A cancer diagnosis by itself is stressful and can be compounded by the financial burden incurred during cancer treatment. According to the American Journal of Medicine, two years after a cancer diagnosis 42.4% of patients will have depleted their entire life savings. A study published by the US National Library of Medicine National Institutes of Health found that 2.3% of cancer survivors between the ages of 18-64 filed for bankruptcy as a result of the medical expenses they incurred during their treatments.

Everyone at Anova Cancer Care is fully aware of the burden patients often face in paying for their cancer treatment. We believe that CyberKnife stereotactic radiosurgery is not only an efficient cancer treatment but also a cost effective one.

In addition, we make every effort to keep down the expense of our patients’ cancer treatments with CyberKnife. Most insurance companies and Medicare cover CyberKnife treatment costs. We will review with our patients their insurance plans so we can assist in meeting requirements for coverage and obtaining pre-authorization for CyberKnife cancer treatment.

Questions to ask insurance providers about CyberKnife cancer treatment cost

If you have insurance, your first step will be to contact your insurance company to see what your health plan will cover. Be prepared by asking the following questions.

1. Is Anova Cancer Care in my network? What are my co-payments for office visits and treatments?
2. Does my plan include pharmacy coverage?
3. Does my plan have any restrictions in drug coverage?
4. Does my insurance plan offer any additional cancer care coverage?
5. If I use an out-of-network provider, what percentage of my bill will be paid by the insurance company?
6. Do I need a referral from my primary care doctor or insurance authorization before making an appointment at Anova Cancer Care?
7. Will my initial appointment, testing, pathology or radiology with Anova Cancer Care be covered by my insurance plan?

Practical tips on managing your cancer medical bills

1. Work with your medical providers to make sure they submit any bills to your insurance company in a timely manner. All medical bills should be submitted to your insurance.
2. Review your bills and keep an up-to-date record of claims submitted and their status. Reconcile the Explanations of Benefits (EOB) your insurance company sends with your medical bills.
3. Use a notebook or computer file to track all of your expenses.
4. Document conversations with your insurance company and medical providers.
5. Keep copies of everything related to your medical claims. Make sure these documents are organized.

Financial resources for CyberKnife cancer treatment costs

We encourage our cancer patients to utilize outside resources to help manage their cancer treatment costs. It is often possible to receive financial support for specific services, like transportation, home care, medications and more.

The Cancer Financial Assistance Coalition, a group of 14 organizations that helps cancer patients experience better health and well-being by limiting their financial challenges.

Cancer Support Community’s Cancer Support Helpline is for anyone affected by cancer. In addition to providing emotional support, the helpline offers referrals to financial resources.

The Patient Access Network Foundation helps underinsured individuals with their out-of-pocket costs.

Accuray, the manufacturer of the CyberKnife system, offers a resource page on the typical process of insurance reimbursement for CyberKnife treatments.

The Cancer Care organization provides services to help cancer patients with resources on coping with cancer care including financial and co-pay assistance.

A guide for spouses and partners of men with a prostate cancer diagnosis

While prostate cancer is only found in men, the aftershock of the prostate cancer diagnosis can be far reaching for all those around him. If you have a spouse, partner or loved one who has prostate cancer, you may be overwhelmed and wondering how to best support and care for him.

It is completely normal for both the patient and his loved ones to experience feelings of anxiety, fear and frustration. Overcoming your fears through education and learning about your partner’s treatment options can help alleviate some of the worry that comes with a prostate cancer diagnosis.

Become familiar with prostate cancer treatment options before your partner’s next doctor appointment.

Supporting your partner through the emotional roller coaster of a cancer diagnosis is incredibly important. The journal of Clinical Medicine: Oncology published a review of studies that found men with prostate cancer experience increased feelings of anxiety or depression. Cancer patients who experience anxiety or depression may be less compliant with their treatment, potentially reducing the treatment’s effectiveness. Emotional worries related to a man’s diagnosis are more likely to negatively affect their relationships.

Prostate cancer and communication

Communication is the key element of supporting your loved one through his prostate cancer diagnosis and treatment. Each individual handles stress differently. You need to talk to your partner about how you can best support him.

When discussing difficult topics with your partner, engage in active listening, be calm and open. Don’t assume anything, or project your thoughts or feelings onto your partner. Depending on how your loved one handles stress, he may want space. Or he may want you or others in his support network to remain close. Ask what he wants and needs.

Your partner may find it helpful to discuss his prostate cancer battle with others who also have a prostate cancer diagnosis or with those who have lived with it. Encourage your partner to attend a prostate cancer support group.

Discussing the prostate cancer diagnosis with other family members or friends may be difficult for your partner. He may want your help telling parents, friends and children about his disease. Ask your partner how he wants to handle informing his extended support system and offer to help.

Be there for your partner

Talk to your partner about going with him to his medical appointments. By joining him at his doctor appointments you can not only benefit from learning more about his prostate cancer diagnosis and treatment options, you can also be an advocate for his care. Come prepared with questions for his doctor and take thorough notes. Encourage your partner to ask his own questions, as well.

Of course you and your partner want the most effective treatment with the fewest side effects.
CyberKnife treatment could well be exactly what he needs. 

Physical intimacy after a prostate cancer diagnosis

Prostate cancer, more so than other forms of cancer, affects the patient’s spouse or partner directly. The side effects of prostate cancer treatments are often a major consideration, some patients even avoid treatment due to potential side effects. These vary depending on the type of treatment.

The range of side effects include erectile dysfunction (ED), lower sex drive and urinary incontinence. If you’re attending medical appointments with your partner, ask his medical provider about potential treatment side effects.

During and after prostate cancer treatments, your partner or spouse may be uncomfortable with his own body. He may be embarrassed due to treatment side effects or experience hormonal mood swings that can lower his sex drive.

