Hypofractionated Radiation Therapy for Prostate Cancer

As the COVID-19 pandemic continues, many cancer patients are having to make the difficult decision to continue with their current cancer regimen or delay treatments.  Cancer patients and physicians must carefully weigh the potential benefit of routine cancer care versus the risk of COVID-19.

To help ease these decisions, several peer-reviewed, non-profit cancer care organizations like the National Comprehensive Cancer Network (NCCN) have recognized the rapidly changing oncology information relating to COVID-19 and have established forums for sharing best practices and specific institutional responses, as well as continue to release updated clinical guidelines in regards to cancer treatment during COVID-19.

This news is especially helpful for prostate patients, as the NCCN recommends that prostate patients receiving radiation therapy for their cancer to continue with treatment, but the shortest (5 to 7 fractions) safe external beam radiation therapy (EBRT) regimen should be used.  This guideline is also supported by the American Society for Radiation Oncology (ASTRO), the premier radiation oncology society in the world consisting of more than 10,000 members who are physicians, nurses, biologists, physicists, radiation therapists, dosimetrists and other health care professionals who specialize in treating patients with radiation therapies.  ASTRO’s current guidelines state that hypofractionation has been demonstrated to be equally effective as standard conventional courses of radiation therapy in specific clinical situations, including prostate cancer.

Using hypofractionation, or hypofractionated radiation therapy, higher doses of radiation are delivered per treatment, so patients can complete their course of radiation therapy much faster than conventional treatment.  Hypofractionation allows larger-dose radiation fractions to be delivered in fewer sessions, with the total dose completed in 5 weeks or less vs up to 9 weeks with conventional radiation dose-fractionation schedules.  Ultrahypofractionation (stereotactic body radiation therapy [SBRT] or stereotactic ablative radiotherapy [SABR]) can involve 5 radiation sessions.

At Columbus CyberKnife, hypofractionation is delivered on the CyberKnife, a painless, nonsurgical prostate cancer treatment technology in which high-dose radiation is delivered to the tumor from a linear accelerator mounted on a highly maneuverable robotic arm.  Hundreds of different angles enable the radiation to be contoured to the shape of the prostate, resulting in treatment aimed directly to the prostate gland, avoiding nearby critical anatomy.  It can shave weeks off the traditional treatment length with the possibility of fewer short term side effects and a better quality of life.

Our highest priority is to always keep our patients and staff as safe as possible, while not wavering on our commitment to providing patients with safe, high-quality, and comprehensive cancer treatment services.  We understand the concerns you may have during this time of uncertainty, but please know that our physicians and staff are here for you and that hypofractionated radiation therapy is an excellent treatment option for prostate cancer.

To learn more about how Columbus CyberKnife treats prostate cancer with CyberKnife technology, please click here.  To contact Columbus CyberKnife with any questions, or to get a second opinion, please click here.

Douglas W. Widman, M.D. Discusses Prostate Cancer on Daytime Columbus

Watch Douglas W. Widman, M.D., Medical Director and board-certified radiation oncologist at Columbus CyberKnife, discuss prostate cancer on Daytime Columbus. Dr. Widman talks about prostate cancer (risk factors, signs and symptoms, and current stats), how it is treated with the CyberKnife® Robotic Radiosurgery System, and CyberKnife treatment benefits for patients.

The Silent Killer: Randy Heim’s Prostate Patient Testimonial

Maybe it’s the bright blue Mohawk that catches people’s attention.  Maybe it’s the prostate cancer ribbon on the back of his head.  Or maybe, just maybe, it’s the gray sweatshirt with the words “Get Your Man Gland Checked” written out in blue letters that stops people in their tracks.  Either way, Randy Heim is getting attention, and that is exactly what he wants.

Randy, a 57-year-old prostate cancer survivor, wants people to know about prostate cancer, or the “silent killer” as he calls the disease (and is also what is written on the other side of that gray sweatshirt). The Etna, Ohio resident was first diagnosed with prostate cancer in October 2018, and since his final treatment that December, he has been a huge advocate for men getting their prostate-specific antigen (PSA) prostate screenings and making sure they know ALL the prostate cancer treatment options available to them.

It was one of those screenings that saved his life.  Randy suffers from Thrombocytopenia, a condition in which you have a low blood platelet count, so he has to undergo blood tests every six months.  Having a history of prostate cancer in his family, Randy knew how important the blood tests were and made sure to pay attention to the results.

