Men with recurrent prostate cancer after radiation still present a challenge even in 2016. It’s a
surprising fact that the vast majority of men are offered only one option-androgen deprivation therapy (ADT). ADT is a polite term for medical castration. ADT is given by injection and carries a few side effects that may have a major impact on a man’s quality-of-life. Some of the side effects include loss of sex drive, impotence, loss of muscle mass, loss of bone mass, mild increase in size and tenderness of a man’s breasts, and increased cholesterol.
In a major study, Dr. Tran found 98% of men with recurrent prostate cancer after previous radiation therapy – recurring in the prostate only and not in the bones – were offered ADT or medical castration as their only option. Dr. Tran’s study was published in 2014 in Urol Oncol. 32, 701-716.
It’s not surprising to me that all of the alternate treatments were invasive, hospital-based procedures needing anesthesia. Treatments like salvage radical prostatectomy, cryosurgery or freezing the prostate, and even re-seeding the prostate with permanent radiation implants.
Cyber Knife: Now A Proven Option
So what is Cyber Knife? Simply put, Cyber Knife is not surgery at all but a highly specialized form of radiation treatment. It’s just as effective as surgery but with no cutting or pain. In fact, it’s noninvasive and done on an outpatient basis. Cyber Knife treatment takes just 5 visits over one week. And men can drive themselves to and from the visit. Men don’t realize that the prostate is constantly moving. The Cyber Knife is the only radiation machine that has motion tracking that adjusts to this movement, allowing for highly targeted radiation beam delivery. This accuracy spares the normal surrounding tissues like bladder and rectum, virtually eliminating most side effects.
Cyber Knife treatment not only greatly improves a man’s quality of life by reducing life altering side effects, but the long term success rate is very high. Very few men had their prostate cancer return or spread to the bone.
Dr. Donald Fuller and his coworkers in San Diego treated men with locally recurrent prostate cancer with Cyber Knife. And the results were outstanding. The prostate cancer was gone in 82% of men within 2 years. The PSA levels decreased to an average of 0.16 ng/ML. And none of the men needed hormone therapy (ADT). Dr. Fuller’s study was published in late 2015 in Practical Radiation Oncology 5, e615-623.
In Dr. Fuller’s study, the vast majority of men with locally recurrent prostate cancer were previously treated with 3D conformal, IMRT, or proton therapy. And most of the men had Gleason 7 prostate cancers. Importantly, serious side effects were few, mostly confined to the bladder. There were no serious side effects on the rectum. In contrast, many patients who undergo salvage radical prostatectomy may need a permanent colostomy bag.
So What Is a Man with Recurrent Prostate Cancer after Radiation to Do?
Instead of undergoing medical castration for the rest of your life or even surgical castration, I believe that recurrent prostate cancer patients need to take a good look at Cyber Knife. At First Dayton Cancer Care, we have performed hundreds of Cyber Knife procedures for our prostate cancer patients. First Dayton Cancer Care is the only center in Southwest Ohio that has long-term experience with Dr. Fuller’s special planning technique for recurrent prostate cancer.
If you have any questions, please feel free to call me, Dr. Edward Hughes, at 855-DAYTON1. I guarantee that I will see you within 1-3 days of your call.