I am in my final decision-making process about pc treatment, either CyberKnife or robotic radical prostatectomy. I need the most current advice about the efficacy of CyberKnife vs robotic surgery. I am 67, my father had pc, my PSA is 5.48, my biopsy was 3 Gleason 6's and 1 Gleason 7 (3+4), my bone scan and CT scan were both clear, my MRI shows four "suspected tumors" ranging from .4 cm to 1.3 cm, two of which have broad capsular contact but there is no bulging of the capsule. I like the ease of CyberKnife but can't find long term curative rates, side effects or toxicty data. My robotic surgeon is a world renown surgeon and I have complete confidence in him. However, if CyberKnife is as efficatious as surgery I may go with that. I would greatly appreciate expert advice today or tomorrow. Thank you very much.
From your description, you have a localized carcinoma prostate with no extraprostatic extension on examination or MRI.
You also appear to be pretty healthy with no comorbidities. I would say you have a fairly long life ahead of you.
Considering all these factors I highly recommend robotic prostatectomy rather than cyber knife.
I can understand your concerns about the surgery but all these concerns are short term. However, in the long term you have better cancer control as well as better side effect profile with surgery. Therefore I strongly recommend robotic prostatectomy.
Hope that this information helps and hope that you will get better soon.
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Dear Dr. Rajiv,
Thank you for your reply and your support for surgery. Could you please give me your evaluation of CyberKnife for prostate cancer treatment. It is very precise, the five-year studies are promising and there are only five noninvasive treatment sessions.
What you say about cyberknife is true. However, patients may develop urinary retention and some experience severe urgency and frequency. Very little data is available on the long term results especially side effects. I have patients under regular follow up with above mentioned side effects post cyberknife and I would say they are difficult to manage.
Hope I have answered all your queries. Please do get back to me if you have any further questions.
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