It is not uncommon for some women whose spouse has prostate cancer to feel unattractive or rejected by the changes in their sex lives. It’s crucial to remember that the change in your sex life is not your fault or the fault of your partner. While your partner or spouse is undergoing prostate cancer treatment it is important to maintain intimacy. Some couples foster intimacy through cuddling or massaging each other.

If your partner is experiencing harmful sexual side effects, this can further impact his emotional well-being. Many men relate the ability to get and maintain an erection with being “manly.” Losing the ability to get an erection can cause those affected to question their identity. Depending on which treatment your partner selected to treat his cancer, he may have options to treat his ED.

Take care of yourself

While caring for a loved one, it is easy to focus all of your attention and energy on his needs. However, if you become emotional drained, your health and well-being may be negatively impacted and your ability to provide care will be compromised.

Maintaining your own health and emotional fortitude will allow you to provide the support your partner needs. Making sure you get enough sleep, exercise and eat well will help you stay healthy. To maintain your emotional well-being, turn to friends and family in your support system. Make time for hobbies and other enjoyable activities.

A prostate cancer diagnosis affects you and your partner. So be aware of the emotional toll your partner’s cancer is having on you.

It’s time to debunk some common cancer misconceptions

Cancer. It’s one of the most alarming words in the world of healthcare, and one people hope they never hear in the context of their health or a loved one’s. While the field of oncology has made leaps and bounds in advancing the prevention of and treatments for cancer, such as our CyberKnife technology, the general public is still often confounded about cancer.

We often find ourselves battling misinformation and myths about cancer, which can go a long way in scaring people about this disease. In order to help people understand the cancer facts, and the continually improving prospects of its treatment, I’d like to address some of the more common myths I hear about cancer.

1. Due to cancer genetics, I will get cancer if it runs in my family.

Among the most common cancer myths is this one: cancer by genetics. About 90-95 percent of cancer types are caused by the mutation of genes that happens over the course of a person’s life. The real cancer fact is that only 5-10 percent of cancer types are developed from a hereditary gene. However, it is very possible for an abnormal gene to be passed down through generations and not lead to cancer.

Sometimes, the reason that members of the same family develop the same type of cancer is because they are exposed to the same elements that could be destructive to their lifestyle. Examples of this destructive behavior that could lead to declining health, and put you at higher risk for cancer, include smoking, not working out or getting proper exercise, and eating an unhealthy, highly-processed diet.

2. Cancer does not run in my family, so I am not at risk of getting it.

Just because cancer does not run in someone’s family does not mean he or she is invincible. The cancer fact is that they are just about at as much risk as in the situation above where someone in the family does have cancer. Genes can become mutated throughout one’s lifespan resulting in cancer, and a person’s lifestyle and personal health can greatly vary from that of their relatives. Both can make a person the first one in their family to get cancer. About 40 percent of men and women will develop cancer throughout their lives. The reality is that most people who are diagnosed with cancer have no familial genetic connection to the condition.

3. Cancer is contagious.

No, cancer is not contagious. You will not acquire cancer from someone via physical contact, such as shaking hands or kissing. The only situation in which cancer can be contagious is in the event of an organ transplant; if the organ donor has a history with cancer, the organ receiver will be at risk for developing the same type of cancer. This is not very typical, but has happened in .02 percent of transplant cases. As a means of prevention, those who have a history of cancer are not usually allowed to donate organs.

4. If one gets cancer, it will always be terminal cancer.

With the advancement of treatment and the use of modern technology such as CyberKnife, the rates at which people are dying from cancer are decreasing. From 1991 to 2015, the combined cancer death rate for men and women declined by 26 percent. The earlier the cancer is detected, the more treatment options will be available and the greater chance of long-term survival. Oftentimes, types of cancers are discovered past the point of being completely cured. But treatment will still extend life and ease symptoms. With the continual research into cancer, the rates of survival from cancer will keep getting better and better.

5. Smoking is a main lung cancer cause, so if you don’t smoke, you won’t get it.

While smokers, and those exposed to second-hand smoke, have the highest chance of developing lung cancer, nonsmokers are also at risk due to other exposures and lifestyle factors. Air pollution and naturally-occurring radon gas are also contributing factors to the development of lung cancer. According to Johns Hopkins Medicine, the presence of radon gas in the air is responsible for roughly 20,000 cases of lung cancer in the United States per year. While cigarettes have a strong odor, you may not know when you’re in the presence of air pollution.

6. It’s a cancer fact that only older men can get prostate cancer.

Prostate cancer is more common in older men, but younger men are also susceptible to it. It’s not uncommon for men as young as in their 40s to get diagnosed. Approximately 40 percent of people diagnosed with prostate cancer are under the age of 65. According to the American Cancer Society, men at high risk of prostate cancer (those with multiple family members who have been diagnosed) should begin getting prostate-specific antigen (PSA) tests at the age of 40. If only one member of the family has had prostate cancer, men should get tested around 45, and someone who is at low risk (no familial connection) should begin getting tested at 50.

7. Having prostate cancer will ruin your sex life.

Sexual activity following prostate cancer treatment depends on multiple variables, including age, health prior to cancer and type of treatment. Though the exact amount of time it takes to regain normal erectile functioning varies, many prostate cancer patients return to their fully-functioning sexual state. Using CyberKnife as a treatment option will reduce the chance of sexual side effects, thanks to its accuracy that targets the cancerous tissue and avoids the surrounding healthy tissue. For any treatment option, younger age patients may have a better chance at making a quick, full erectile recovery.

8. There is a sugar and cancer connection.

To date, there have been no conclusive studies that have shown active cancer to worsen from the consumption of sugar, or lessen due to cutting out sugar. That being said, eating a high-sugar diet can lead to weight gain, diabetes and a myriad of other health issues, which could contribute to the development of cancer.

