Johns Hopkins Health Alert
Talking About CyberKnife
Recently a subscriber to the Johns Hopkins Prostate Bulletin asked: "I am 63 years old and I was diagnosed last week with prostate cancer (4.7 ng/dL PSA; Gleason 7). I have begun my due diligence to find an appropriate therapy. My doctor recommends radical prostatectomy surgery, but I have now read a lot about a treatment called CyberKnife. What are your thoughts about this prostate cancer therapy?" Since many of you are interested in learning about prostate cancer treatments, we thought we'd share our reply.
CyberKnife is a type of conformal beam radiotherapy that uses implanted "seeds" in the prostate to guide and adjust the accuracy of the beam in real time during surgery. The expectation is that this will improve precision in beam delivery due to small adjustments and changes in position during treatment, and can allow for a greater, more accurate concentration of the beam to the prostate than might be available by other methods.
Like many new forms of treatment, this therapy raises expectations that prostate cancer outcomes will be improved and complications will be reduced, but this has yet to be determined. The CyberKnife hasn't been around long enough for its effectiveness in prostate cancer treatment to be confirmed.
Like brachytherapy (seed radiation implants), CyberKnife relies in part for its accuracy of radiation delivery on target seeds that are placed by hand into the prostate, using needles and guidance systems. Conventional external beam radiotherapy relies only on CT-guided images for accuracy. The need to place seeds by hand into the prostate introduces a potential for error that is dependent on the experience and skill of the person placing the seeds.
In general, it takes a long time to prove the value of any new technology in medical care, but the public -- and many members of the medical profession -- are often quick to embrace new technology and make bold claims for its effectiveness.
Posted in Prostate Disorders on September 1, 2010
Reviewed June 2011
Medical Disclaimer: This information is not intended to substitute for the advice of a physician. Click here for additional information: Johns Hopkins Health Alerts Disclaimer
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The physician "experience and skill" needed for Cyberknife treatment is in the definition of the target organ, not the seed placement. Correct seed placement is critical for brachytherapy. Fiducials(seeds)used for Image Modulated Radiation Therapy (IMRT) and Cyberknife treatments are markers for spatial orientation. As long as they are near the target organ and can be identified by the treating software program they serve their purpose. Fiducial placement should not be a factor when considering Cyberknife radiosurgery or IMRT. Both are highly accurate in delivering radiation dosages.
Posted by: tsmd | September 4, 2010 8:55 AM
Greetings,
I was diagnosed on 5-5-2010. I am now doing Active Surveillance. I know that JH did some research years ago on the use of Noscapine for the treatment of cancer. Apparently, it affects the cancer cells ability to grow. This may be a very simple condensation of the information. What does JH think of this treatment today? I know that the drug companies can't make much money on it since it is long out of the patent status.
Thanks for your help!
Tex
Posted by: Texan | September 4, 2010 10:49 AM
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Before you have surgery, there is a new method of treatment and it is called Proton Therpy Treatment. Check it out.
www.proton-therapy.org/howit.htm - Cached
It does not make you sick and it only takes about 1 hr and then you can go play golf or whatever you want to do. It is highly effective.
Prostate PSA was 17 now it is .001 after 3 years from the proton treatment.
Good luck.
Posted by: jyw1221 | September 4, 2010 8:23 AM