CyberKnife® Treatment Option Brings New Hope for Prostate Cancer Patients

According to the American Cancer Society, one in seven men will be diagnosed with prostate cancer within their lifetime - and of those cases, one in 39 will prove to be fatal. However, with early detection, prostate cancer is very treatable, with both surgical and nonsurgical interventions.

And one of the most promising nonsurgical treatments emerging as a new option for prostate cancer patients  is called CyberKnife®. This treatment uses targeted beams of radiation to the prostate, sparing the surrounding healthy tissue - including critical structures like the bladder and rectum.

But how does CyberKnife® benefit our patients?

Fewer Treatments and Side Effects with CyberKnife®

The MedStar Georgetown Cancer Institute was the first in the mid-Atlantic region to offer CyberKnife®, and is one of the most experienced in the world to use this technology. And Sean Collins, MD, a radiation oncologist who is a leading expert in the procedure, says one of the most significant benefits of CyberKnife® is the reduced number of treatments required.

“For many men, the CyberKnife® requires only five treatments instead of the standard course of radiation therapy that generally requires up to 40 treatments and lasts eight to nine weeks,” says Dr. Collins.

He also notes that side effects are similar to those a patient might experience with traditional radiation therapy, such as bladder and bowel urgency, impotence and rectal bleeding. “However, we know that quality of life is a big issue for prostate cancer patients, and with the CyberKnife®, we typically have fewer side effects—both short and long term.”

“I even hit golf balls in the days between my treatments,” said Neal Bobys, 68, who was the 1,000th CyberKnife® under. Dr. Collins. “I’ve had no pain from the treatment at all. Nothing about my daily life has changed because I have prostate cancer. I now look forward to getting on with my active life and improving my golf game.”

CyberKnife® vs. Traditional Radiation Therapy

In your body, prostates move and adjust with rectal and bladder filling. To account for this range of motion, conventional radiation therapy requires the use of large treatment margins. To protect the adjacent bladder and rectum, this treatment for prostate cancer is given five days per week over eight weeks.

CyberKnife® is unique in that it tracts prostate motion and adjust for it allowing for smaller treatment margins. It’s also more precise, given that it can deliver the required amount of radiation from hundreds of directions.

“Another benefit to CyberKnife® is that studies show that higher doses of radiation decrease the risk of the prostate cancer coming back.”

In fact, a recent study of CyberKnife® - in which the MedStar Georgetown University Hospital was one of over 20 participating centers - has shown promising results over longer periods of time, with high rates of biochemical control and low high-grade toxicity. In addition, it's proven as highly convenient for patients.

"But the important thing about this study is that the patients are actually followed for five years," says Dr. Collins. "And in that timeframe, we still see a very low rate of late toxicity with adequate follow-up. For our patients, that means, instead of going for eight weeks of daily radiation an hour a day, Monday through Friday, you can actually get your treatment done in five treatments over one to two weeks."

You Need a Team in Your Corner

CyberKnife® is a new chapter of hope for prostate cancer patients - because it doesn’t matter if you have a new, early-stage diagnosis, have already undergone radiation therapy or are too frail for surgery. CyberKnife® is an option worth exploring.

We are here to help.

If you have questions about the MedStar Georgetown Cancer Institute or are ready to schedule a consultation with one of our specialists, call us at 202-295-0513 or click the request a consultation button.

Prostate Cancer Treatments and Emerging Therapies

When men are diagnosed with prostate cancer, their first question is usually, “Can it be cured?” Often, their second question is, “What are my treatment options?”

Fortunately, research, diagnosis and treatment of prostate cancer has advanced significantly. Many treatments for prostate cancer are considered safe and effective; even so, it’s important to discuss your treatment options with your doctor or specialist(s), so you can understand the process and side effects.

Discussing Treatments

When you begin your exploration of prostate cancer treatments, you should think of your urologist as your team leader. Ask him or her for the names of two or three other prostate cancer experts you can speak to, including a medical oncologist, a radiation oncologist and another urologist.

Ask your doctor the following questions:

  • Whom would you depend on for your own diagnosis and treatment?
  • Whom would you want a family member to visit if they were diagnosed with prostate cancer?

When you discuss your cancer with a professional, it helps to bring along a significant other or friend who might be willing to raise topics that you feel uncomfortable bringing up; and may absorb information from the conversation that you don’t yet understand.

Seeking a Specialist

After you've gathered diagnosis and treatment advice from more than one source, it's time to find a provider. Keep in mind that it's best to prioritize your search by looking for a recommended expert or well-established practice rather than for a specific therapy. 

