Prostate Cancer Screening and Treatment

Prostate Cancer Pretreatment:

Once the team is in place, you will begin preparations for CyberKnife treatment. Initially the doctors will determine prostate specific antigen (PSA) levels in your blood through a blood test that will be used to help track treatment results. You will then be scheduled for a short outpatient procedure, usually with a urologist, in which three to five tiny gold seeds (called fiducial markers) are inserted into your prostate. The fiducials are placed through a needle, which is guided using ultrasound. Patients may be asked to clean out their rectum with an enema the day of the fiducial placement. The CyberKnife will use the fiducials as reference points to identify the exact location of the prostate. Following placement, the doctors will wait approximately one week before CyberKnife treatment planning can begin to ensure that fiducial movement has stabilized.

Prior to the treatment, a special custom-fit body cradle will also be made for you. The cradle is made of a soft material that molds to your body, ensuring that the patient is in the same position for each treatment session and is comfortable during the procedure.

Before treatment plans can be determined, several scans must be done to identify the exact position and dimensions of your prostate. You will undergo a CT scan and the data will be used by the CyberKnife team to determine the exact size, shape and location of your prostate. An MRI scan also may be necessary to fully visualize the prostate and nearby anatomy.

Prostate Cancer CyberKnife Treatment:

Before treatments begin, a plan will be specifically designed between the physicist and your doctors. You will not need to be present at these planning meetings. During treatment planning, CT and/or MRI data will be downloaded into the CyberKnife System’s treatment planning software. The medical team will determine the size of the area being targeted by radiation and the radiation dose, as well as identifying critical structures – such as the bladder and rectum – where radiation should be minimized.

After the treatment plan is developed, you will be asked to return to the hospital for treatment. The treatment is usually delivered in one to five sessions.

For most of our patients, the CyberKnife treatment is a completely pain-free experience. You may dress comfortably in street clothes, and in the CyberKnife suite at Capital Health, patients are allowed to bring in music to listen to during their treatment. You also may want to bring something to read or listen to during any waiting time. Many of our patients bring a friend or family member with them to provide support before and after treatment.

When patients are ready for treatment to begin, the location of the prostate will be tracked and detected. The medical team will be watching patients every step of the way as the CyberKnife tracks the patient’s prostate as it moves, and safely and precisely delivering radiation to it. Then, special software will determine precisely where the radiation should be delivered. Nothing will be required of the patient during the treatment, except to relax and lie as still as possible.

Once the treatment is complete, most patients quickly return to their daily routines with little interruption to their normal activities. If treatment is being delivered in stages, patients will need to return for additional treatments over the next several days as determined by their doctors.
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