Re: If Cyber Knife does not work...
Good Questions best answered by doctors. However will share my experience.
Management of Recurrence from any modality depends on the failure, is it local or has the cancer escaped the local therapy. I will discuss only local failures.
Local failure from surgery is typically treated with IMRT and may in conjunction with ADT depending on the risk of cells that have escaped to the area around the prostate capsule. Some methods to detect, local failure are, bone scans, CT/MRI and PSA.
There is a clinical trial using the CyberKnife to treat IMRT failures. Not sure if this study includes Proton Therapy and CyberKnife(very few failures) failures. Dr. Don Fuller, San Diego, Calif. is the Principal Investigator for this study.