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What side effects, if any, did you have with Cyberknife?

Posted by jaygk @jaygk, May 4, 2025

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. .

Interested in more discussions like this? Go to the Prostate Cancer Support Group.

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odie10 | @odie10 | May 19 11:11am

I had cyberknife x 5 treatments to Pubis bone and ribs. I've watched three friends do longer, more traditional radiation for their cancer locations. I wouldn't say it was easy, having had severe headaches most every afternoon, exhaustion, and some diarrhea, but I'd do it again over all the driving and time my pals went through if it had been an option for me. "Cremated". I hadn't heard that word used, but I like it. Best of luck to you.

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alangjonesrs999 | @alangjonesrs999 | May 20 6:49am
In reply to @icorps "My experience with SBRT post prostatectomy has been very good. As I understand it, SBRT is..." + (show)
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My experience with SBRT post prostatectomy has been very good. As I understand it, SBRT is being recommended as your first treatment.
The treatment seems to be improving with the wider use of PSMA PET, which can detect more micrometasis deposits. They can see more cancer at lower levels and can target it with SBRT.
Also, it's not clear whether your cancer is still organ confined. If it is, then SBRT, is still a good choice. If it's treated within the prostate itself, you'll be monitored to see if any has gotten out. If it has, SBRT may be a good therapy for that too.
Prostactomies are becoming increasingly safer and thorough.
But there are still risks of losing erectile function etc. And it's surgery after all.
But also, a prostatectomy may be a back up to the SBRT.
If SBRT doesn't work, prostatectomy may be good follow on.
Talk to your docs, and check the issue out by using AI on the internet. Just pose the question.
Good luck.

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@icorps . Be careful, once you have had High dose radiotherapy your anatomy will be messed up and could be a problem for any surgery. If anything, have surgery first then Cyberknife. I am a retired Trauma Surgeon.

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Jeff Marchi | @jeffmarc | May 20 10:50am
In reply to @alangjonesrs999 "@icorps . Be careful, once you have had High dose radiotherapy your anatomy will be messed..." + (show)
Profile picture for alangjonesrs999 @alangjonesrs999

@icorps . Be careful, once you have had High dose radiotherapy your anatomy will be messed up and could be a problem for any surgery. If anything, have surgery first then Cyberknife. I am a retired Trauma Surgeon.

Jump to this post

@alangjonesrs999

Here is an interesting article that discusses treatment after reoccurrence following Radiation, Where the recurrence occurred in the remaining prostate tissue. Surgery after radiation does cause some serious incontinence and ED issues, as if there were already enough.

People who have radiation as their primary treatment have been told by doctors that surgery isn’t really an option if there’s a reoccurrence. Other options are not really mentioned..

This study shows that both salvage focal therapy (HIFU and cryotherapy) and salvage surgery were equally effective at extending the life of a patient that started off with radiation.

Those that had focal therapy had fewer perioperative complications.
https://jamanetwork.com/journals/jamaoncology/article-abstract/2844900

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jaygk | @jaygk | May 20 12:11pm
In reply to @jeffmarc "@alangjonesrs999 Here is an interesting article that discusses treatment after reoccurrence following Radiation, Where the recurrence..." + (show)
Profile picture for Jeff Marchi @jeffmarc

@alangjonesrs999

Here is an interesting article that discusses treatment after reoccurrence following Radiation, Where the recurrence occurred in the remaining prostate tissue. Surgery after radiation does cause some serious incontinence and ED issues, as if there were already enough.

People who have radiation as their primary treatment have been told by doctors that surgery isn’t really an option if there’s a reoccurrence. Other options are not really mentioned..

This study shows that both salvage focal therapy (HIFU and cryotherapy) and salvage surgery were equally effective at extending the life of a patient that started off with radiation.

Those that had focal therapy had fewer perioperative complications.
https://jamanetwork.com/journals/jamaoncology/article-abstract/2844900

Jump to this post

@jeffmarc jeff thanks.

one thing my radiologist oncologist mentioned for
his experience…..was that if the cancer comes back after radiation, it is usually not in the prostate itself but in surrounding areas?

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brianjarvis | @brianjarvis | May 23 11:28am
In reply to @jaygk "@jeffmarc jeff thanks. one thing my radiologist oncologist mentioned for his experience…..was that if the cancer..." + (show)
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@jeffmarc jeff thanks.

one thing my radiologist oncologist mentioned for
his experience…..was that if the cancer comes back after radiation, it is usually not in the prostate itself but in surrounding areas?

Jump to this post

@jaygk In Dr. Kwon’s presentation about recurrence: https://youtu.be/Q2joD360_pI), he mentions that for patients who had primary surgery, if there is recurrence:
> 33% of the time it’s local to the pelvis;
> 45% of the time it’s distant from the pelvis;
> 22% of the time it’s both local and distant.

He also mentions that for patients who had primary radiation, if there is recurrence:
> 55% of the time it’s local to the prostate.

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