain your physical position from one treatment to the next and ensure your comfort during treatments.
Each treatment session will last between 20 and 45 minutes, once per day for five days or less. Patients may experience some minimal side effects, but those often go away within the first week or two after treatment.
Are There Any Surgical Techniques That Have Been Developed To Improve Erectile Function Outcomes
At this time, there are several different surgical approaches to carry out the surgery, including retropubic or perineal approaches as well as laparoscopic procedures with freehand or robotic instrumentation. Much debate but no consensus exists about the advantages and disadvantages of the different approaches. Further study is needed before obtaining meaningful determinations of the success with different new approaches.
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More Than Two Decades Of Clinical Proof
The CyberKnife is commonly used for treating low- to intermediate-risk prostate cancer and is the only radiotherapy device supported by years of published clinical follow-up with a large number of patients.
SAFE AND EFFECTIVE
Prospective, multi-institutional study data supports the safety and efficacy of CyberKnife for men with low- and intermediate-risk prostate cancer.1, 2
EXCELLENT LONG-TERM OUTCOMES
Clinical studies report CyberKnife provides excellent long-term disease control for prostate patients.3, 4, 5, 6, 7, 8, 9
20,000+ PROSTATE CANCER TREATMENTS
More than 20,000 men have been treated with CyberKnife.
References:
1 Meier. R. et al. Five-Year Outcome From a Multicenter Trial of Stereotactic Body Radiation Therapy for Low- and Intermediate-Risk Prostate Cancer. International Journal of Radiation Oncology Biology Physics, Volume 96, Issue 2, S33 S34.
2 Fuller D.B., et. al. 5-year outcomes from a prospective multi-institutional trial of heterogeneous dosing stereotactic body radiotherapy for low- and intermediate-risk prostate cancer. J Clin Oncol 35. 2017 6S 35.
3 Zelefsky M.J., Chan H et al. Long-term outcome of high dose intensity modulated radiation therapy for patients with clinically localized prostate cancer. J Urol 2006 176:1415-9.
4 Cheung R., Tucker S.L. et al. Dose-Response Characteristics of Low- and Intermediate-Risk Prostate Cancer Treated with External Beam Radiotherapy. Int J Radiat Oncol Biol Phys 2005 61: 993-1002.
Are There Side Effects Of The Combination Approach To Prostate Cancer Radiation Therapy
When it comes to early stages of disease, patients very frequently do well with either brachytherapy or external beam radiation. Success rates of around 90% or higher can be achieved with either approach. When the disease is somewhat more advanced based on the PSA level, Gleason score, extent of visible disease on magnetic resonance imaging we have learned over the years that higher doses of radiation are critical to achieving better results. Some evidence, including a large trial, suggests that for patients with intermediate- or high-risk prostate cancer, a combined approach using brachytherapy along with external beam radiation may be best compared to standard dose external beam radiation therapy alone.
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What Is Sbrt/srs Radiation Therapy
Stereotactic Body Radiation Therapy , also called Stereotactic RadioSurgery , is the most advanced form of Radiation Therapy. SBRT and SRS are techniques used in Radiation Therapy to ablate diseased tissue by precisely directing very high doses of radiation, while avoiding surrounding normal tissue. Unlike conventional radiation therapy , , SBRT and SRS treatments are given once per day for five days or less.
The robotic CyberKnife VSI System is the only technology specifically designed to perform SRS and SBRT treatments with sub-millimeter accuracy. During treatment, and prior to each beam, the robotic CyberKnife VSI System takes digital images to ensure that the radiation beam is aimed at the target. And when there is movement, , the robotic CyberKnife VSI system precisely adjusts the position of the radiation beam under robotic control to keep it on target, sparing healthy tissue.
A problem with conventional radiation treatment for prostate cancer has been that the prostate and any tumors within it tends to move involuntarily in response to body functions. CyberKnife Stereotactic Body Radiation Therapy , also known as Stereotactic Radiosurgery , solves this problem by tracking tumor movements. Cancer doctors use fiducial markers to help the CyberKnife System keep track of the tumors position, even as it moves. Fiducial markers are tiny, gold-colored seeds inserted into the prostate with a needle.
What is the Cyberknife VSI Treatment Process?
When Is Brachytherapy Alone The Right Choice
For some patients with disease that is confined to the prostate and not too aggressive , brachytherapy alone is a good option. It is also convenient for the patient as it is done in an outpatient setting and most people can get back to work within a few days.
But brachytherapy is not right for everyone. For some patients with less-aggressive disease, a watch-and-wait approach would be preferred. At MSK, our philosophy is that when the disease is caught very early, it is very appropriate to do active surveillance and hold off on treatment.
This philosophy applies to patients with a low PSA level, or nonaggressive disease as reflected by a Gleason score of 6 with evidence of cancer in only a few of the biopsy samples and no evidence from the MRI of a significant amount of disease. There are also very select patients with Gleason 7 disease who may be candidates for active surveillance.
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Are There Side Effects Of The Combination Approach
There is a slightly higher chance that patients who receive the combined therapy will have rectal irritation or urinary side effects. This is common with prostate cancer radiation therapy because the radiation can damage cells in the tissues surrounding the prostate. But at MSK, we routinely use sophisticated computer-based planning techniques that help us reduce the dose given to normal tissues such as the rectum, bladder, and urethra, lessening the chances of side effects and complications. We have also found that, when treating with the combined approach, using the high-dose-rate brachytherapy compared to low-dose-rate brachytherapy may have less in the way of side effects.
In addition, at MSK, we routinely use a rectal spacer gel, which we inject between the prostate and the rectum while the patient is under mild anesthesia, to create a buffer between these two tissues. By creating this space, we can further reduce the dose of radiation the rectum is exposed to. This leads to fewer side effects for the patient. The rectal spacer gel is biodegradable and dissolves on its own within the body after a few months.
What Happens On Treatment Days
If you get external radiation therapy, youâll need to get regular sessions during a period of about 5 to 8 weeks.
For each treatment, the radiation therapist will help you onto the treatment table and into the correct position. Once the therapist is sure youâre positioned well, theyâll leave the room and start the radiation treatment.
Theyâll watch you closely during the treatment. Cameras and an intercom are in the treatment room, so the therapist can always see and hear you. Try to stay still and relaxed during treatment. Let the therapist know if you have any problems or you feel uncomfortable.
Theyâll be in and out of the room to reposition the machine and change your position. The treatment machine wonât touch you, and youâll feel nothing during the treatment. Once the treatment is done, the therapist will help you off the treatment table.
The radiation therapist will take a port film, also known as an X-ray, on the first day of treatment and about every week thereafter. Port films verify that youâre being positioned accurately during your treatments.
Port films donât provide diagnostic information, so radiation therapists canât learn about your progress from them. But these films do help the therapists make sure theyâre delivering radiation to the precise area that needs treatment.
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