For instance, it's not a good idea to focus your search based on the procedure such as transoral robotic surgery (TORS) for prostatectomy and then hoping the surgeon will meet your needs.  Instead, search for an outstanding specialist and allow that person to help you decide which form of therapy is best for you. Also consider a multidisciplinary medical team with proven expertise in prostate cancer care. Experience is crucial to successful remission of the disease.

Traditional vs. Cutting-Edge Therapies

The vast majority of prostate cancer cells present as localized areas of disease. Standard treatments for localized cancers are radiation and surgery. For metastatic or recurrent prostate cancers, hormone therapy has become a common treatment option. 

As research advances, new and promising forms of prostate cancer treatments are becoming available. One of the most exciting innovations is molecular analysis of DNA abnormalities; in particular, researchers are investigating DNA repair genes, mutated androgen receptors and ways to tailor hormone and chemotherapies to address specific molecular defects. 

Molecular analysis can help doctors and specialists decide which specific cancer therapies will be ideal for individual patients. Additionally, these tests can indicate the best time to initiate or end a treatment based on the reaction of genes found on cancerous tumors.  Ideally, scientists will use molecular analysis to develop inhibitors that prevent the cellular abnormalities that can lead to prostate cancer. Other innovations include turning to chemotherapy early in the treatment schedule as well as utilizing vaccines to combat the growth of tumors.

When the Best Treatment Is No Treatment

New urine and blood tests may be able to calculate a prostate cancer patient's risk of spreading. If your prostate cancer is not aggressive and unlikely to spread, you and your doctor might want to discuss simply monitor your health over time - a course of action called "active surveillance."  Active surveillance might include regular biopsies and other tests, but not necessarily treatment. When your best treatment is no treatment, you can avoid unnecessary, expensive therapies and possible side effects.

Final Thought

If you face a prostate cancer diagnosis, know that you have a variety of treatment options available to you and that innovative options are possible. With the guidance of experienced medical professionals and your loved ones at your side, you can find a treatment that is right for you to help you continue living an active, healthy life.

We are here to help.

If you have questions about the MedStar Georgetown Cancer Institute or are ready to schedule a consultation with one of our specialists, call us at 202-295-0513 or click the request a consultation button.

Benefits of Robotic Prostate Cancer Surgery

After the initial shock of finding out that you have prostate cancer, you will probably think of multiple questions for the surgeon. A question we are frequently asked is whether surgery is the only course of action.

When surgery becomes the best option for removing prostate tumors, the next question typically is whether robotic prostate cancer surgery is an option what the risks are, and how long the recovery takes.

Robotic surgery is an innovative technique that can minimize bleeding, risk of infection and damage to surrounding tissues. Educating yourself about the benefits of robotic surgery may help allay your fears of the procedure, thereby reducing stress and worry, and enabling you to have a more positive treatment outcome.

The Risks of Traditional Prostate Surgery

The prostate gland is located in the deepest part of the male’s pelvis. This area is full of blood vessels and nerve structures that control sexual function. The prostate gland is also adjacent to the urinary sphincter, which controls urinary function. During traditional prostate tumor removal surgery, it can be difficult to identify the adjacent muscles, veins and nerves that tightly surround the prostate gland.

If these tissues, muscles or the sphincter are inadvertently damaged during surgery, it is likely that the patient will suffer from urinary incontinence or erectile dysfunction.

Robotic Prostate Cancer Surgery: Who Is a Candidate?

Robotic surgery uses tiny tools that can fit into a laparoscopic incision that is much smaller than the incision required for traditional procedures. The result is reduced ancillary damage to surrounding muscles and tissues, less bleeding, less chance of infection and a shortened recovery period. In fact, while recovery time from traditional surgery might require six to eight weeks, typically times with robotic surgery are about three weeks.

Not everyone is a candidate for robotic surgery. In fact, if you are like two out of three men diagnosed with slow-growing prostate cancer, you may not need surgery at all.

Factors that indicate viability for robotic prostate cancer surgery include:

  • Being sexually active
  • Having normal urinary function
  • A life expectancy of 15 years or more.

Necessary Testing Before the Robotic Surgery

Your doctor will order a 3D MRI that uses the latest technology to identify the prostate gland, urinary sphincter, various nerves and blood vessels that surround the prostate gland. The MRI will provide an accurate view – or map – of the area in order to minimize collateral damage to surrounding tissues.

Doing Your Own Research

Your doctor can provide you with a name of a well-respected surgeon. Look for a surgeon with extensive experience in robotic surgeries and narrow your list to doctors affiliated with facilities that can prove consistent positive robotic surgery outcomes. Ask for data that specifically focuses on the facility’s success with this type of surgery. Most reputable facilities are happy to share this information with potential patients.

