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Cyberknife - possible option ?

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User
Posted 29 Dec 2022 at 17:21

I am due to meet with an Urology MDT Consultant on Thursday 5 January 2023 to learn the results of the  transperineal biopsy that was completed on 24 November. After an earlier biopsy, in June 2020, I received a letter advising me that 'no cancer had been found'. I am both anticipating, & hoping for, a positive result this time in order that whatever treatment may be necessary can be completed & my life return to something that is more like 'normal' !


I have spent much of the holiday period researching treatment options. I am 75, which as I understand it, rules out surgery & I have a large prostate which, I believe, rules out brachytherapy. I assume that I would follow a HT / RT 'route'. We live 16+ miles from what would usually be my treatment centre - my wife does not drive & our nearest family member is close to 100 miles away.


Cyberknife, looks to be a possible treatment option, from the little that I have read, although I understand that it is not widely available with only limited access under the NHS. I would appreciate guidance as to the appropriateness of Cyberknife together with thoughts as to the best way of accessing this treatment ideally through the NHS, although I accept that if it 'ticks all the right boxes' it may be worthwhile exploring the cost & availability of private treatment if necessary.


Thanks


 

User
Posted 30 Dec 2022 at 00:20

Well we won't know the diagnosis till you get it. I believe a life expectancy of 10 years is the tipping point for surgery, and 85 is the usual life expectancy of a male. So 75 tends to be the cut off for surgery. If you are incredibly healthy you may be able to push for surgery and if you are not at least reasonably healthy you probably should not have surgery.


My prostate was 57cc which is large and I had brachy (HDR) so that depends how large yours is. 


35 sessions of EBRT is a lot of driving. I had 15 sessions, but I was 54 and had a motorbike. You could almost certainly access hospital transport, but I would guess that involves sitting on a minibus going around the houses for a few hours.


There are definitely EBRT treatments now with as few as six treatments twice a week. I have heard the name cyberknife, I think it is a brand name of one of these very high dose very few session treatments.


I think you need a diagnosis, then hear all the options on offer, and if you don't like them ask why the others are ruled out. If something is ruled out for a clinical reason then at least you can cross it off your list.


I consider myself lucky that most things were ruled off my list so I only had one treatment path and no choices to make.


 

Dave

User
Posted 30 Dec 2022 at 01:45
Should it be found that you would benefit from radical treatment, Prostatectomy might still be an option if you meet the medical criteria although this might be restricted to 'open' rather than robotic surgery.

Cyberknife is just another form of RT albeit more precise and this may not be best in your case if you need RT..

You have yet to be diagnosed with Prostate Cancer and following a PCa diagnosis, it is usual for a patient to be told options he is suitable for and given some time to think about these before making a treatment decision. As you have already been looking at various forms of treatment, you have the possibility of asking your Consultant about an aspect of concern on the options offered.
Barry
User
Posted 30 Dec 2022 at 06:10

Once you have your diagnosis, post again with the results.   My husband had Cyberknife and I will be pleased to fill you in with the details if it is found you need treatment.


 


 

User
Posted 30 Dec 2022 at 09:03
Just to add that there shouldn't be any particular medical reason why you wouldn't be able to drive to a daily RT session. I had a 90-mile daily round trip for mine and, other than needing a midway loo stop towards the end of treatment (a convenient McDonald's) there was no problem. RT doesn't usually make someone feel unwell.

Best wishes,

Chris
User
Posted 30 Dec 2022 at 13:57

I was able to catch two buses from where I was based for a 45 minute journey and stopping off at transfer for the loo on my way for RT. I think it was more the frequency of getting up at night which peaked at 8 times that made me tired to the extent that I catnapped and was glad I didn't have to drive during this period of the treatment. So I think it was this rather than the RT that caused excessive tiredness. Outside the period of excessive urinary frequency and consequential tiredness, I would have been happy to drive. Some men are not greatly affected in this way but you can't be sure until the event.

