Prostate Cancer: Surgery Vs Radiation Vs Cyberknife
An analysis of more than a dozen studies indicate that prostate cancer patients do better with surgery vs. radiation treatment especially men with localized prostate cancer.
Patients treated with radiation are twice as likely to die from prostate cancer,one a half times likely to die sooner than prostate cancer patients treated with surgery, exposure to radiation may end in secondary cancers such as bladder cancer and rectal cancer.
Dr. David Samadi explores the details.
When men are diagnosed with prostate cancer it can be extremely confusing at times picking the right treatment option as theres a lot of information out there.
Dr David Samadi says that with any cancer, surgery should be the first line of treatment.
With prostate cancer surgery patients get accurate staging i.e. how much cancer a patient has, has the cancer spread to surrounding tissues the PSA levels which has always got to be zero.
He says that patients are led to believe that radiation is a viable first line of treatment if the cancer comes back, it is extremely difficult to perform surgery after radiation.
Dr. Samadi also explain why it is extremely important to weigh in the experience of the surgeon as working with the right doctor would ensure a better and faster recovery.
Dr. David Samadis patients have a continence percentage of 95% 97% regular sexual functionality in about 80% of prostate cancer patients.
Some prostate cancer facts:
What Is A Cyberknife
The first thing prostate cancer patients should know about ground-breaking CyberKnife Radiotherapy Treatment, is that it doesnt involve a knife or any surgical procedure. Patients rest on a manoeuvrable seat or table each fifteen seconds their x-rays are taken, as a robotic arm manoeuvres around them, accurately delivering beams of radiotherapy from numerous angles.
Traditionally, radiotherapy treatments allow for a small margin of error this is due to basic inaccuracies or unavoidable movements of the prostate or patient. The CyberKnife vastly reduces this margin of error, bringing it down from between five and fifteen millimetres to just two or less with this high level of precision.
The Big 3 Benefits Of This Prostate Cancer Treatment
Most often we use CyberKnife by itself in prostate cancer treatment to treat early stage cancer that only affects the prostate and not surrounding areas. We also use CyberKnife in conjunction with other treatments such as traditional radiation when the cancer has spread beyond the prostate.
Prostate cancer patients treated with CyberKnife realize three benefits. These three benefits, in order of importance, follow.
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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
Patient Liable For Cyberknife Treatment For Prostate Cancer
Cyberknife is typically used for patients with
- Early-stage disease.
- A prostate volume of less than 80-100 cm
- A lesion or tumor that is untreatable by surgery or other radiation modalities.
Most people with enlarged prostates may be given hormone therapy and try to shrink the prostate to be able to get cyberknife treatment for prostate cancer. Patients who are considered high risk for spread to the lymph nodes or have cancer in the lymph nodes are not good candidates for cyberknife treatment for prostate cancer.
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Where Can I Have Cyberknife Radiation Treatment In Miami
If youve been diagnosed with cancer or a have a non-cancerous tumor and are unsure of where to turn, contact the CyberKnife Center of Miami today at 204-0455 or 279-2900 to learn more about how we can help you restore your health. For more information, please visit our website at cyberknifemiami.com and our prostate cancer website. www.prostatecancertreatmentmiami.com
You can also simply fill out our online form to request an appointment. Our dedicated staff would love to talk to you about your treatment options and help you on your journey to recovery.
With The Beam of Life, CyberKnife Miami is giving thousands of people new hope in treating various cancers where there was none. Visit the CyberKnife Center of Miami located in Miami, Florida.
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.
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What Happens If The Cancer Comes Back
Usually the first sign of a problem is that the PSA begins to rise. PSA levels can bounce up and down a little day to day, so if it rises the first rule is to not panic and to simply recheck it in 3 months. If it rises on 3 consecutive occasions and/or if the PSA rises to 2 points above its post-treatment minimum value then there could be a cancer recurrence.
If the PSA trend is concerning then we will do CT scans and a bone scan to look for prostate cancer in the bones or lymph glands. If the cancer is coming back in the bones or lymph glands then it is usually no longer curable and the treatment will be long term hormone therapy such as Lupron. If the scans are normal we may do a biopsy of the prostate gland. If the cancer is found in the prostate gland and not in the bones or lymph glands, then you may be referred for cryotherapy or HIFU.
Candidates For Cyberknife Radiotherapy Treatment
CyberKnife is suitable for all patients with a small or medium-sized prostate those with localised T1 or T2 stage prostate cancer, have a Gleason score of seven or lower, or a PSA score below twenty are also appropriate candidates. Claustrophobic patients can usually be accommodated, due to the free, open design of the machinery used.
Due to its use of MRI scanning, unsuitable candidates also include patients with implants such as pacemakers or metal plating patients who have had both hips replaced are also unsuitable candidates . CyberKnife is also unsuitable for severe urinary symptoms.
