Life– Terror. Ecstasy. Fight. Denial. Flight. Failure. PAIN. Forgiveness. Reconciliation. Hope. Love. Peace – Death.
Also known as stereotactic body radiation treatment or CyberKnife® (SBRT), is a highly focused radiation treatment that gives an intense dose of radiation concentrated on a tumour, while limiting the radiation dose to the surrounding organs. Lowering the risk of collateral damage.
SABR differs from conventional radiation in several ways. Stereotactic radiotherapy (SRT) gives radiotherapy from many different angles around the body. The beams meet at the tumour. This means the tumour receives a higher dose of radiation and the tissues around it receive a much lower dose. It delivers a high radiation dose to the target that can potentially eliminate cancer. It is typically used to treat smaller tumours that have been detected early.
High effectiveness and accuracy – For most indications, local tumour control rates of 90% can be achieved. SABR uses the latest image guidance technologies to ablate tumours with millimetre-scale accuracy. The ability to spare healthy tissue while intensifying the radiation dose is the primary advantage of SABR over other modalities, particularly when critical structures (bowel, bladder) are located near the treatment area.
Non-invasive – SABR is non-invasive and comfortable for the patient.
Convenient, outpatient service – The vast majority of treatments are done as short outpatient visits of 30 minutes to an hour, requiring no hospitalisation. Treatment courses are generally completed in 1-5 days, allowing more freedom for patients’ busy lives, even if they are travelling from a distance, and resulting in little or no interruption of their scheduled chemotherapy or other cancer treatments.
It has become a treatment of choice for many people with limited volume tumours for whom surgery may not be an optimal treatment, treating tumours throughout the body, with extracranial sites that include head and neck, thorax, abdomen (liver, pancreas, adrenal), prostate, pelvis and bone. SBRT for prostate cancer was pioneered by Stanford’s radiation oncologists.
SABR might be available as a treatment option through routine commissioning for patients (all ages) with controlled primary cancer presenting with up to three extracranial metachronous oligometastases which manifest after a disease-free interval following primary treatment of at least 6 months, in line with NHS criteria.
Availability will be governed by postcode. Available/prioritised funding within individual (PCT’s) primary care trusts. PCT’s now, rebranded, clinical commissioning trusts. My first SABR treatment (2019) via The Royal Liverpool Primary Care (Hospitals)Trust was only made available due to a specific, externally funded trial, examining the effectiveness within Prostate Cancer treatment.
Back in 2019 SABR was reserved for other cancers, such as paediatric, brain cancer patients. After assessment (a nuclear isotope induced PSMA-PET Scan), I was advised they would not perform SABR, the risks were too high. I requested a second opinion via the Christie, Manchester who also refused to treat via SABR.
Clatterbridge, reconsidered (after gaining access to trial funding) and eventually agreed to my treatment to remove a small tumour within a lymph node close to the old prostate sight (pelvic bed) area. 3 infractions over 3 days with no, post treatment, obvious short or long term side-effects.
Private SABR is available.
Private SABR costs are an average of £6,700 per treatment.(infraction). Not cheap!
Potential side effects are individual and can vary and include, fatigue, nausea, headache, bleeding, pain, occasionally vertigo and sometimes infection (depending upon the treatment site).
Repeat SBRT appears to be a relatively safe treatment in patients not developing grade 2 or higher radiation pneumonitis after their first SBRT, although grade 5 toxicities have been reported especially in patients with a central tumour. Patients with local recurrence still have a chance of cure by repeat SBRT.
I am currently (2022) midway thru my second SABR round to remove an 11mm tumour also within the pelvic bed. This time 5 infractions, every other day over two weeks.
In some cases, SBRT can be a more effective form of treatment for prostate cancer than conventional radiation or surgery. A 5-year study found that those who received SBRT for prostate cancer had a 94 percent survival rate at 3 years and 89.7 percent survival rate at 5 years.
The most common side effect of SBRT for prostate cancer is urinary irritation (feelings of both frequency and urgency). Some patients may also experience a weaker stream. “These symptoms usually go away a few weeks after SBRT, and patients typically return to baseline function within six months,”
Based on the natural history of locally (advanced) prostate cancer, the life expectancy (LE) of men treated with either radical prostatectomy (RP) or definitive external-beam radiotherapy (EBRT) will not exceed 10 years.
What is a good PSA level after radiation?
Recent studies have shown that for optimal results, PSA levels post radiation therapy should be lower than 1 ng/ml, and even lower than 0.5 ng/ml. Levels that are above 1 or 2 ng/ml 12 to 18 months following completion of radiation treatments are very worrisome, because they indicate that the cancer may not have been eradicated
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