Treatment Decision: CK in NYC

I have been considering treatment options after getting a biopsy in January that showed progression from one core to three and Gleason 6 to Gleason 3 + 4. I have been on AS since 2010 with no progression until now. I had also posted recently on the wisdom of traveling long distances if necessary to get treatment. I appreciated those responses.

I've now decided that SBRT with Cyberknife will be the chosen treatment, and that I'm going to go to NYC (from NC) to get it. I'm looking at scheduling things in the next 4-6 weeks. (I was pleased to find out this week also that BCBS is going to cover the treatment, so that is one less thing to worry about.)

I'm interested in any advice those that have had SBRT might give me, and any insight on the logistics of pulling this off. The Dr's office (Dr. Alan Katz) offers to do everything over a two week period, with placement of the fiducials and doing the scans and planning the first week, and 5 consecutive days of treatment the second week. They indicate that you can do it alone, and that bringing a "helper" is not required.

So what makes sense to you guys that have been through something similar? Anyone done the NYC thing? Did you bring anyone with you? What would you plan on doing to minimize side effects?

Also, on a related note, I've got a 10 year colonoscopy due. I've read on some other threads that it would be smart to get this done before the radiation. Is that also a no brainer?

Thanks for the input!

Mac

Yeah- get the colonoscopy done before the radiation, and get any internal hemorrhoids fixed while you're at it. You don't need any support during the treatment itself - it's a big nothing to go through. Any SEs will crop up a week or two after.

I think the world of Dr. Katz, but it seems a long way to go for CK - is there nothing closer? Did you call UNC at Chapel Hill or Duke U? I'm pretty sure that Va Commonwealth in Richmond and maybe UVa offers it too. I know Sean Collins at Georgetown U has go to be closer, and he is excellent.

It's not the kind of therapy that has a steep learning curve, and there are lots of experienced practitioners.

Tall Allen,

I did talk to guys at Duke and UNC.

Duke doesn't have CK but a RO there, Dr. Robert Lee, I liked a lot and would have probably gone there for Brachy if I had chosen that.

UNC has some great surgeons and I really liked Raj Pruthi, the urology dept head, and would have gone there for RALP with him. UNC does have CK but I was disappointed to learn that they don't recommend it for intermediate cases like mine. "Maybe with a G 3 + 4 and one core, but not with 3." They recommended 42 sessions of IMRT with 6 months of hormones. They also state that they are concerned that CK may have worse side effects than other options.

I just couldn't make sense of the UNC recommendations in light of the other credible data I had. Data on Dr. Katz was pretty easy to get, and he is also accessible on the Cyberknife web site, and his feedback re my case was very positive. So, I figured I'd just go to him rather than try to interview everyone else on the east coast.

Probably is farther to go than it needs to be, but I was satisfied with his credentials and setting things up with his office was easy. So, that is what I decided to do.

Mac

You are probably already aware of this but Dr. Allen Katz is a regular poster on

cyberkife.com

If I recall Tall Allen's handle there is AllenE.

I have not gone there lately but found it a valuable resource when I was considering the first cousin of Cyberknife, SBRT last Fall.