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Frequent Urination Burning With Urination And Difficulty Urinating
These are the most common complaints. Occasionally the urinary stream will weaken. Generally these symptoms are managed with medications to help the bladder function better or eliminate burning. Rarely, your doctor may order a urine test. Symptoms will resolve after the end of treatment. Contact your doctor if you see blood in your urine or if you are unable to urinate.
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 donât 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.
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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.
Frequent Or Loose Poo
Your bowel movements might be looser or more frequent than before your treatment.
You might need to take anti diarrhoea medicines, such as loperamide . Bulking agents, such as Fybogel, might also help. Your doctor or nurse can prescribe these for you. Talk to your doctor before taking these.
You might find that you need to avoid high fibre foods. Although we normally think a high fibre diet is the most healthy, it might worsen long term diarrhoea. Some people find it best to avoid high fibre vegetables, beans and pulses .
Let your doctor know if you have ongoing problems with frequent bowel movements or bleeding. They can refer you to a specialist team. The team includes:
- specialist nurses
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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 Precision Delivers A Number Of Unique Benefits To Patients
Excellent Long-Term Cancer Control
No Surgery, No Hospitalization
CyberKnife treatment is an outpatient procedure that requires no incisions, no general anesthesia, no hospitalization and no long recovery period.
CyberKnife treatment can be completed in dramatically fewer treatment sessions, compared to conventional radiation therapy.
Minimized Side Effects
The unparalleled, sub-millimeter precision of CyberKnife treatment significantly reduces the risk of common side effects.
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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.
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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Potential Side Effects Of Cyberknife Treatment For Prostate Cancer
Most radiation side effects are minimal and last only a short time. Side effects can, however, sometimes be severe because of rectum or bladder wall exposure to radiation. Possible side effects could include, but are not limited to:
- Constipation, fecal urgency, fecal incontinence, hemorrhoid, rectal bleeding
- Urinary retention, urinary urgency, increased frequency, incontinence, urinary bleeding
- Erectile dysfunction
Ask your doctor for more details about potential side effects associated with your specific radiation therapy treatment.
What Is Involved In Cyberknife Treatment
You will see a urologist a week or two before treatment. This doctor will place gold markers, known as âfiducialsâ, in your prostate as a way of marking the target. This is done under ultrasound guidance, similar to the procedure for prostate biopsy. The tumor position will be tracked during the Cyberknife treatment using the fiducials.
After the gold markers have been placed, a CT simulation is performed. During this CT scan, you will be positioned in the same way you will be positioned during the actual treatments. The physician uses this scan to outline the treatment area and organs or tissues to be avoided. This information is used to create the treatment plan.
The number of treatments and the amount of radiation per fraction can vary. Each fraction is a higher radiation dose than is used with traditional radiation, but fewer fractions are given. Typically, treatments include:
- Four or five fractions .
- Treatment is given over 1-2 weeks.
- The total dose in the mid to high 30 Gray range.
- Each treatment session is 30 to 90 minutes .
While you are being treated, the machine takes pictures of the tumor, which are compared in real-time to the images from the CT simulation. The CyberKnife robot moves around you to deliver precise treatment that can be adjusted as the prostate moves when you breathe.
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The Initial Causes Long Term Side Effects Of Cyberknife For Prostate Cancer
One of the first symptoms of prostate issues is pain or tenderness in the groin or lower back. This can be the result of a noncancerous condition called enlarged prostatic tissue, or it could be an infection of the bladder. In either case, its important to see a doctor as soon as possible. If youre suffering from prostate pain, you may want to consider reducing your caffeine intake.
Another symptom of a potentially enlarged prostate is difficulty starting a stream of urine, leaking, or dribbling. These symptoms are not serious, but theyre still alarming. Most men put up with an enlarged prostate for years before seeking medical attention, but they typically seek treatment as soon as they notice symptoms. Even if you dont have symptoms, its worth getting checked to determine if you have any prostate issues.
If you experience nightly bathroom runs, you may be experiencing an enlarged prostate. You may be having difficulty starting a stream of urine, or you may even be dribbling or leaking during the day. These problems arent life-threatening, but can become a nuisance. You should not ignore these signs and seek treatment as soon as you notice them. If you feel any of these symptoms, you should consult a doctor.
What You Need To Know About The Prostate Long
A enlarged prostate can also cause blockages in the urethra. A blocked urethra can also damage the kidneys. A patient suffering from an enlargement of the prostate may have pain in his lower abdomen and genitals. If pain is present, a digital rectal examination will reveal hard areas. A doctor may prescribe surgery or perform an endoscopic procedure. If the enlarged prostate is not completely removed, it will shrink.
While the size of an enlarged prostate will influence the extent of urinary symptoms, men may experience a range of urinary symptoms. Some men have minimal or no symptoms at all. Some men will have a very enlarged prostate, whereas others will have a mild enlargement. Generally, the symptoms can stabilize over time. Some men may have an enlarged prostate but not notice it. If they have an enlarged colon, their physician can perform a TURP procedure.
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