Adjusting well to life after cancer requires taking action to boost your physical and emotional well-being

It’s over. The worry, the CyberKnife radiation therapy, the calendar filled with doctor’s appointments and tests. You’ve finally been given the all-clear. You are a cancer survivor.

Now what?

No one knows how they’ll adjust to life after cancer. After all, your life has been in upheaval for months, maybe even years. You’ve changed physically and emotionally.

And these changes don’t just disappear when the cancer does. Long-term side effects, greatly reduced by CyberKnife treatment, can include fatigue, nausea and dizziness and may show up weeks or years later. Fear of the cancer returning may cause anxiety or depression.

Or you may sail through post-cancer life with no issues at all. No one can predict what will happen.

What we do know is that there are proven ways to stay healthy and limit recurrence. And the good news is that cancer survivors who want to live a healthy life don’t have to do much of anything differently than someone who’s never received the nerve-wracking diagnosis.

The how’s of staying healthy are the same for all of us and include things like exercise, a good diet and limiting stress. It’s the whys that differ now, the reasons why you should exercise and eat well. For survivors, exercise is no longer all about heart health. It’s also about staving off depression and recurrence.

So bear with us. We know you’ve heard much of this advice before – probably even more than once! But listen with new ears this time. Listen as a cancer survivor.

How cancer survivors can stay on the path of physical health

A healthy lifestyle can limit or mitigate long-term side effects from cancer treatment, according to the American Cancer Society. Although most studies can’t definitively link recurrence to specific health choices, there’s no doubt that making healthier choices can give you a better quality of life.

Create a plan

At your last appointment with us, we’ll talk about life after cancer. Well talk about what you might expect, how often you have to come back for tests and what you can do to boost your overall health.

Eat right

In my January blog, I talked about maintaining a healthy diet during cancer treatment. That same healthy diet is just as important after treatment ends.

I won’t belabor the topic. But I need to address it because a national study of cancer survivors’ diets showed that they ate less healthfully than the general population. They consumed more empty calories and less fiber.

Studies haven’t been clear about diet’s effect on recurrence. But research has been quite clear about how diet affects our overall health. Cancer survivors who followed the American Institute for Cancer Research recommendations for cancer prevention significantly reduced their risk of death. A plant-based diet had the biggest impact on health and has been shown to decrease the risk of cancer.

Incorporating more plants into your diet is a great place to start. Shoot for two or three plant foods on your plate with every meal. Remember that eating nutritious foods, full of the right vitamins and minerals, will help you regain your strength and energy and keep you at a healthy weight.

Refer to my January blog for additional healthy eating tips 

Exercise

Exercise can be tough for some cancer survivors. When you’re tired or weak, it’s hard to get up and go.

But the benefits have been proven. Survivors who exercise feel better physically and emotionally. They’re more optimistic and have fewer signs of depression. They build strength, sleep better and have less pain. It may even reduce the risk of recurrence. Need I say more?

The American Cancer Society recommends adult cancer survivors exercise for at least 2 ½ hours a week, including strength training at least two days a week. Check with your doctor before you begin any exercise regimen.

Take it slowly at the beginning and build up gradually. Some days you might not feel like moving at all, and some days you might feel like you can walk for miles. Listen to your body.

Sleep well

Sleep – and our lack of it – has been much in the news lately. Nearly half of adults in the United States don’t get enough sleep, and the problem is even more common in cancer survivors. As many as 90 percent report trouble sleeping. Treatment side effects, stress and myriad other reasons can cause these sleep issues.

A restful night in bed is vital to healing. Being sleep-deprived can keep you from exercising and affect your memory, concentration, hormone production and mood. The list goes on.

Talk with us about making adjustments after your CyberKnife treatments, which may include lifestyle changes like limiting caffeine, medications or cognitive behavioral therapy.

Stop smoking

We all know that smoking can cause cancer. That should be reason enough to quit.

But lighting up also can increase your chances of recurrence and the risk of developing a secondary cancer.

Like any bad habit, smoking is hard to break. You’ll probably have to try more than once. Ask your primary care physician for information on resources from acupuncture and patches to hypnotism.

Staying on top of post-cancer emotional health

Wouldn’t it be great to you could look up “cancer survivor” in the dictionary and get a definitive profile – how to act, what you’re going to feel like, whether you’ll have any long-term side effects?

Unfortunately, there’s no one way to be a cancer survivor.

After you’ve finished treatment, you may find that you’re bombarded with a host of new feelings. You’ve lost your cheerleaders, your platoon of meal makers. It may seem as if everyone but you forgot you had cancer.

It’s not surprising that cancer survivors in the U.S. take medicine for anxiety or depression at about twice the rate of people without a history of cancer.

Survivors worry about the cancer coming back. They may have sexual difficulties, infertility or body-image issues after surgery or treatment.

It’s imperative to be proactive about your emotional health. If you don’t deal with the emotional side effects of cancer, you may find it harder to heal and move on.

Limit stress

I know. Easier said than done. But there are ways to reduce stress, even if it’s just in small ways like learning to live with a little more mess if you’re a neatnik or staying away from your “sandpaper” people (the ones who rub you the wrong way).

Find a coping strategy that works for you

What makes you feel more alive and helps you forget the stress? Do more of it.

You may also find the following ideas help to alleviate the symptoms of anxiety and depression.

• Meditation or other mindfulness techniques like yoga, which has been studied for its links to easing pain and fatigue in cancer patients and survivors
• Therapists can be of immense help, yet cancer survivors often don’t seek out mental health professionals. Don’t be afraid to give counseling a try; we can provide resources.
• Cancer support groups, either online or face to face
• Advocacy or volunteer work, especially with cancer organizations
• Exercise. It seems to be the cure for all ills, doesn’t it? But it really can improve your mood.

