Who Is A Candidate For Treatment
Cyberknife is typically used for patients with:
- Early-stage disease.
- Localized disease .
- A prostate volume of less than 80-100 cm.
- A lesion or tumor that is untreatable by surgery or other radiation modalities.
Some people with enlarged prostates may be given hormone therapy to try to shrink the prostate to be able to get Cyberknife treatment. Patients who are considered high risk for spread to the lymph nodes or have cancer in the lymph nodes are not good candidates for Cyberknife.
Do We Know Which Treatment Is Best For Prostate Cancer Brachytherapy Or External Beam Radiation
Its not a question of which type of radiation therapy is best in general, but rather which therapy is best for the patients specific disease and quality-of-life concerns. We want to use the most tailored, pinpointed radiation to treat the prostate tumor effectively while minimizing side effects. This can depend on the tumors size and stage as well as other patient characteristics and even a patients individual preferences.
Stereotactic Body Radiation Therapy
This technique uses advanced image guided techniques to deliver large doses of radiation to a precise area, such as the prostate. Because there are large doses of radiation in each dose, the entire course of treatment is given over just a few days.
SBRT is often known by the names of the machines that deliver the radiation, such as Gamma KnifeÂ®, X-KnifeÂ®, CyberKnifeÂ®, and ClinacÂ®.
The main advantage of SBRT over IMRT is that the treatment takes less time . The side effects, though, are not better. In fact, some research has shown that some side effects might actually be worse with SBRT than with IMRT.
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Protecting Healthy Tissue Protecting Quality Of Life
Despite the higher dose rate associated with SBRT, multiple studies have validated that there are no worse side effects with CyberKnife SBRT than with traditional radiation.1 Unlike any other radiation treatment, the CyberKnife System continually tracks the target and automatically adapts the radiation beam for movement of the prostate in real-time throughout the entire treatment session. With this automatic motion tracking and synchronization, the CyberKnife System enhances your treatment teams ability to maximize the radiation dose delivered to the target, while minimizing dose to surrounding healthy tissues to reduce negative side-effects on urinary, bowel, and sexual function that can impact a patients quality of life. The majority of patients can continue normal activity during and immediately after treatment.
How Effective Is The Cyberknife And What Are The Possible Side
Several clinical studies have shown that CyberKnife is as effective as standard radiotherapy. CyberKnife is one of the recommended treatment options for the treatment of localised prostate cancer by the American Society of Radiation Oncology . Read the results of a study in full.
Possible side effects during treatment
Mild to moderate urinary problems and mild fatigue for 12 months about 1% of patients need catheterization for urinary retention resume normal activity immediately after treatment.
Possible long-term side effects
Despite receiving high doses of radiation, long-term urinary effects are not common and rectal injury is rare 2030% patients develop erectile dysfunction.
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Safe And Effective Prostate Cancer Treatment
Not only has the FDA-cleared the CyberKnife System, It has been used successfully to treat conditions throughout the body, including prostate tumors, but it is one of the safest cancer treatment options currently available. Despite its name , it doesnt involve any invasive surgical incisions, so the procedure is pain-free.
Plus, unlike conventional radiation therapy, CyberKnife has minimal if any side effects. Typically, treatments are completed in just one to five sessions as opposed to the numerous treatments over many weeks and months as required with conventional radiation therapy. In addition, there is no recovery time required, so you can immediately return to your normal activities once the treatment session is over.
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What Is Different About The Cyberknife
The key difference is the degree of accuracy achieved by the CyberKnife, as a result of x-rays being taken every 15 seconds. For prostate cancer patients, this is important because the prostate moves internally, even when the patient remains absolutely still.
The imaging we have from treatment so far has shown exactly how much the prostate can move without any external signs of movement, such as when gas passes through the rectum or as the bladder fills, says Dr El-Modir
When using traditional radiotherapy , oncologists plan treatments using margins of 515mm, to allow for natural movement and slight inaccuracy. The margins with CyberKnife are much smaller: just 02mm. Because of this confidence in accuracy, the CyberKnife can safely deliver much higher doses of radiotherapy in each session. This very high dose, delivered with such precision, is known medically as stereotactic therapy. With the CyberKnife the number of treatment sessions is just five, compared with 37 required for standard prostate cancer radiotherapy.