After the biopsy his urologist performed came back positive for prostate cancer, Randy wanted him to discuss his treatment options with him.

“My urologist said I could have my prostate taken out, have the seeds implanted (brachytherapy), or go through 40 rounds of radiation,” Randy said.  “Where I worked there were two people that had CyberKnife treatment for their prostate cancer and they were both fine, so I asked him about CyberKnife, to which he replied that there is not enough history with CyberKnife to make it a treatment option that he recommended.”

In addition to speaking with his coworkers about their positive CyberKnife experience, Randy did his own research and found that the CyberKnife® System, which the FDA cleared for prostate tumors back in 2001, was clinically proven to be a good treatment option with excellent survival rates.

Randy chose CyberKnife for the treatment of his prostate cancer, but before he began his CyberKnife treatments, his radiation oncologist, Douglas W. Widman, M.D., Medical Director at Columbus CyberKnife, recommended that Randy undergo a SpaceOAR® Hydrogel procedure.

SpaceOAR, which stands for Spacing Organs at Risk, hydrogel is a gel that is injected into place prior to the start of radiation treatment that acts as a spacer providing space between the rectum and the prostate, making it much less likely that the rectum is exposed to radiation.  It is called a hydrogel because it contains mostly water and it is not broken down by radiation, so the radiation does not change the hydrogel’s chemical properties, safety, or effectiveness.  The hydrogel remains in place during the length of radiation treatment but is then absorbed into the body and excreted through the patient’s urine. Nothing is left behind and there are no negative side effects.  The procedure takes about 30 minutes and is typically done in a hospital, surgery center, or doctor’s office, and patients should be able to immediately resume their normal activities after the procedure.

“I think SpaceOAR gives physicians that extra degree of confidence when delivering severe hypofractionated doses of radiation near the prostate-rectum interface,” said Dr. Widman.  “It also appeals to the patient’s desire to make the radiation therapy experience as safe as possible.”

Randy had his SpaceOAR procedure on October 29, 2018, and was ready to begin his CyberKnife treatments the next month.

“When I went in for my first CyberKnife treatment, I was nervous,” Randy said.  “Then I got in there and the staff was fantastic and put me at ease.  They explained everything to me, we had some good laughs, they put on some music that I enjoyed and I laid back and slept.  No pain, no discomfort, the whole treatment went really smoothly.”

Randy’s treatment plan included five CyberKnife sessions that took place November 26 through December 2, 2018.  Each treatment lasted about an hour and he recalls the treatments being quick and easy.

After his treatments, Randy said he felt fine and that the treatments did not interfere with his life or his normal daily routine.

“The treatments didn’t slow me down at all,” Randy said.  “In fact, I never even missed a day of work.  I got my treatments and went right into work.”

Today, Randy says he is doing fine and feels like he never even had prostate cancer.  He is enjoying life and watched his PSA score drop from 4.4 to .5, which he was very happy about.

When asked if he would recommend Columbus CyberKnife to others facing a prostate cancer diagnosis, Randy replied, “In a heartbeat.  It was the best medical experience I have ever had.  As a matter of fact, I’ve already talked to two people that I that have been diagnosed into getting CyberKnife treatment.  I feel that strongly about it.”

Douglas W. Widman, M.D. Discusses Prostate Cancer on Daytime Columbus

In honor of September being National Prostate Cancer Awareness Month, Douglas W. Widman, M.D., board-certified radiation oncologist and Medical Director at Columbus CyberKnife, was a guest on Daytime Columbus to discuss prostate cancer. Watch Dr. Widman cover prostate cancer risk factors, signs and symptoms, and current stats, how the disease is treated with the CyberKnife® Robotic Radiosurgery System, and CyberKnife treatment benefits for patients.

Prostate Cancer Treatment and Sexual Function

When deciding which treatment option is best for their prostate cancer, men take numerous factors into consideration.  While their physician’s recommendation does play an important role in the treatment decision, in the end, most men make the choice that is best for them.  That choice is often based on treatment outcomes and side effects, and sexual function is a central consideration for most men.

As with any cancer patient, the number one priority for men diagnosed with prostate cancer is survival, but for many men, sexual performance is highly valued and is more important than other side effects and treatment characteristics.  Many physicians say that sexual function is one of the first things men ask about if they are diagnosed with prostate cancer.

