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Cyberknife 6 1/2 years

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Posted 9/16/2022 5:41 PM (GMT -5)
In January 2016 I had Cyberknife radiation (4x 9.5Gy) at UCSF for Gleason 7 (3+4) prostate cancer. Everything went smoothly for years and PSA is now down to 0.163.

But last month I had blood in my urine one day, went to the urologist and after a CT contrast scan and cystoscopy he found possible villous neoplasm in my bladder. I'm scheduled for TURBT surgery on Monday to resect the tumor. The tissue will be sent to pathology and the urologist thinks it is likely cancer, but stage 0 or 1.

Will see. It could be caused by the radiation but said there's no way to tell fo sure.
Posted 9/16/2022 9:05 PM (GMT -5)
Hope it turns out to be nothing and removal solves the problem, getting old is not for the weak…
Posted 9/17/2022 2:47 PM (GMT -5)
I see in your signature that you had four treatments over the course of two different months in 2016. I am also a G7 (3+4), with a low volume of pattern 4 disease, and I finished SBRT three years ago. I had five treatments of 7.25 Gy each over the course of 11 calendar days and the Radiation Oncologist told me that we were looking for a nadir of 0.50. Can you tell us about your treatment schedule and the treatment plan from your RO?
Posted 9/19/2022 3:23 AM (GMT -5)

e.noont said...
Can you tell us about your treatment schedule and the treatment plan from your RO?

There's not a lot to add. I had a Prolaris test that indicated low risk. Then gold markers were\e inserted andI had a MRI for positioning. Then 4 days treatment over 2 weeks.

Dr Gottschalk told me: " I use a heterogeneous radiation dose. The purpose of this dosing is to avoid excess dose to urethra, not to target the cancer with higher dose. 4x9.5 Gy has a higher biological equivalent dose compared to 5x7Gy. Toxicity is the same."

He did not say what the expected nadir was, but indicated that five years out was normal. So far is it still dropping but I only test once a year now.
Posted 9/19/2022 3:07 PM (GMT -5)
rainwest, thanks for your reply.

I try to stay current on the various radiation treatments and was curious since I've never known of your particular four dose treatment plan. I was not in the low risk classification of my Oncotype testing and knew I needed to treat my disease. Surgery seemed like too much risk for complications with my low level of pattern four disease, which is why I went with SBRT. I have four gold markers and had the SpaceOar placed prior to my test MRI. Treatment was a breeze and I've had no side effects other than reduced ejaculate. I'm three years post-treatment and doing well. The SpaceOar is still of questionable need, but I didn't want to wonder later if it might have helped me avoid a complication from the radiation. I will be on six month PSA testing for three more years.

Good Luck with TURBT surgery.
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