Choose to be healthy

You are now one of an estimated 15.5 million cancer survivors in the country. That number will continue to grow as treatments like CyberKnife improve.

We know it’s not a club you wanted to join, but these millions of survivors are proof positive that it is possible to live a healthy life after cancer.

Find out more

Questions? Contact us Make an appointment

How to craft a cancer diet and lifestyle plan fit for CyberKnife treatment

It’s likely you’ve heard that maintaining a healthy diet and lifestyle is a critical factor in the battle to beat cancer. You’ve probably also heard horror stories about how difficult that can be during cancer treatment.

Both cancer and cancer treatment can cause extreme fatigue. Having the energy and appetite to prepare food can become difficult, and cancer treatment can also cause foods to taste unpleasant or different from what you’re used to.

Thankfully, CyberKnife delivers radiation to very small, targeted areas and is known for having a much smaller impact on quality of life, with fewer chronic side effects than chemotherapy or traditional radiation. Most CyberKnife patients are spared many of the diet and health difficulties frequently associated with cancer treatment.

However, while a CyberKnife patient may not face some of these cancer treatment challenges, battling cancer still takes a toll on your body, and well-rounded diet and lifestyle choices continue to play a key role in cancer treatment success. This means making healthy choices should be part of your overall cancer treatment plan.

Cancer fighting foods & the do’s and don’ts of a cancer diet

For starters, eating healthy does not mean eating perfectly. A good cancer diet after you’ve been diagnosed doesn’t have to be all about kale smoothies and roasted Brussels sprouts. But concentrating on getting the proper nutrients and hydration is critical to help you feel better and stay stronger through the whole course of cancer treatment.

To avoid malnutrition, weakness and fatigue, your cancer diet should be full of vitamins, minerals, protein, carbohydrates and good fats. Focus on whole, unprocessed or minimally processed foods, including fruits, vegetables, lean meat and grains.

Following are some cancer fighting foods and cancer diet tips you can use as a guide.

Plan ahead & don’t be afraid to mix it up

Treatment may have you feeling somewhat nauseous or dizzy, so it can be helpful to prepare your favorite foods and freeze them for when you need them. You may find that foods you used to love no longer taste as appealing and foods you used to dislike taste very good. Don’t be afraid to branch out.

Boost your greens

Aim for at least two to three cups of mixed fruit and vegetables each day. Vegetables and fruit are full of fiber and can help you effectively manage your weight.

Diversify proteins

During treatment meat may not sound as appealing or may have a higher fat concentration than your doctor would advise. Fish, eggs, cheese, beans, nuts, nut butters, tofu, or smoothies or shakes are all high in protein and provide a great reprieve from meat.

Pack a snack

Some cancer patients find it advantageous to graze or eat small snacks through the day. Snacks with high protein content like yogurt, hard boiled eggs, cheese and crackers, or dried fruit with nuts can help keep you full and give you much needed energy.

Hydrate creatively

If plain water seems unappealing, you can get creative by adding fresh fruits and vegetables like lemon or cucumber. Tea, milk, broth, sports drinks or unsweetened electrolyte powders can also help you stay hydrated.

Add a probiotic

Some studies have found that taking probiotics can improve treatment outcomes. Probiotic-rich foods like yogurt or fermented foods like kimchi and sauerkraut are good additions to your diet that can boost the good bacteria in your gut.

Change up cooking techniques

Baking or broiling foods can reduce the fat content of your favorite meal to make it healthier. Swapping high-fat products for lower-fat products can also help reduce the fat content of your meals.

Keep a food & symptom diary

This can be particularly helpful if you experience a lot of nausea or other food related symptoms. Track what you’re eating and when you’re eating to better understand if certain foods are irritating your stomach. This will help you determine how often you need to eat to avoid feeling drained.

No boozy brunches

Alcohol use is a risk factor for a number of cancers, and alcohol can have negative interactions with medications. So it’s best not to touch it. Even trace amounts in mouthwashes may be best avoided, as they can irritate and cause mouth sores. Mouth sores are more common during treatment of cancers in the head and neck area.

Busting cancer diet myths

Cancer causing agents are constantly researched, and there’s a lot we do and still don’t know about what causes cancer. However, there’s also a lot of misinformation about cancer and diet, so here are some of the most rampant rumors debunked.

Does sugar cause cancer?

Many people believe that refined sugar causes cancer, and that removing it from your diet can dramatically improve treatment outcomes. There’s no evidence to support the idea that including sugar in your diet makes cancer worse, or that removing sugar from your diet will “shrink” cancer.

Sugar does not cause cancer, but a diet high in sugar can lead to weight gain, which does increase your risk of cancer. So eating foods with sugar sparingly is a good step in a cancer diet.

What about artificial sweeteners?

There is still more research needed, but preliminary research has not uncovered a clear link between artificial sweeteners and cancer in humans. Artificial sweeteners like saccharin, aspartame, acesulfame potassium and sucralose have been approved by the Food and Drug Administration (FDA) for consumption.

Can superfoods like kale prevent and treat cancer?

Not only does a garlic, beetroot, kale and green tea smoothie sound terrible, there is little evidence that designated “superfoods” can prevent or treat cancer. While the term “superfood” has little scientific basis, you should still eat fresh fruits and vegetables that are rich in vitamins and minerals. Cancer is incredibly complex, and your diet is just one small factor in getting cancer free.

Does microwaving plastic containers make food cancerous?

Not necessarily. Some plastics with BPA or other chemicals that make the plastic soft can be dangerous to human health, but a majority of the plastic pre-prepared food comes in reusable plastic containers that are microwave safe. Single use bottles, margarine containers, yogurt cups and other single use containers can contain chemicals, however.

