Cyberknife

Is this something I can consider? How do I find out about it? Has anyone had it?

Better than surgery?

I am diagnosed with a Gleason 7 (4+3)
DRE is good.
PSA 7.5

SBRT seems to be coming of age as a good option. Several guys on the forum have had good results with it. If I had the option to do it again, I would give serious consideration for it as my treatment.

Better than surgery? There is no simple answer to that question.

Basically Cyberknife/SBRT is external beam radiation treatment. Traditional external beam radiation uses many fractions (daily doses) of very low amounts of radiation. Anywhere from 25-45 doses for prostate cancer. Cyberknife/SBRT elevates the radiation level and delivers it in 5 or 6 fractions/doses. So you can do in a week what otherwise would take 2-3 months of daily treatment to accomplish.

Another form of radiation is brachytherapy. In this form the radiation is inserted into the prostate. There are two forms; one is permanent seeds and the other is High Dose Rate that does not leave the radiation in you. Permanent seeds deliver a low constant dose over a long period of 6-9 months, similar to traditional external beam. The HDR brachytherapy delivers all the radiation in a period of 15-30 minutes at a higher level, similar to SBRT/Cyberknife. Actually SBRT/Cyberknife for prostate cancer was developed based on HDRBT.

Radiation versus surgery? Which is better? For most men they deliver comparable cancer control. Studies show that for most men the negative side effects from treatment are worse for surgery than radiation. Surgery is inherently more physically damaging due to the cutting, scarring and anatomical changes that result from the surgery. The expected side effects from any treatment must be seriously considered.

We suggest that you meet with surgeons and different radiation oncologists for separate independent assessments by the specific specialists to gather the information in order to make your treatment decision. Do not let a surgeon tell you about radiation, nor the opposite. Get the information from the specific specialist. When I was diagnosed I saw three surgeons and two radiation oncologists in a three week period. Based on that I made treatment decisions that have worked wonderfully without any second thoughts or regrets.

I think it's definitely a treatment worth exploring, along with surgery and brachytherapy.

I'm one of the guys who had CyberKnife treatment. I was diagnosed at G3+4=7, no other issues, so I was favorable intermediate risk PCa. When I had treatment, in November, 2016, most SBRT practitioners were offering SBRT to favorable intermediate risk men, but were only treating unfavorable intermediate risk men if they were part of a trial/study. My RO, Dr. Arica Hirsch at Lutheran General Hospital near Chicago, had such a trial. We joked about whether she should enroll me in the trial, but with my 3+4, low PSA and low % involvement, we decided that it would be unfair to do so.

If you are considering any form of radiation treatment (and early in your research, I think you should think about all treatment modes that may be applicable), do give it a look. Much less disruption of your life, and results are gratifying all around.

I have had PC since mid 2015 and am on AS up to the present time. My PSA finally went above 10 in December and my Urol is now recommending i start EBRT .I have had 2 random biopsies..2015 and 2016 ..and annual Multiparametric MRIs each December since the biopsies.I am 79 years old and have other somewhat serious medical conditions so i may end up declining any treatment of my PC,however, i want to be prepared for the treatment i would choose if i decide to go that route.I am looking for a new Urologist who performs fusion targeted biopsies , and a Rad Onc who specializes in SBRT...in the greater Atlanta area , other than Emory Winship where i have been going for 3 years. If anyone on this forum can provide me with recommendations for specific doctors or Oncology Groups i would appreciate it.

bearcatjer...one of our most knowledgable posters is JNF and he's in the Atlanta area and is familiar with the ROs in that area. Hopefully, he'll see your post, but if not you should be able to reach out directly to him by searching for his name and clicking on it, which will take you to his e-mail.