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Cyberknife side effects.
Considering SBRT Cyberknife. Local Urology group has performed 4,000+ over last 10 years.
I am 65 I have T1c with all 12 cores positive (this seems unusual based on others I have followed). 11 (3 + 3) and 1 (3 + 4) with only < 5% a 4. No cribform or perinureal invasion. Had a CT and MRI. No cancer spread. Had second opinion and not recommended to active surveillance.
ED (only married 5 years )and leaking are important to me. Also worried about radiation bleed over to the rectum
What have been your experience with Cyberknife side effects. They would use the space OAR and 5 treatments. Very skilled radiologist
Any other recommendations for my type of cancer.
Having trouble deciding on treatment. I have been told it’s like pick your poison. .
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Actually, my situation was a little more involved.
Having first heard about PSA testing when I was 40y (in 1995), I started having PSA tests as part of my annual health checkups when I was 45y, and watched my PSA slowly rise each year (1.30, 1.64, 1.79, 1.87, 2.10, 2.60, 2.70, 3.40, 4.00 & 4.20). So, it wasn’t a big shock to me in April 2012 (at 56y), that my urologist told me that my “blind” biopsy showed low-grade, localized prostate cancer: Gleason 6(3+3); an independent second opinion confirmed this.
But, since it was only a 3+3, there was no need to panic or rush to a hasty treatment decision; I had time on my side. (Note that this was well before the availability of PSMA PET scans, and PET CT scans were generally not approved for initial diagnosis. So, we were reliant on MRI, CT, and bone scan results for any indications of metastasis.)
With no medically-necessary reason to treat (and after a thorough evaluation of the data and literature), I chose AS. I was on AS for about 9 years, not only tracking PSA (every 4-7 months) and biopsy (about every 2-1/4 years), we also regularly calculated the lesser-tracked numbers (% Free PSA, PSA Doubling Time, and PSA Density), as well as obtained OncotypeDx and Prolaris biomarker (genomic) test results in order to keep my AS truly “active.”
After about 9 years on AS, my Gleason reached 7(3+4), PSA reached 7.976, and a Prolaris biomarker test indicated that I had “exceeded the threshold for active surveillance.” That was my cue to leave AS and seek active treatment.
I ultimately chose 28 sessions of proton radiation + SpaceOAR Vue. Prior to starting treatment, a 2nd opinion increased the Gleason to 7(4+3), so we added 6 months (two 3-month injections) of Eligard.
I’ve had minimal adverse quality-of-life side-effects, which was my intent with my initial choice of AS and then proton radiation treatments. Now at 4 years post-treatment, PSA hovers between 0.35-0.55. My most recent PSA test (2-1/2 months ago) was 0.478; not bad for still having a prostate.
Today, it’s as if nothing ever happened - just walked through a door, got treated (28x), and then walked out the door…..it’s practically back to the way it was before the prostate cancer journey started.
Brian. Thanks. I think the only issues I may have against AS is all 12 cores positive. I think the other things you listed are N/A for me.
May request a decipher test and or PET scan. And possibly second opinion on slides. All less trouble than possible treatment side effects
Yes, a biomarker (genomic) test (like Decipher) and a 2nd opinion on the biopsy slides are good ideas.
A PSMA PET scan may not be approved given a 3+4=7 (and the low risk of metastasis). Never hurts to ask….