To determine whether a container is safe to microwave, you can generally find a warning on the box or container itself. If you are uncomfortable microwaving FDA approved or BPA-free containers, you can always switch to glass containers.

Cancer lifestyle changes & choices

Here are some other lifestyle changes and choices to consider during cancer treatment.

Exercise

Regular light-to-moderate exercise has a lot of benefits during cancer treatment and recovery. It can help you control weight, lessen nausea, lower the risk of and improve the symptoms of depression and anxiety, and improve your self-esteem. Yoga, dancing, walking, swimming, leisurely bike rides and tai chi are all gentle options.

Rest

It’s also important to balance the benefits of staying active with the priority of not getting too fatigued. Give yourself ample rest. Your activity level will depend on the type of cancer and your treatment plan, so it can be beneficial to discuss your routine with your oncologist.

Managing weight

If you’ve been diagnosed with cancer, it can be beneficial to discuss your diet and weight with your oncologist. They may recommend losing, gaining or maintaining weight in order to remain strong and healthy through treatment.

The CyberKnife difference on cancer treatment impact

CyberKnife does not have the same negative side effects as chemotherapy and traditional forms of radiation. Most patients remain highly active through their treatment, and do not face certain health difficulties such as severe nausea or loss of appetite.

Cancer risks and symptoms vary greatly from person to person, as do treatment symptoms. Your symptoms are likely to vary depending on the stage of treatment. It’s important to maintain an open line of communication with your doctor throughout treatment in order to manage food related symptoms and maintain a healthy quality of life.

Learn more about CyberKnife cancer treatment

Find out more

Questions? Contact us Make an appointment

Stereotactic body radiation therapy (SBRT) delivered by CyberKnife has distinct advantages over other treatments

Having performed more than 1,500 CyberKnife prostate cancer treatments, if I didn’t know better I would think that this technology was created specifically to treat this disease. It is completely suited to the specific challenges of prostate cancer treatment. Yet CyberKnife was first used mostly as a treatment for head, neck and spine tumors that were very difficult to reach.

The Food and Drug Administration (FDA) opened the door in 2001 to the use of CyberKnife to treat other cancers in the body. Since then urologists and oncologists are turning more and more to CyberKnife, as are patients.

CyberKnife’s primary advantages relate to reduced damage to healthy tissue surrounding the cancerous prostate tissues. This is largely due to CyberKnife’s ability to precisely target a tumor in the prostate without radiating healthy tissue. Damaging healthy tissue is the leading cause of side effects from radiation treatment.

SBRT limits the field of radiation

CyberKnife is a form of stereotactic body radiation therapy (SBRT), which is a coordinated system to exactly locate the tumor and limit the field of radiation treatment. SBRT delivers a single high dose of radiation or a few fractionized radiation treatments.

There are various types of SBRT, and I believe CyberKnife is the best. CyberKnife utilizes a robotic arm to deliver radiation in different ways and at different angles.

Ever try to slice a grape? It almost seems to squiggle away from the blade, and can result in a poor cut or even a smashed grape. But if you hold that grape against the cutting board between two fingers so it doesn’t move, you can slice it precisely the way you want.

The tumor under prostate cancer treatment acts much like the grape: It squiggles away. That’s because the prostate moves unpredictably, caused by air passing through the rectum and by the filling and emptying movements of the bladder, not to mention the patient sneezing – or just breathing.

The CyberKnife Robotic Surgery System blends robotics, computer-processing power, advanced imaging and the surgeon’s skill to make instantaneous corrections in radiation delivery. This is possible despite any movement of the patient or the prostate cancer tumor being targeted.

We accomplish this by injecting 3-5 tiny, gold reference-point markers into the prostate to guide the radiation beams. The patient lies comfortably in a custom made body cradle that molds to his body and ensures the same positioning during each treatment. The robotic arm swivels around the patient and delivers radiation at the precisely targeted tumor from various angles.

The big 3 benefits of this prostate cancer treatment

Most often we use CyberKnife by itself in prostate cancer treatment to treat early stage cancer that only affects the prostate and not surrounding areas. We also use CyberKnife in conjunction with other treatments such as traditional radiation when the cancer has spread beyond the prostate.

Prostate cancer patients treated with CyberKnife realize three benefits. These three benefits, in order of importance, follow.

It works

Clinical experiences published about CyberKnife prostate cancer treatment show a 93 percent recurrence-free rate five years after treatment; 94 percent recurrence-free rate at four years after treatment; and up to 100 percent recurrence-free rate after 44 months. Results also show lowered prostate-specific antigen (PSA) levels, which are recoded before treatment and tracked afterward and are good indications of longer-term recurrence-free rates.

Fewer side effects

Less toxicity following prostate cancer treatment or any cancer treatment means fewer side effects. The primary side effects from radiation treatment for prostate cancer are erectile dysfunction due to genitourinary toxicity and damage to the bowels and urinary function from gastrointestinal toxicity. These are graded from 0-4, with 0 being no toxicity and 4 being extreme toxicity.

The clinical studies on CyberKnife show that toxicity from the treatment is low, with grade 2-3 levels at 20-60 months following CyberKnife ranging from 2-10 percent for urinary toxicity and less for bowel toxicity (0-5 percent). Erectile dysfunction ranged from 60 percent to 13 percent, depending on the stage of the cancer and whether the prostate gland was precisely located.

Fewer treatments in less time

Compared with standard radiation treatment, CyberKnife delivers 4 times the usual dose of radiation per day, but with half the overall radiation dose over the full course of treatment. That’s because CyberKnife allows the higher dose to be more accurately delivered to “hug the prostate tumor” and spare the surrounding healthy tissue.