If, after your initial visit with the surgeon, you are still undecided about going ahead with the procedure, ask him or her for names of patients who have undergone this type of surgery and who have agreed to answer other surgical candidates’ questions. Being able to talk frankly with other men who have experienced the surgery might help to calm your fears.

Recovery From Robotic Surgery

Some types of slow-growing prostate tumors don’t require surgery at all. Instead, your doctors and specialists can actively observe them during regularly scheduled checkups. Other types of aggressive tumors may require traditional surgery. If your prostate cancer diagnosis and treatment protocol includes surgery, ask your surgeon if you are a candidate for robotic surgery.

In fact, if your prostate cancer is aggressive and threatens to spread to nearby organs or tissues, robotic surgery may be the best choice for you. The advantages of robotic surgery are many, including faster recovery and less downtime.

No one wants to have surgery, but take comfort in knowing that the latest technology enables you to have a shorter recovery time and less chance of potential side effects of the surgery.

We are here to help.

If you have questions about the MedStar Georgetown Cancer Institute or are ready to schedule a consultation with one of our specialists, call us at 202-295-0513 or click the request a consultation button.

How to Choose the Right Prostate Surgeon

If you have been diagnosed with prostate cancer, surgery might be the best treatment for you, especially in younger men less than 65 years old who have higher risk disease and overall good health. But, before you undergo an operation, you need to feel confident that you are using a surgeon you can trust.

Read on to learn what factors you should consider, as well as what you should avoid, when choosing the right prostate surgeon.

Factors You Should Consider

When it comes to choosing a prostate surgeon, experience is the primary concern. While there is no "magic number" of years a doctor needs to have practiced necessarily, one who has performed prostate surgery hundreds of times is better able to put your mind at ease than someone who does not perform prostate cancer surgery very often. A doctor who has had extra fellowship training focusing on prostate cancer treatment is beneficial, too.

Additionally, a multidisciplinary team can help you get the best treatment. Since the decision between surgery and radiation is not always black and white for patients, the surgeon you choose should offer a consultation with a radiation oncologist to determine if radiation is the better option.

Red Flags to Avoid

First and foremost, avoid a surgeon who seems to push or market the surgery they offer. Also, if they say they can do the surgery tomorrow or next week, it’s probably because they are not very busy and don’t do many surgeries.

It is always wise to ask the doctor about patient outcomes. If the surgeon cannot answer or doesn’t know, this is a concern. It indicates that they do not engage with patients enough during their journey beyond treatment, and are not following their own outcomes. In short, these surgeons simply can’t know what they don’t know. Similarly, if you meet with a doctor who quotes outcomes that seem too good to be true, they probably are.

For example, if a surgeon claims that 95 percent of all patients have no trouble with erectile function after surgery, he is probably not giving you an honest or realistic picture of typical outcomes, or outcomes specific to your condition. They may only be considering young men with low-risk disease and good preoperative erectile function, who also have bilateral nerve sparing to preserve erections.

These patients realistically only consist of about half of men seeking treatment.

Why Your Prostate Surgeon Choice Matters

Prostate cancer surgery is not a procedure that can be done well by just any surgeon, especially when it comes to preserving your long-term health. Nearly any urologist can remove the prostate safely, but there may be side effects that reduce quality of life in the long run. For example, surgery can not only affect erectile function, but it can also disturb urinary function, depending on the surgeon’s skill.

So don't let the pressure of a prostate cancer diagnosis rush you through this decision-making process; take your time and make the right choice. See as many practitioners as you can to explore all of your treatment options and gather as much information as possible before you get prostate cancer treatment.

Also, remember that there is a lot of misinformation about prostate cancer out there. For example, a common misconception heard in our clinics is: “I didn’t think prostate cancer could kill me."

This is simply not true, as it remains the second leading cause of cancer death in men. It is, however, generally slow-growing if caught in time. So there is time to make the correct decision for you, which may even be no treatment at all.

While prostate cancers may be slow-growing — which is why you don’t need to make a treatment decision in one day — avoiding treatment altogether is not recommended without expert guidance and input from a trained doctor or surgeon. At the same time, some low-risk cases require no treatment at all. So do your research and be mindful of your choice in prostate surgeon, and you'll increase your chances of positive outcomes.

We are here to help.

If you have questions about the MedStar Georgetown Cancer Institute or are ready to schedule a consultation with one of our specialists, call us at 202-295-0513 or click the request a consultation button.