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Nerve sparing and CK
Rick in IL
Posted: Tuesday, December 04, 2018 6:42 AM
Joined: 10/18/2018
Posts: 11


I am considering CK and have a couple of questions for the forum physicians and members. "Nerve sparing" procedures are often discussed related to RP, however, I don't see it discussed with CK. The CK Rad Onc I have spoken with indicated CK would "treat" the nerves within the perimeter of CK treatment, albeit at a lower dose (35gy). As damage to these nerves seems to be a primary contributor to ED, do these nerves regenerate or is damage permanent? Would additional time between procedures reduce the nerve damage. I don't see much reported on ED and CK. Thank you for any replies.
Rick MP MRI 43cc volume 1.7x1.0 lesion in mid prostate 6/18 PSA 10/17 4.6, 5/18 5.4, 11/18 6.9 Biopsy 9/18 Gleason 3+4=7 for 2 of 18 cores and 3+3=6 for 1 of 18 cores. Positive cores were those targeted to lesion. Others (random) were negative T2b
viperfred
Posted: Tuesday, December 04, 2018 4:34 PM
Joined: 10/10/2008
Posts: 852


Hi Rick, I was treated with the Cyberknife for prostate in May 2008. Today I would make the same choice. Suggest all men with prostate cancer read the published studies for each option and compare their side effects and biological disease control(some call cure). More then 10 years after Cyberknife therapy I continue to believe that the Cyberknife is the best option for patient quality of life and biological control. In my research the Cyberknife has the lowest risk of ED and other side effects and no other therapy has a higher rate for biological control. Surgery has so many risk that in my opinion it should not be an option unless the patient is very sensitive to radiation (including the Sun). iprostatecancer.com is my history and has not been updated for years but the information and my opinion is unchanged. However there are now published studies with longer term patient outcome. Cyberknife is still the best therapy in my opinion based on biological control, lowest risk for ED, and other side effects. Suggest all men make an informed choice so there are no regrets. I feel most men are ill informed when diagnosed with prostate cancer. The process has a flaw because the urologist(has a vested interest and has the first sales pitch) gives the diagnosis to the patient with a script that goes something like this: Sorry you have prostate cancer, however I can remove it with surgery(open or by robotics). There are other options however only surgery removes the cancer and if you have radiation and it fails then surgery is not an option. Ther do not tell you buy the way surgery is no better at biological control had has many added risk(google surgery risk prostate cancer - www.cancer.org/cancer/prostate/treating/prostate/surgery.html), Reaction to anesthesia, Blood loss, blood clots, damage to nearby critical structures(rectum, baldder etc.) and infection. Then look at side effects urinary incontinence, ED, inguinal hernia, etc. Surgery Risk for what benefit? Add the fact that surgery has typically a 2 week period for recovery with a cathiter and or diaper. I worked every day during the treatment and after the treatment. Most men have little to no side effects from the Cyberknife when treated by expereinced radiation oncologist and radiation physicist. However some men have expereinced some toxicity. I expereinced a couple days of increased frequency of urination and bowel activity but this quickly resolved. Added Benefit: Before Cyberknife therapy I would get up 2-3 times per night and after treatment up until know I sleep through the night. This may be isolated to me but I suspect this is another benefit. Good Luck with whatever choice you make! Fred Not a medical professional. A prostate cancer parient treated with the Cyberknife!
Rick in IL
Posted: Wednesday, December 05, 2018 10:03 AM
Joined: 10/18/2018
Posts: 11


Thank you very much for your time to reply Fred. I have spent six months reading everything I can find. I agree with your summary of the conversation with the urologists. I met with two and the message was exactly the same as your summation. I am happy I took the last six months to consider treatment or no treatment options. I believe Cyber is the right call today. I don't know if it will be the best option in five years, but I believe I am better served by some form of active disease control (thank you for the term) and Cyber seems best for the reasons you note. Thank you again and best of luck to you too. Rick

Rick MP MRI 43cc volume 1.7x1.0 lesion in mid prostate 6/18 PSA 10/17 4.6, 5/18 5.4, 11/18 6.9 Biopsy 9/18 Gleason 3+4=7 for 2 of 18 cores and 3+3=6 for 1 of 18 cores. Positive cores were those targeted to lesion. Others (random) were negative T2b
viperfred
Posted: Wednesday, December 05, 2018 3:17 PM
Joined: 10/10/2008
Posts: 852


Hi Rick, Wish you the best! Fred
 

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