That means each CyberKnife treatment only takes about 45 minutes per day for about five days. Normal radiation treatment takes longer per session and sessions go on from 6-8 weeks. For younger men 50-60, who are likely to be working still, this is a valuable convenience.

I urge all men with prostate cancer to consider CyberKnife for treatment. It’s not for every man with prostate cancer that needs to be treated, but it’s a great option for a lot of them.

Is CyberKnife right for your cancer?

The most accurate way to deliver radiation, upgrading a century-old treatment.

Just about everyone knows that radiation is a standard form of treatment for cancer. It’s been used since 1896 in the form of x-rays. As you would imagine, in the last 120 years it’s been substantially improved and is now provided in different forms, with x-rays still one of them.

The objective in all forms of radiation therapy is to alter the DNA of the cancer cells so they do not reproduce and lose fluids. That causes the tumor to shrink at the rate of the cancer cells’ growth.

The different forms of radiation and delivery are all aimed at accomplishing the same objective. But that’s approached differently according to the cancer type, stage and other variables.

One radiation treatment option is stereotactic radiosurgery (SRS). Anova Cancer Care uses the CyberKnife robotic surgical system to perform SRS. Even though it has “surgery” in its name, stereotactic radiosurgery is not surgery at all. It got that name because the effects in the targeted zone are so dramatic they are referred to as “surgical.” CyberKnife and all methods of SRS discussed below apply radiation.

Some basics on radiation therapy

Cancer treatments utilize ionizing radiation that creates ions in cells it passes through. The ions, electrically charged particles, can kill cancer cells and stop their growth. The two types of ionizing radiation are photon (uses x-rays or gamma rays) and particle (uses electrons, neutrons, protons, alpha particles and others).

High-energy photon beam, the same as used in an x-ray machine, is the most commonly used in radiation therapy for cancer. Photon beams affect all cells they pass through before exiting the body.

Proton beam is a type of particle radiation. Proton beam releases its energy only after travelling to its target, causing little damage to the tissues the beams pass through.

Both photon beams and proton beams can be produced by a linear accelerator. CyberKnife is a specialized type of linear accelerator and is one way to perform stereotactic radiosurgery (SRS). It also produces electron and particle beams used to treat skin cancers and tumors close to the skin.

The three forms of SRS are linear accelerator (CyberKnife), proton beam and Cobalt-60 based using photons. Each type uses different technology, instruments and sources of radiation. And each are appropriate for delivering high-energy radiation to treat certain cancers.

All forms of SRS differ from traditional radiation therapy, which delivers radiation to a wide tissue field and damages more of the healthy tissue. SRS more accurately targets the cancer tissues specifically. The difference is in how they do that.

Comparing stereotactic radiosurgery methods

Stereotactic radiosurgery merges 3-D computer-assisted delivery of radiation with a high degree of accuracy to target only the cancerous cells and not surrounding healthy cells. That accuracy used to be achieved by limiting treatment to areas of the head and neck that could be immobilized by placing the patient’s head in a form, or screwing a plate into the skull. That’s now changed.

Linear accelerator SRS (CyberKnife)

The CyberKnife Robotic Radiosurgery System is the specific type of linear accelerator Anova Cancer Care uses. Other manufacturers produce linear accelerators, such as the Novalis Tx machine. Linear accelerators have benefits over the other types of SRS.

• One of the main advantages of the linear accelerator is that it can treat larger volume tumors by doing it over several sessions.
• Treating over time like this is called fractionated stereotactic radiotherapy, and it allows a flexibility unmatched by other machines providing SRS.
• Can be used on the head, neck and throughout the body.
• Linear accelerators move around the patient, eliminating the need for restraining devices.
• Delivering one large radiation beam that is split into many different arcs lessens the damage to healthy tissue.

Advantages of CyberKnife

In addition to the linear accelerator benefits above, CyberKnife has other specific advantages.

• Uses proprietary software that adjusts for patient movement – even breathing – during radiation beam delivery. This real-time, 3-D respiratory motion adjustment is key to CyberKnife’s reduced damage to healthy tissue.
• Image guidance compensates for the shifting of tumors during treatment and automatically adjusts to the location without pausing treatment. Tiny gold markers can be placed around the tumor to aid in this.
• CyberKnife can move in 360-degrees on multiple planes, where most other SRS delivery systems are limited to clockwise and counter-clockwise directions. CyberKnife’s flexibility delivers the beam of radiation in hundreds of different angles to target the precise margins of the tumor.
• Treatments can be completed in 1-5 days.
• No pain, no anesthesia, no pain medications, no recovery time or rehabilitation needed.
• Patient can go home right after treatment.

Particle/proton beam SRS

The radiation oncologist directs the high energy of the proton beams in a 3-D pattern from each beam. The protons release their maximum energy when they reach the designated target. The major limitation of proton beam SRS is that there are only a few facilities in the nation, as each facility costs upwards of $100 million.

Cobalt-60 SRS (Gamma Knife)

Cobalt-60 is a synthetic isotope of cobalt that produces gamma rays when it decays. It has been used to deliver radiation for the treatment of brain cancer since 1950, and that is still the cancer it is most often used on. The most well-known machine for delivering cobalt-60 is the Gamma Knife.

Gamma Knife doesn’t move during treatment so it can deliver high-energy radiation in a precise area of the brain. These machines are generally only located in dedicated neuroscience centers, and they are limited to treating brain cancers and some other smaller tumors.

Conclusion

CyberKnife is a specially advanced type of linear accelerator that has the versatility to effectively treat a wide range of cancers while greatly minimizing side effects commonly associated with radiation therapy.

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Recent studies prove CyberKnife’s efficacy in preserving sexual health with little to no side effects.

