an article from the fall 2009 issue of…

When Wilbert Braxton of Baltimore learned that he qualified for a study at Franklin Square Hospital Center evaluating the use of a new treatment for prostate cancer, he didn't hesitate to join.

CyberKnife is a type of radiation therapy called stereotactic radiosurgery because of its ability to destroy tumors with knifelike precision, sparing surrounding healthy tissue. Benefits of the therapy include minimal side effects and a short course of treatment. While patients undergoing more traditional radiation therapy for prostate cancer usually have more than 40 treatments, CyberKnife patients need only five.

In April, Braxton, 61, became the first patient at Franklin Square to be treated for prostate cancer with CyberKnife. His doctors say his response to the therapy has been "very encouraging" and that they are optimistic about the long-term results. "I feel great," Braxton says. "And the therapy was extremely convenient, compared with the alternative. About the only side effect was a little burning and itching for a couple days after treatment. I haven't had any problems."

Frequently Diagnosed Cancer

According to the American Cancer Society, one in six men will develop prostate cancer in his lifetime. The disease is the second-leading cause of cancer death in men and the secondmost common type of cancer in men, after skin cancer. At Franklin Square, patients with prostate cancer benefit from the most advanced technologies and treatments. Our multidisciplinary team- comprising urologists, radiation oncologists, medical oncologists and oncology nurses- ensures that each patient's care is comprehensive and well-coordinated.

"When prostate cancer is found early, the prognosis is very good," says Cengiz Aygun, MD, a board-certified radiation oncologist who is chief of radiation oncology at Franklin Square. "At Franklin Square, we are able to offer some of the most sophisticated services to evaluate and effectively treat prostate cancer."

"Although Franklin Square has been using CyberKnife since 2007 to treat many types of cancer and benign conditions, the hospital only recently began using the technology for prostate cancer," Dr. Aygun says. Currently, CyberKnife is offered only as a clinical trial treatment to patients with early-stage prostate cancer.

"This is an emerging technology with very promising early results," Dr. Aygun says. "Long-term data is needed before we make any definitive conclusions about cure rates. As the data becomes more mature, we hope to offer CyberKnife as a standard of care for prostate cancer."

Precise Planning and Delivery

With CyberKnife, results from a computed tomography (CT) scan or magnetic resonance imaging (MRI) are used to identify the exact location, size and shape of the tumor. During treatment, radiation beams are delivered from many directions. A sophisticated guidance system continuously tracks the position of the tumor and adjusts delivery of the beams, minimizing exposure to nearby tissues. CyberKnife therapy is given over five days, with sessions lasting 90 minutes to two hours.
In addition to the CyberKnife clinical trial, Franklin Square offers these standard prostate cancer treatments:

• External beam radiation. Options include intensity-modulated radiation therapy (IMRT), a type of three-dimensional radiation therapy in which thin beams of radiation of varying intensities are aimed at the tumor from many angles.
• Internal radiation (brachytherapy). The radioactive material is usually contained in small implants called seeds. Needles are used to plant the seeds in the prostate.
• Hormonal treatments. This treatment reduces levels of the male hormones that stimulate prostate cancer cells, so the cancer will shrink or grow more slowly.
• Surgery. The tumor is removed through an incision.

Close Monitoring of Disease

Because prostate cancer is often a slow-growing disease, doctors may recommend "active surveillance" instead of immediate treatment for patients who are older or who have other major health conditions, according to William Dowling, MD, a board-certified urologist on staff at Franklin Square. "Active surveillance doesn't mean we ignore the cancer," Dr. Dowling says. "It means the patient is monitored with regular testing and a yearly biopsy to check whether the cancer has grown and treatment should be started."

Braxton's prostate cancer was detected in 2008 during a routine physical exam, he says. Noting that his father had prostate cancer and was treated with external beam radiation and brachytherapy, Braxton says he feels lucky that his treatment lasted days instead of weeks-and that he felt so well the whole time.

"I'd recommend Franklin Square to anyone," Braxton says. "I was very confident in my care."

To learn more about the CyberKnife clinical trial for prostate cancer, call 1-877-CYBER01 (1-877-292-3701) to speak with our CyberKnife representative.

Treatment with CyberKnife
Is CyberKnife Right for You
How CyberKnife Works 

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The editorial content of this online publication is taken from the print version of Discover published by Franklin Square Hospital Center. Check out complete issues of Discover.