Over the years, improved techniques, corrective procedures, and medications have reduced many of the urinary and bowel side effects historically associated with prostate cancer treatment, so the quality of a man’s sex life can now be the deciding factor for many men and their partners.

Radiation therapy has long been a standard treatment in prostate cancer treatment.  Similar to surgery, damage to blood vessels and nerves after radiation therapy can result in decreased erectile function over time, but, in general, radiation therapy has less of an influence on erectile function after treatment.  According to the Prostate Cancer Foundation, radiation therapy has less of an impact on erectile function in the first five to ten years after treatment compared with surgery, and approximately 70% of men who have baseline erectile function before treatment will keep erectile function after treatment.

At Columbus CyberKnife, we use the CyberKnife® Robotic Radiosurgery System to deliver targeted radiation therapy to men diagnosed with prostate cancerCyberKnife is a painless, nonsurgical prostate cancer treatment technology in which high-dose radiation is delivered to the tumor from a linear accelerator mounted on a highly maneuverable robotic arm.  Hundreds of different angles enable the radiation to be contoured to the shape of the prostate, resulting in treatment aimed directly to the tumor and sparing nearby healthy tissue, including the nerves and blood vessels involved in sexual function.  This precision reduces treatment time to just five outpatient visits, compared to the average 45 visits conventional radiation therapy requires.

It is natural and healthy to want an active sex life.  If you, or someone you love, have been diagnosed with prostate cancer, or you have questions regarding prostate cancer treatment options, please contact Columbus CyberKnife today.

Studies Show CyberKnife Provides Excellent Prostate Cancer Survival Rates in Five or Fewer Sessions

Accuray Incorporated, developer and manufacturer of the CyberKnife® System, announced that published data from two multicenter studies using differing protocols provide consistent results and reinforce the use of the CyberKnife system for the effective management of low-and intermediate-risk prostate cancer.  The studies are the largest conducted to date evaluating stereotactic body radiation therapy (SBRT) in patients with localized prostate cancer.

Highlights of the multicenter studies included prostate SBRT administered by the system resulted in the following disease-free survival rates:

97% – 100% for low-risk patients

– Superior to the 92% – 94% from conventional radiation therapy historic data

– Equivalent to low dose rate (LDR) brachytherapy and high dose rate (HDR) brachytherapy without the inconvenience and risk associated with invasive seed and catheter implants

88% – 97% for intermediate-risk patients

– Equal to or higher than the 85% – 90% reported with conventional radiation therapy without the inconvenience of daily visits over several weeks

Despite the high dose delivered to the prostate, side effects were uncommon (less than two percent grade 3 or higher toxicities) and were similar to other radiation therapy procedures without the need for invasive rectal balloons or spacers to spare the rectal wall.

At Columbus CyberKnife, men diagnosed with prostate cancer are treated with SBRT with the CyberKnife® System, a painless, non-invasive prostate cancer treatment technology in which high-dose radiation is delivered to the tumor from a linear accelerator mounted on a highly maneuverable robotic arm.  Hundreds of different angles enable the radiation to be contoured to the shape of the prostate, resulting in treatment aimed directly to the prostate gland, avoiding nearby critical anatomy.  This precision reduces treatment time to just five outpatient visits, compared to the average 45 visits conventional radiation therapy requires.

To learn more about how Columbus CyberKnife treats prostate cancer with CyberKnife technology, please click here.

Dr. Heuser’s CyberKnife Story

Watch general surgeon, Dr. Louis Heuser, talk about why he chose CyberKnife for the treatment of his prostate cancer. Dr. Heuser was very happy with the quick treatments and the fact that he was able to stay close to home and continue to work and see his patients. It’s Your Prostate, Your Cancer, Your Choice.

Columbus CyberKnife: Treat Prostate Cancer in 5 Treatments

Watch Douglas W. Widman, M.D., Medical Director at Columbus CyberKnife, and Thomas, a CyberKnife patient, talk about how CyberKnife is an excellent treatment option for prostate cancer. CyberKnife is as effective as surgery and is completed in only 5 outpatient treatment sessions compared to the 44 you have with traditional radiation therapy. In addition, CyberKnife treatment is painless, there are minimal (if any) side effects, and there is no disruption to your daily life.