As one of the global leaders in treating prostate cancer patients with the revolutionary CyberKnife Robotic Radiosurgery System, I recently teamed up with several oncologists to collect and report on clinical research conducted to evaluate the efficacy and toxicity of CyberKnife for treatment. In the study, called the Multi-Institutional Registry for Prostate Cancer Radiosurgery, I along with my co-authors, report that CyberKnife treatment is effective in preserving sexual health without any other significant side effects.

Men who have been diagnosed with prostate cancer have a variety of treatment options available. Deciding which treatment to pursue can often be difficult, as there are many aspects to consider. One of the most important, aside from efficacy of treatment, is their quality of life after treatment compared with before treatment. Because treatment of the prostate involves the areas governing bowel, sexual and bladder function, quality of life after treatment is a major concern for men.

What we found in our study, whose results were published in Frontiers in Oncology, is that CyberKnife treatment is minimally harmful. We reported the following key findings:

• CyberKnife treatment produces low levels of toxicity that are superior to the level produced by other radiation treatment options including brachytherapy.
• Preservation of sexual function was achieved for 80 percent of patients who were sexually potent prior to CyberKnife treatment and somewhat less in men over 70 years old.
• The positive quality of life outcomes, low side effects, and brief duration of the CyberKnife treatment are particularly encouraging and significant for men weighing their many treatment options.

A proven radiosurgery therapy option

CyberKnife is a highly sophisticated type of stereotactic body radiation therapy (SBRT). SBRT focuses radiation beams and tracks an exact area of the body while the patient rests comfortably on the treatment couch.

The CyberKnife Robotic Radiosurgery System is the most advanced system for the delivery of radiosurgery therapy. And that’s the system we use exclusively.

Radiation therapy has been used for decades to treat prostate cancer with varying degrees of success. The goal of any radiation therapy for prostate cancer is to deliver the appropriate dose of radiation needed to kill the cancer cells, while not harming the surrounding healthy tissues and organs, which is what causes side effects.

The CyberKnife is one of the most recently developed tools for delivery of a high dose of radiation in a short time period, however high dose radiation for prostate cancer has been around for 30 years. The CyberKnife radiosurgery treatment has been recognized as a breakthrough system of cancer treatment since it’s inception in 1987. The first prototype, created by Dr. John R. Adler, a Stanford University Medical Center professor, was approved in 1999.

In 2001, the FDA approved SBRT-type therapies, including CyberKnife, for use throughout the entire body. In 2012, the American Society of Therapeutic Radiation Oncology (ASTRO) released a revised position on the use of radiosurgery in the management of prostate cancer, citing that these treatments “could be considered an appropriate alternative for select patients with low to intermediate-risk disease.” In 2013 the National Comprehensive Cancer Network (NCCN) recognized SBRT for prostate cancer as a standard treatment option.

I’ve personally treated more than 1,100 patients with the CyberKnife for prostate cancer and this is what I have seen:

• Patients with the earliest stage and grade of disease experience zero failures and have 100 percent control of their prostate cancer.
• In the next highest grade, patients enjoy over 99 percent control of the disease.
• All of the patients I’ve treated over the last year, regardless of stage and grade of prostate cancer, have had zero delayed side effects.

How does CyberKnife treatment work?

CyberKnife radiosurgery uses stereoscopic image guidance techniques to deliver large doses of radiation to a certain precise area, such as the prostate, and tracks it while it is moving. The doses of radiation are much greater than with other types of radiation treatment and are more effective at killing the cancer cells. The entire course of treatment is given over just a few days compared with typical radiation therapy, which can include over 40 separate treatments.

Questions? Read CyberKnife FAQs Contact Us

Patients who undergo CyberKnife treatment lie on a table under a robotic device that delivers beams of radiation. The radiation dosage applied is calculated based on the location, size, shape and density of the tumor.

A computer controls the robot that delivers the CyberKnife device’s radiation beams. Since the prescribed dose of radiation is only being applied to a specific area, the healthy parts of the body surrounding the tumor are not significantly affected. In addition, the CyberKnife automatically shifts its positioning to align with any movement of the tumor during the radiosurgery process, which occurs when the patient breathes, when muscles contract and relax, when the bowels fill, and as the bladder fills.

The treatment does not cause pain so an anesthetic is not needed and the patient can go home immediately after the procedure. Quite often patients will fall asleep, enjoying a nice nap on the comfortable, softly padded table during treatment. The primary patient benefits are:

• No incision
• No pain
• No hospital stay

CyberKnife treatment is a safe alternative to surgery for the treatment of cancerous and non-cancerous tumors anywhere in the body – including the prostate. Although there is always some risk of radiation exposure to areas of the body outside of the tumor, the instances of this occurring during CyberKnife treatment are significantly lower than with other radiation therapy treatments.

“An individual’s quality of life is an important aspect of having a fulfilling future. And the side effects of cancer treatment shouldn’t rob patients of this.”

At Anova Cancer Care, we treat patients with CyberKnife exclusively so they can return to life as they know it after cancer treatment. The majority of my patients say the same thing after being treated at Anova Cancer Care, “Why would anyone go anywhere else?” My patients’ lives are practically uninterrupted by the treatments that they receive.

Read our patient stories and testimonials to learn more about what they think about the treatment they received.

If you or someone you love or know needs to know more, I encourage you to reach out. Contact Us

CyberKnife provides men with prostate cancer treatment that doesn’t result in the consequences of surgery, nine weeks of daily radiation therapy or the surgical implanting of radioactive seeds.

Until the mid-1980s men diagnosed with prostate cancer were most likely detected at advanced, and often incurable, stages. A few men were diagnosed earlier when the cancer was discovered during surgery to relieve problems associated with urinating, but as a young doctor I saw countless men in misery with advanced prostate cancer that caused disabling and crippling bone metastases, urination problems, bleeding and swollen lower body parts—all due to the out of control growth of prostate cancer. We treated them by removing their testicles, giving them female hormones and delivering course after course of radiation to try to relieve their suffering.