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What Does Treatment Feel Like And How Long Does It Take
Treatment is painless. You will not feel anything as the radiation is delivered. You may hear and see the CyberKnife machine moving and setting up for the next position in treatment. Relaxing is the best thing you can do, while lying still. You can bring a CD of relaxing music to listen to during your treatment.
Time of treatment will vary, depending on the area being treated. Each stage or fraction, typically lasts one hour. You may need only one fraction, while others require up to 5 fractions for most effective treatment. Your doctor will tell you how long the treatment will take.
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Radiation Therapy For Prostate Cancer
Radiation therapy uses high-energy rays or particles to kill cancer cells. Depending on the stage of the prostate cancer and other factors, radiation therapy might be used:
- As the first treatment for cancer that is still just in the prostate gland and is low grade. Cure rates for men with these types of cancers are about the same as those for men treated with radical prostatectomy.
- As part of the first treatment for cancers that have grown outside the prostate gland and into nearby tissues.
- If the cancer is not removed completely or comes back in the area of the prostate after surgery.
- If the cancer is advanced, to help keep the cancer under control for as long as possible and to help prevent or relieve symptoms.
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Cyberknife May Reduce Side Effects Of Prostate Cancer Treatment
Stereotactic body radiation therapy is a type of external beam radiation therapy in which the radiation therapy is given in five or fewer treatments. Conventional radiation treatment for prostate cancer consists of 39 to 45 treatments. With SBRT, a higher radiation dose is delivered with each treatment compared to conventional treatment.
The Power of CyberKnife
External beam radiation therapy consists of high energy X-rays delivered from a linear accelerator targeting the tumor. The CyberKnife machine at UofL Brown Cancer Center is a lightweight linear accelerator with a robotic arm that delivers radiation to the tumor precisely and accurately. Additionally, the CyberKnife can track the motion of the tumor during the treatment delivery, which allows for a higher amount of radiation to the tumor and less to the surrounding normal tissue.
CyberKnife technology can be used to treat several types of cancer while minimizing side effects for eligible patients including brain, kidney, liver, lung, ocular/orbital, prostate, pancreatic and spinal tumors, as well as metastatic cancer. It is also used to treat acoustic neuroma, arteriovenous malformation and trigeminal neuralgia. For more information about CyberKnife, visit www.louisvilleck.com.
Lets take a closer look at using CyberKnife for prostate cancer.
Prostate cancer patient eligibility
Technology to reduce side effects
PSA levels after treatment
Side effects of SBRT with CyberKnife for prostate cancer
The Prostate Moves The Cyberknife System Adapts And Synchronizes Treatment Delivery With The Motion In Real Time
The prostate gland can move unpredictably throughout the course of treatment as much as half an inch in as little as 30 seconds because of normal patient bodily functions .1 Unlike any other radiation treatment, the CyberKnife System continually tracks the target, automatically adapts and synchronizes the radiation beam with movement of the prostate in real-time throughout the entire treatment session. This helps to ensure the radiation dose is delivered to the target maximizing treatment effectiveness while protecting surrounding tissues to reduce the incidence of side effects.
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The Big 3 Benefits Of This Prostate Cancer Treatment
Most often we use CyberKnife by itself in prostate cancer treatment to treat early stage cancer that only affects the prostate and not surrounding areas. We also use CyberKnife in conjunction with other treatments such as traditional radiation when the cancer has spread beyond the prostate.
Prostate cancer patients treated with CyberKnife realize three benefits. These three benefits, in order of importance, follow.
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Indications For Cyberknife Treatment And Current Clinical Scenario
As of now the majority of Cyberknife treatment has been delivered to adult patients. Only 2 studies have reported its use in children between 5 months and 16 years.15 The majority of studies are also concentrated on palliative settings, although currently increasing interest is being focused on curative intent for early small volume disease, especially in benign conditions, AV malformations, trigeminal neuralgia, acoustic neuroma, meningiomas and pituitary adenomas.
