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CyberKnife Or Robotic Radical Prostatectomy

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Posted on Fri, 25 May 2012
Question: CyberKnife or robotic radical prostatectomy
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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 XXXXXXX 6's and 1 XXXXXXX 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.
doctor
Answered by Dr. Rajiv goel (10 hours later)
Dear,

From your description, you have a localized carcinoma prostate cancer with no extraprostatic extension on examination or MRI.
You also appear to be pretty healthy with no comorbidities and seem to be well preserved. You still have pretty long time to go.

Considering all these factors I shall highly recommend robotic prostatectomy rather than cyber knife.

I can understand your concerns about the surgery but all these concerns are in the short term. However, in the long term you have better cancer control as well as better side effect profile with surgery. I once again strongly recommend robotic prostatectomy.

Hope I have answered your query.

Regards
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Rajiv goel (2 days later)
Dear Dr. XXXXXXX

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.

Thank you,
RW744.
doctor
Answered by Dr. Rajiv goel (8 hours later)
Dear,

What ever 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, but I have patients under regular follow up with above mentioned side effects post cyberknife and I am finding it very difficult to manage them.

Hope I have answered all your queries. Please do get back to me if you have any further questions.

Wishing you all the very best.

Regards.
Note: For further follow up on related General & Family Physician Click here.

Above answer was peer-reviewed by : Dr. Yogesh D
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Answered by
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Dr. Rajiv goel

Urologist

Practicing since :1998

Answered : 581 Questions

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CyberKnife Or Robotic Radical Prostatectomy

Dear,

From your description, you have a localized carcinoma prostate cancer with no extraprostatic extension on examination or MRI.
You also appear to be pretty healthy with no comorbidities and seem to be well preserved. You still have pretty long time to go.

Considering all these factors I shall highly recommend robotic prostatectomy rather than cyber knife.

I can understand your concerns about the surgery but all these concerns are in the short term. However, in the long term you have better cancer control as well as better side effect profile with surgery. I once again strongly recommend robotic prostatectomy.

Hope I have answered your query.

Regards