In the mid-1980s it was discovered that prostate cancer was frequently associated with elevated levels of prostatic specific antigen (PSA). A PSA blood test was developed and it was the beginning of a revolution. Over the following years, the PSA test provided earlier detection of prostate cancer, which allowed for potentially curable treatments. As a result, the number of men who died of prostate cancer over the years has decreased tremendously.

Why did the PSA guidelines change?

Despite such an incredible difference the PSA test has made in the lives of millions of men over the last 30 years, the United States Preventive Services Task Force (USPSTF) recommended against using it to screen men for prostate cancer in 2011. The task force comprised of 16 volunteer clinicians including family physicians, general internal medicine physicians, nurses, obstetrician-gynecologists, occupational medicine physicians and pediatricians. There were no urologists or radiation oncologists directly involved in the recommendation.

The task force stated that they evaluated evidence on whether primary-care practitioners should recommend PSA screening. One of their concerns was the chance of a false-positive reading and the potential stress it could cause for patients. While this is a valid consideration, many physicians believe it is best for patients with elevated PSA levels to be under the care of a urologist to monitor their PSA levels and determine if they have prostate cancer.

I remember reading about the final recommendation of the USPSTF and predicted there would be unfortunate consequences for men, and this has proven true. The 2015 American Society for Clinical Oncology (ASCO) Genitourinary Cancers Symposium reported that since 2011, there has been an increase in the proportion of men diagnosed with higher-risk prostate cancers. With 233,000 new cases of prostate cancer every year, this means 14,000 more of them will be diagnosed with prostate cancer that is less likely to be cured.

The American Urologic Association, ASCO and the National Comprehensive Cancer Network—all specialists in treating prostate cancer—disagree with the USPSTF PSA screening recommendation.

European and American randomized studies have also shown a survival advantage for men who undergo screening compared with those who do not because prostate cancer is very curable when it is diagnosed early and classified as low risk. It is less curable when it is classified as intermediate and high risk.

I do not know how a stronger case can be made for PSA screening for prostate cancer.

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I’ve been diagnosed with prostate cancer, now what?

After a prostate cancer diagnosis, there has been a trend for some patients to watch, wait and not treat until the prostate cancer gets worse. One reason for this approach is that the side effects of treatments like radical prostatectomy surgery, nine weeks of daily radiation therapy or surgical seed implants may have more negative consequences than actively watching the cancer.

Patients have an alternative – stereotactic body radiation therapy (SBRT) using the CyberKnife system. CyberKnife is a specialized radiation device attached to a robotic arm that allows us to “paint” the tumor with radiation and with extreme accuracy. This allows us to place the radiation on the prostate gland where it is needed and avoid the surrounding critical tissues (the rectum, bladder and nerves that control the ability to have erections). CyberKnife delivers an effective treatment in just five visits rather than 30-45 treatments using common radiation equipment. Less time in the clinic means less interruption of your life.

Over the past six years, I’ve treated hundreds of prostate patients with CyberKnife, and they would likely tell you the biopsy caused more side effects than the treatment did. For those with early low-risk tumors, there has not been a single failure to control their cancer. These results, along with those from 44 other CyberKnife centers throughout the United States, are published in the January 2015 paper titled “Multi-Institutional Registry for Prostate Cancer Radiosurgery,” a prospective observational clinical trial written by me, as well as Drs. Freemen and Perman, that presents data on 1,750 men treated with the CyberKnife for prostate cancer.

The standard for treating brain metastases back in 1954 was whole brain radiation therapy. The intent of whole brain radiation therapy is to help deal with cancer that spread to the brains by treating the whole brain, all of it, with radiation.

When I trained in the ’80s, whole brain radiation remained the standard of care for brain metastases. I observed that the effects of the treatment were often worse than the disease itself with respect to the patient’s quality of life. Patients always had moderate to severe problems with brain function after treatment.

How bad was it? Let’s say if they could balance their checkbook prior to treatment, they weren’t likely to be able to after. Other negative effects included memory problems, being able to understand, and other changes in how they were able to think and do things prior to treatment.

The benefit of the treatment was that the patients could live a few months longer…but I always thought, and still think, that the downside was very significant.

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Fifty years later the standard for treating brain metastases is still whole brain radiation. What? How can this be true with all the advances in medical science over the last 50 years? How can this be true when treating brain metastases, using radiosurgical techniques with CyberKnife and other machines, is readily available?

According to the Wall Street Journal article, “Cancer Radiation Questioned,” 200,000 patients with brain metastases are subjected to whole-brain radiation therapy for brain metastases each year. Doctors at MD Anderson have recently investigated the outcomes after using whole brain radiation and…. surprise! They found a negative impact on brain function that was “more than they expected!”

This is not the first group of doctors who studied problem and found whole brain radiation an unsatisfactory treatment option for patients with brain metastases who were doing well otherwise — responding to other treatments, and would live for months or years if not for the brain metastases.

What alternatives are there? As I have said, treating brain metastases with radiosurgical techniques, such as with CyberKnife and other machines, is readily available and is not associated with the consequences of whole brain radiation.

However, to be fair, there are some patients for whom whole brain radiation could be the right treatment, and I do recommend it for those few patients that I consider it to be the best treatment option.

The treatment of brain metastases is another one of the many areas where radiosurgical treatment with the CyberKnife excels, and if you’re reading this, know that the procedure is available today for patients who have brain metastases.

Make it your mission to not let someone you love or know become one of the 200,000 casualties of over-treatment with whole brain radiation every year.