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Cyberknife Reduces Bladder Side Effects In Prostate Cancer Patients
New data from the Prostate Advances in Comparative Evidence trial indicate that Accurays CyberKnife robotic radiotherapy platform is superior to conventional linear accelerators in reducing the incidence of late grade two or higher bladder toxicity associated with prostate cancer stereotactic body radiation therapy treatments.
The two-year follow-up data presented at the European Society for Radiotherapy and Oncology annual congress showed that bladder side effects were experienced half as often with CyberKnife SBRT as with conventional linear accelerator delivered SBRT.
This data suggest that men treated with CyberKnife SBRT are less likely to experience long-term side effects that can impact them over the course of their lives compared with men receiving conventional linear accelerator delivered SBRT.
SBRT treatments involve the delivery of very high doses of externally administered radiation over a small number of sessions, unlike conventional radiation therapy that requires substantially more treatment sessions. In the PACE trial, SBRT was delivered in five sessions, while conventional radiation therapy was delivered in 20 or 39 sessions. SBRT treatments increase patient satisfaction by reducing discomfort and scheduling inconvenience versus conventional radiation treatments and can minimize patient out-of-pocket costs.
More Than Two Decades Of Clinical Proof
The CyberKnife is commonly used for treating low- to intermediate-risk prostate cancer and is the only radiotherapy device supported by years of published clinical follow-up with a large number of patients.
SAFE AND EFFECTIVE
Prospective, multi-institutional study data supports the safety and efficacy of CyberKnife for men with low- and intermediate-risk prostate cancer.1, 2
EXCELLENT LONG-TERM OUTCOMES
Clinical studies report CyberKnife provides excellent long-term disease control for prostate patients.3, 4, 5, 6, 7, 8, 9
20,000+ PROSTATE CANCER TREATMENTS
More than 20,000 men have been treated with CyberKnife.
1 Meier. R. et al. Five-Year Outcome From a Multicenter Trial of Stereotactic Body Radiation Therapy for Low- and Intermediate-Risk Prostate Cancer. International Journal of Radiation Oncology Biology Physics, Volume 96, Issue 2, S33 S34.
2 Fuller D.B., et. al. 5-year outcomes from a prospective multi-institutional trial of heterogeneous dosing stereotactic body radiotherapy for low- and intermediate-risk prostate cancer. J Clin Oncol 35. 2017 6S 35.
3 Zelefsky M.J., Chan H et al. Long-term outcome of high dose intensity modulated radiation therapy for patients with clinically localized prostate cancer. J Urol 2006 176:1415-9.
4 Cheung R., Tucker S.L. et al. Dose-Response Characteristics of Low- and Intermediate-Risk Prostate Cancer Treated with External Beam Radiotherapy. Int J Radiat Oncol Biol Phys 2005 61: 993-1002.
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Will My Diet Affect My Treatment
Yes. Good nutrition is an important part of recovering from the side effects of radiation therapy. When you are eating well, you have the energy to do the activities you want to do, and your body is able to heal and fight infection. Most important, good nutrition can give you a sense of well-being.
Since eating when you donÃ¢t feel well can be difficult, consider working with a dietitian. They can help make sure that you are getting adequate nutrition during your radiation therapy.
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Prostate Cancer Causes & Symptoms
Unfortunately, the exact cause of prostate cancer is not always known. Some recent discoveries have linked prostate cancer to changes in DNA and also to high levels of certain male hormones.
Prostate cancer is not, however, linked to an enlarged prostate gland, a condition also called benign prostatic hyperplasia or benign prostatic hypertrophy. An enlarged prostate gland is not cancer and does not cause cancer.
The symptoms of prostate cancer are also the same type of symptoms shared by many non-cancerous conditions. Therefore, it is very important to have a doctor determine the source of the problem for men who experience changes in their urinary functions.
It is also possible to have prostate cancer and not have prostate cancer symptoms.
Prostate Cancer Symptoms may include:
- Problems with urination
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Get Your Free Prostate Cancer Guidebook
Make an informed prostate cancer treatment decision. Our 40-page, comprehensive guidebook provides answers to our most frequently asked questions from men diagnosed with prostate cancer, and compares various treatment methods, cure rates and side effects. Our team can also connect you with one of our oncologists at no cost.
