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Old 10-05-2010, 03:36 PM   #1
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Question Cyberknife: Opinions

HAs anyone opted for the cyberknife procedure. What are the latest opinions on this form of therapy. I went with the brachytherapy and IMRT radiation process plus the triple hormone deal. A good friend is weighing his options with the doctors recommending a program similar to mine. He is 70 years of agewith a Gleason of 8 and some other health issues. Surgery is not an option for him. He doesn't know if he can deal with 30 radiation sessions. It is an ordeal, I know, having gone through it myself. I did consider the cyberkife but results seemed inconclusive with not enough history and concerns about the impact of so much radiation delivered in 3 treatment sessions. What is the latest in Cyberknife treatment for prostate?

 
Old 10-05-2010, 11:45 PM   #2
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Re: Cyberknife: Opinions

Here's the latest update on CyberKnife. I recommend your friend read the free full text article:
http://www.ncbi.nlm.nih.gov/pubmed/20815417

The idea of fewer higher dose treatments (hypofractionation) came out of the success of high dose rate (HDR) brachytherapy. They found that prostate cancer is peculiar in that the cancer cell kill rate is better with the higher doses. Toxicity is minimized by delivering the dose very precisely within the prostate. It is much less debilitating than the typical 40+ IMRT dose schedule. That said, I don't know if it's the best for his stage of disease.Most (but not all) CyberKnife patients have had early stage disease, so there wouldn't be a lot of data on outcomes for his stage.

 
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Old 11-11-2010, 04:21 AM   #3
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Re: Cyberknife: Opinions

There are several of us here who have had Cyberknife-you can look for my "blog" on my experience. I had the procedure this past Feb. and I haven't looked back. I had a PSA of 8 with a Gleason 3+4 in 3 of 12 biopsies, I looked at every option carefully and settled on Cyberknife for all of the reasons stated above. It's a very easy treatment regiment with, in my case, very minimal and temporary side effects which are typical of this procedure. While everyone has to choose what they are willing to go through based on diagnosis, with early, slow-growing PC, I would not hesitate to recommend Cyberknife as the treatment of choice if you must deal with it in a physical manor. For me, 90% of everything was over within about two weeks of treatment and the treatments were absolutely painless. The worst of the lot is having to get the fiducials put in, but that was much less uncomfortable than the biopsy procedure. Oh, and 9 months later my PSA is 2.0 and falling. Treatment can take up to 18-24 months to yield a .0. As of now I have zero negative side effects-I am sooo glad that I didn't opt for surgery! BTW, the very latest studied out this year (I am in one of the studies) shows Cyberknife to be very effective at the 5-year mark. My decision to opt for Cyberknife was based on the science behind the procedure and the studies are proving it to be sound.

Bob

 
Old 11-11-2010, 12:22 PM   #4
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Re: Cyberknife: Opinions

Hi Bob-

Did you mean 3 years? I haven't seen any 5-year studies this year, although Dr King will be publishing soon.

Quote:
Originally Posted by RJM3 View Post
BTW, the very latest studied out this year (I am in one of the studies) shows Cyberknife to be very effective at the 5-year mark.
Bob

 
Old 11-11-2010, 01:11 PM   #5
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Re: Cyberknife: Opinions

Quote:
Originally Posted by Tall Allen View Post
Hi Bob-

Did you mean 3 years? I haven't seen any 5-year studies this year, although Dr King will be publishing soon.
The mean age of the study is at 3 years right now but there are people in the study already 5 years out. My radiologist went over the latest results of the study the last time I saw her. She looked at all of the data and informed me that the patients in the study hitting the five year mark are doing better than expected, statistically. She feels very encouraged by the results to venture that this will become the treatment of choice. One of the things about PC is that it responds better to hypo-fractionated radiation over standard low-dose which is why high-dose brachy (on which the Cyberknife routine is based) is so successful.

Bob

 
Old 11-15-2010, 08:28 AM   #6
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Re: Cyberknife: Opinions

The study by Alan J. Katz "CyberKnife Radiosurgery for Prostate Cancer,Oct. 2010 presents data for all radiotherapy options.

At the recent ASTRO Nov. 2010, meeting Dr. Christopher King presented a paper and abstract with summary of data from Stanford, Stanford, CA and Naples, FL. First patient was treated 2003, study median is 5.5 (verbal reports from the meeting) years post CK.

Today there are still nay sayers who are intellectually biased or challenged, have an economic interest in older technology.

Search for the truth, it is published.

FredK

Last edited by viperfred; 11-15-2010 at 11:47 AM.

 
Old 11-15-2010, 09:22 AM   #7
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Re: Cyberknife: Opinions

Quote:
Originally Posted by viperfred View Post
Today there are still nay sayers who are intellectually biased or challenged, have an economic interest in older technology.

Fred, Really? Wow! Even the study authors are a little more constrained...

  • "Recently, new data have emerged that show promising outcomes with minimal toxicity for CyberKnife SBRT of prostate cancer." Yes, it is promising.
  • "Although long-term follow-up is necessary to further validate CyberKnife SBRT for prostate cancer, much can be learned from the available data." Yes, keep working on it.
  • "...with a mind towards future studies aimed at optimizing CyberKnife SBRT for prostate cancer" Yup, while it is still at pioneering stage, it looks promising and we should keep working on it.


"Intellectually challenged?" You words portray someone desperately anxious to self-justify.

I am hopeful that Cyberknife continues to develop favorably, but let's be balanced on recognizing an emerging technology without being too quick make bold claims which appear intended to shame all other established protocols, especially when this is beyond what the study itself says.

Last edited by kcon; 11-15-2010 at 09:35 AM.

 
Old 11-15-2010, 10:40 AM   #8
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Re: Cyberknife: Opinions

Hi Bob,

All radiotherapy is changing with better imaging, planning, increasing dose. All need long term data to confirm todays therapy.

No shame on other therapies only those who misrepresent any therapy. The best we can do is make an informed choice. We need only look at the published data understand all treatment technology and make an informed choice.

Your personal slam is welcome!

 
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