Edited by member 30 Dec 2022 at 14:16  | Reason: spelling

Barry
User
Posted 01 Jan 2023 at 14:16

Cyberknife is a particular branded piece if kit for delivering SABR (or SBRT, same thing). It also has the ability to track moving tumors (e.g. while breathing) which is not so relevant for the prostate. Newer LINACs (the machines which deliver standard radiotherapy) can and are being used to do prostate SABR treatments now in typically 5 sessions in many centres.


Obviously, it depends on your diagnosis if it's a suitable treatment or not.

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User
Posted 30 Dec 2022 at 00:20

Well we won't know the diagnosis till you get it. I believe a life expectancy of 10 years is the tipping point for surgery, and 85 is the usual life expectancy of a male. So 75 tends to be the cut off for surgery. If you are incredibly healthy you may be able to push for surgery and if you are not at least reasonably healthy you probably should not have surgery.


My prostate was 57cc which is large and I had brachy (HDR) so that depends how large yours is. 


35 sessions of EBRT is a lot of driving. I had 15 sessions, but I was 54 and had a motorbike. You could almost certainly access hospital transport, but I would guess that involves sitting on a minibus going around the houses for a few hours.


There are definitely EBRT treatments now with as few as six treatments twice a week. I have heard the name cyberknife, I think it is a brand name of one of these very high dose very few session treatments.


I think you need a diagnosis, then hear all the options on offer, and if you don't like them ask why the others are ruled out. If something is ruled out for a clinical reason then at least you can cross it off your list.


I consider myself lucky that most things were ruled off my list so I only had one treatment path and no choices to make.


 

Dave

User
Posted 30 Dec 2022 at 01:45
Should it be found that you would benefit from radical treatment, Prostatectomy might still be an option if you meet the medical criteria although this might be restricted to 'open' rather than robotic surgery.

Cyberknife is just another form of RT albeit more precise and this may not be best in your case if you need RT..

You have yet to be diagnosed with Prostate Cancer and following a PCa diagnosis, it is usual for a patient to be told options he is suitable for and given some time to think about these before making a treatment decision. As you have already been looking at various forms of treatment, you have the possibility of asking your Consultant about an aspect of concern on the options offered.
Barry
User
Posted 30 Dec 2022 at 06:10

Once you have your diagnosis, post again with the results.   My husband had Cyberknife and I will be pleased to fill you in with the details if it is found you need treatment.


 


 

User
Posted 30 Dec 2022 at 09:03
Just to add that there shouldn't be any particular medical reason why you wouldn't be able to drive to a daily RT session. I had a 90-mile daily round trip for mine and, other than needing a midway loo stop towards the end of treatment (a convenient McDonald's) there was no problem. RT doesn't usually make someone feel unwell.

Best wishes,

Chris
User
Posted 30 Dec 2022 at 13:57

I was able to catch two buses from where I was based for a 45 minute journey and stopping off at transfer for the loo on my way for RT. I think it was more the frequency of getting up at night which peaked at 8 times that made me tired to the extent that I catnapped and was glad I didn't have to drive during this period of the treatment. So I think it was this rather than the RT that caused excessive tiredness. Outside the period of excessive urinary frequency and consequential tiredness, I would have been happy to drive. Some men are not greatly affected in this way but you can't be sure until the event.

Edited by member 30 Dec 2022 at 14:16  | Reason: spelling

Barry
User
Posted 01 Jan 2023 at 14:16

Cyberknife is a particular branded piece if kit for delivering SABR (or SBRT, same thing). It also has the ability to track moving tumors (e.g. while breathing) which is not so relevant for the prostate. Newer LINACs (the machines which deliver standard radiotherapy) can and are being used to do prostate SABR treatments now in typically 5 sessions in many centres.


Obviously, it depends on your diagnosis if it's a suitable treatment or not.

 
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