Largest Prostate Sbrt Studies To Date Show Accuray Cyberknife System Provides Excellent Prostate Cancer Survival Rates In Five Or Fewer Sessions
Recently Published Data Demonstrate Benefits of CyberKnife Treatment for Both Low- and Intermediate-Risk Patients at Five Years Post-Treatment
SUNNYVALE, Calif. /PRNewswire/ — Accuray Incorporated announced today that published data from two prospective, multi-center studies using differing protocols provide consistent results and reinforce the use of the CyberKnife® System for the effective management of low- and intermediate-risk prostate cancer. These studies are the largest conducted to date evaluating stereotactic body radiation therapy in patients with localized prostate cancer. The studies were recently published online in the International Journal of Radiation Oncology*Biology*Physics and in the European Urology Oncology.
The CyberKnife System delivers radiation with sub-millimeter precision, enhancing clinicians’ ability to treat effectively while preserving healthy tissue. In addition to clinical benefits, SBRT is more convenient for patients and has been shown to be less costly than long courses of intensity-modulated radiation therapy .
Highlights of the Multi-Center Studies
Pinpoint precision results in exceptional survival rates Prostate SBRT administered by the system resulted in the following disease-free survival rates:
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Mechanism Of Radiobiological Damage
Evidence has been obtained that large radiation doses induce endothelial cell damage causing microvascular dysfunction enhancing the killing of tumour cells. The instigation of apoptosis for these cells triggers translocation of endothelial cell acid spingomylinase into the plasma membrane where it is hydrolyzed to sphingomyelin.10 This results in the generation of ceramide, which acts as a second messenger for apoptosis.
The radiobiological effectiveness of a plan is usually predicted by the Linear Quadratic model. The validity of this model to quantify the risk of late effects has been questioned as it has been derived from data acquired through in vitro cell survival assay of cancer cell lines. Therefore, this tool may overestimate the potential for cell kill, and may underestimate the in vivo risk of toxicity. Nonetheless, there is growing evidence that tumours with low alpha/beta value may actually achieve superior biological equivalent dose with hypofractionation and patients are maximally benefitted by this treatment. Carcinoma prostate and other slowly proliferating tumours such as chordomas, chondrosarcomas, meningiomas, acoustic neuroma, etc. all fall into this category. The converse is however also true regarding normal tissues which also have lower alpha/beta ratio and may manifest injury if they receive high dose per fraction.11,12
Is Prostrcision The Right Treatment For You
ProstRcisionÂ® has high documented disease-free survival rates using the strictest definition . This unique approach to eradicating prostate cancer preserves sexual function and maintains urinary control for the vast majority of men. The documented 10-year and 15-year high disease-free survival rates, combined with no cutting of the prostate and very few side effects, are why over 16,000 men from all 50 states and over 40 countries have chosen ProstRcision.
Find out more about prostate cancer treatment options, including ProstRcision, in our free prostate cancer guide booklet. Or contact our Prostate Cancer Nurse Patient Navigator to get your questions answered and to request a consultation with a radiation oncologist.
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You can eat various types of other meats. I suggest to eat chicken,turkey,& lots of fish. I buy all natural chicken, all natural turkey,& wild caught & fresh fish.
I eat as much as I want of these type meats. I never thought Id like grounded turkey. I can honestly say that a turkey burger is much better than any hamburger I ever ate. I wouldnt have thought so but it honestly is a better taste & health option.
I eat all the chicken I want. I suggest you to bake it & not fry it in oils. If you do fry then please use Extra Virgin Olive Oil. I add Mrs. Dash seasonings to all my meats. This is an all natural source for seasonings. There are many different flavors by Mrs Dash.
I also eat all the fish I want. I suggest eating salmon,flounder,tilapia,pollack,catfish,trout,& many other fish. Try to eat the oily type fish. Salmon & trout are two of the top oily fish on the market. Here too I suggest baking instead of frying.
Now, I want to move onto another area of the diet. I will be discussing the importance 0f fruits & vegetables. Fruits was definitely a foreign word to me before prostate problems. I did eat limited amounts of veggies but not enough. I made that change as well in my life. Its very important to eat fruits & veggies to have a healthy diet. Disadvantages of Cyberknife for Prostate