Cyberknife still considered very new, despite it being used since about 1998, reliable long term outcomes and good long term epidemiological data does not seem to be available.

I think the general opinion in the medial community is that stereotactic radiosurgery offers better outcomes for low risk tumors, but the hard data showing that is still evolving. Comparisons between the different radiosugery techniques are much more muddy, and there isn't a clear winner when it comes to clinical/cost effectiveness. I think at this point the decision rests with the doctor and patient after looking at the available patient case information, tumor type, location, etc etc etc.

Gamma knife surgery, which is still used today is a very old technique, and overall the long-term outcome for that appears to be favorable according to this study.

http://www.ncbi.nlm.nih.gov/pubmed/23140152

Since the urogenital area is less "delicate" than the brain, my opinion is that the long term outcome to be similar or better than with GKS.

Cyberknife still considered very new, despite it being used since about 1998, reliable long term outcomes and good long term epidemiological data does not seem to be available.

I think the general opinion in the medial community is that stereotactic radiosurgery offers better outcomes for low risk tumors, but the hard data showing that is still evolving. Comparisons between the different radiosugery techniques are much more muddy, and there isn't a clear winner when it comes to clinical/cost effectiveness. I think at this point the decision rests with the doctor and patient after looking at the available patient case information, tumor type, location, etc etc etc.

Gamma knife surgery, which is still used today is a very old technique, and overall the long-term outcome for that appears to be favorable according to this study.

http://www.ncbi.nlm.nih.gov/pubmed/23140152

Since the urogenital area is less "delicate" than the brain, my opinion is that the long term outcome to be similar or better than with GKS.

Dear Tawara

I appreciate your answer.

Best regards.

For low-risk prostate cancer, more than 50% of cases can be "treated" by active surveillance. Followup consists of PSA monitoring and repeat prostate biopsies every 1 or 2 years. If repeat biopsies reveal evidence of tumor progession (i.e., more cores positive for cancer, a greater percentage of cancer in the biopsies, or more aggressive cancer based on Gleason score), treatment can be effectively done.

For well-characterized low-risk prostate cancer, the cumulative prostate cancer specific mortality beyond 10 years is less than 1% regardless of conventional treatment modality. Because curative treatment of prostate cancer always results in some decrement in quality of life, many national advisory bodies have concluded that the harms considerably outweigh the benefits in low-risk men.

Because the cost of radiosurgery or stereotactic body radiotherapy (SBRT) is almost as high as conventional intensity modulated radiotherapy and data from randomized studies confirming safety and efficacy as compared to well-established treatments is lacking, some insurers are refusing to pay for SBRT in low-risk men. Low-risk prostate cancer identified by TRUS biopsy is upgraded in 40% of cases by either surgery or transperineal mapping biopsy.

http://www.ncbi.nlm.nih.gov/pubmed/22307210

If a low-risk prostate cancer is confirmed by either multi-parametric MRI guided biopsy or by saturation transperineal mapping biopsy, then active surveillance by PSA only is by far the best choice.

For those who still insist on treatment, SBRT is a reasonable choice, particularly if treatment is part of a randomized trial. A trial report on 864 patients found a decline in urinary and bowel function during the first year followed by recovery, but sexual dysfunction remained unrecovered.

http://www.ncbi.nlm.nih.gov/pubmed/24119836

Likewise, PSA response and biochemical survival after SBRT are comparable to conventional XRT:

http://www.ncbi.nlm.nih.gov/pubmed/23668632

http://www.ncbi.nlm.nih.gov/pubmed/24484652

However, low-dose rate brachytherapy has much longer follow-up, achieves a much lower PSA nadir, and has a lower failure rate.

http://www.ncbi.nlm.nih.gov/pubmed/24474970

There are no modern randomized trials comparing surgery to various forms of radiotherapy. We have to rely on retrospective reviews of series from major centers and various groups that combine data/patients. Here is a reprint that certainly supports radical prostatectomy for long term cancer control

I am a medical oncologist with 31 years focused on evaluating and treating men with PC (prostate cancer). I have yet to see one patient treated with radiosurgery. I have read through all the responses above and your question is often not being answered. The answer to your specific question involving radiosurgery is that sufficient clinical data is not available to advise patients. The more comprehensive and well thought out answer, however, relies on what is needed and most often missing in EVALUATING most men with PC → a thorough proper risk assessment relating to extent of disease. Instead of the "quick & easy" pseudoevalation with CT & Technetium-99 bone scans and then the usual advice to use surgery, radiation therapy, cryo or HIFU, the man newly diagnosed with PC needs a well thought out and diligent assessment of risk. This involves confirmation of the Gleason score with an expert in PC pathology, the baseline use of available risk assessment tools in the form of nomograms and ANNs (artificial neural nets) and then further staging studies based on where the patient's risk lies. This is rarely done in my experience over 3+ decades. If the patient's risk assessment indicates a very high probability i.e., 80% or more for OCD (organ-confined disease) then a local ablative form of therapy is reasonable. This presumes that the patient does NOT have low risk or so-called "insignificant" PC defined by validated Gleason score of 6, minimal core involvement with low volume PC tissue involvement. In such cases an integrative approach to treating the adjunctive internal medicine issues that "feed" the PC can often turn the PC into a "sleeping dog" that the patient can outlive. But this major swing in the pendulum of care to active surveillance must be associated with documentation that low volume and non-aggressive PC exists at baseline, does not change over time and ideally that the patient's biological milieu is altered in favor of the host, and not the tumor.

Prostae Cancer is typically having high PSA, swollenand blocking prostate which is kind of fatty massive tumor and chronic infected with viruses such as HPV, Herpes viruses together with certain microbes. I would recommend very simple methods which worked for some of my clients with early state of prostate cancer. [1] Site on a rubber hot water bottle starting temp from 60 degree C for 1 hour each time, for 3 times daily. That temp can inactivate viral DNA or RNA from pairing and replication. [2] One hour before sitting on hot water bottle, take 3 capsules of serrapeptase (4,000 units/capsule), i.e. 12,000 units daily, for 7 days. Serrapeptase is the strongest enzyme from silkworm, which can digest the toughest proteins blocking body blood vessels as well as prostate cancer mass as well as the PSA. [3] Record down your blood pressures up/down daily. If your blood pressures are still above 110/70 after 7 days treatmentl, then repeat the above procedures in [1], [2] and [3], untill your blood pressures reach 110/70 and stop. [4] Then you can go to get a test check for PSA level. Meantimes, you should [5] go fast walking as frequent as possible.