Cuts Like a Cyberknife: New Surgical Technique for Prostate Cancer

CyberKnife is a newer technology that allows noninvasive treatment of prostate cancer.

Treatment planning involves MRI and CT imaging that are fused into a single image, with radiation oncologist and surgeon collaborating to contour the prostate and surrounding structures.

Dose planning aims to deliver tumoricidal dose to the prostate while protecting the rectum, bladder, and nerves controlling erections from high doses.

The CyberKnife robotic arm moves approximately 360 degrees around the patient, delivering one beam of radiation from hundreds of different locations.

Each individual beam is a very low dose, causing minimal side effects or damage to tissue it traverses, but the beams converge at the prostate focal point to destroy cancer.

Initial CyberKnife treatment schedule was five consecutive days (Monday through Friday).

Initial data on CyberKnife showed that treating patients in five fractions every other day (Monday, Wednesday, Friday, following Monday, Wednesday) may result in slightly fewer side effects than consecutive daily treatment.

At this institution, treated patients are monitored with PSA and have shown a nice drop-off in PSA over the years, indicating cancer cure.

Monitoring of urinary side effects and erectile dysfunction in this cohort has found very minimal side effects in the majority of patients.

The overall cost of CyberKnife treatment is slightly less than some other treatments because of the shorter treatment period.

CyberKnife treatment is covered by most insurance companies.

Patients are pre-screened to ensure insurance coverage will not be a problem before CyberKnife is offered.

Patients should ask their physician about experience (number of patients treated, duration of practice), treatment approach, follow-up plan, expected side effects and their management, and establish a working relationship.