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Douglas J. Rivera, M.D., Radiation Oncologist and Medical Director at Austin CyberKnife, recently spoke at the Williamson County Us TOO Prostate Cancer Support Group chapter meeting.

The meeting, which takes place on the second Thursday of every month, was held at 3 p.m. on April 11 at the Baylor Scott & White Clinic community room in Georgetown, Texas.

Dr. Rivera was a guest speaker at the event and lectured about radiation treatment options for patients with prostate cancer.  The men in attendance asked detailed questions, shared their personal experiences, and a few of Dr. Rivera’s former patients recounted their experiences with CyberKnife treatment for prostate cancer.  The meeting organizers commented on Dr. Rivera’s clinical knowledge, as well as his attentiveness to his patient’s needs.

Us TOO International is the largest non-profit prostate cancer education and support network in the world today.  Founded in 1990, their mission has been to serve as a resource for peer-to-peer prostate cancer support and educational materials provided at no charge to help men and their spouses/partners/families make informed decisions about prostate cancer detection, treatment options, and related side effects.

Us TOO has a network of hundreds of support groups and chapters.  Meetings are free of charge and open to newly diagnosed patients, patients currently undergoing treatment, prostate cancer survivors, their spouses/partners, family members, friends, and health care professionals interested in sharing information and learning more about prostate cancer.

Dr. Rivera, along with the other members of the radiation oncology team at Austin CyberKnife, uses a team approach in which the center’s medical experts collaborate to develop a customized treatment plan for each patient’s specific case.

For more information about Dr. Rivera, or any of the radiation oncologists at Austin CyberKnife, please click here.

Photo caption:  Dr. Rivera speaks at the Austin Us TOO monthly meeting.

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At his annual physical in the spring of 2016, Phil Van Ostrand’s primary care physician told him that his PSA (Prostate-Specific Antigen) level was elevated. The 72-year-old Woodcreek, Texas resident was not too alarmed, he had heard this news before.

“I had struggled with intermediate and high PSA levels off and on for several years,” said Van Ostrand. “It was generally diagnosed as prostatitis and aggressively treated with antibiotics until the PSA level went back down.”

Phil’s PCP told him that his PSA had jumped back up again and he was starting to get concerned because every time it went up and back down again, the final number was a higher low. He referred Phil to an in-house urologist who ordered a biopsy and the result came back positive for prostate cancer.

The urologist was ready to move forward with surgery, but Phil was not. He talked with his PCP and his physician let him know that he did not have to have surgery, he had options. Van Ostrand felt that the “future that the urologist offered with surgery was unacceptable, so they were done.”

Once Van Ostrand decided that surgery was not the right treatment option for him, he took some time to think about his next step. He self-referred himself to two oncology practices where he was offered surgery (again) or conventional radiation therapy, which consisted of over 30 office visits that did not work with his busy travel schedule. It was back to more research for Van Ostrand.

“As part of my research online, I had come across stereotactic radiation therapy,” Van Ostrand said. “I like what I read and wanted to learn more about it, so I made an appointment with Dr. Ghafoori at Austin CyberKnife.”

Van Ostrand met with Paiman Ghafoori, M.D., a board-certified radiation oncologist at Austin CyberKnife, and learned that he treated prostate cancer with Stereotactic Body Radiation Therapy, or SBRT, with the CyberKnife® Robotic Radiosurgery System, a painless, non-invasive treatment technology in which high-dose radiation was delivered to the tumor from a linear accelerator mounted on a highly maneuverable robotic arm. Hundreds of different angles enabled 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 reduced treatment time to just five outpatient visits, compared to the average 45 visits conventional radiation therapy required.

“After speaking with Dr. Ghafoori, I decided that the stereotactic approach was the right one for me,” said Van Ostrand. “My lack of patience is legendary, so the fact that the appointments were quick and would not consume a lot of time appealed to me. I also liked that the efficiency of the treatments was well documented and the location of the center was convenient.”

After Dr. Ghafoori completed Mr. Van Ostrand’s treatment plan, and the office worked with his schedule, his first CyberKnife treatment was booked.

Van Ostrand’s treatment plan included five CyberKnife treatment sessions that lasted about an hour each. He recalls the treatments being quick and easy.

“At no time during the course of treatment did I have any after effects,” said Van Ostrand. “Treatments were a breeze and I worked full days every day of treatment. My experience with the whole treatment regime was a non-event.”

In addition to his CyberKnife treatments being rather easy, Van Ostrand noted that Dr. Ghafoori and the entire multidisciplinary staff at Austin CyberKnife were outstanding and he appreciated them working with his schedule. He also commented on the ease of getting in and out of Austin CyberKnife for his treatments. He appreciated the center’s close proximity to the complimentary parking garage.

Today, Phil Van Ostrand says he feels fantastic and is enjoying life. He continues to receive good reports regarding his PSA levels and he has celebrated his second anniversary of being cancer free.

When asked if he would recommend Austin CyberKnife to others facing a cancer diagnosis, Mr. Van Ostrand replied, “Absolutely. I am very happy with the decision I made to go with CyberKnife and I would definitely suggest it to anyone searching for treatment options for prostate cancer.”

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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 Austin 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 Austin CyberKnife treats prostate cancer with CyberKnife technology, please click here.

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Dr. McCurdy Discusses Prostate Cancer on Studio 512 - YouTube

In honor of September being National Prostate Cancer Awareness Month, watch Matthew McCurdy, M.D., radiation oncologist at Austin CyberKnife, discuss prostate cancer, how it is treated with the CyberKnife® Robotic Radiosurgery System, and CyberKnife treatment benefits for patients.

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Dr. McCurdy Discusses Prostate Cancer on Studio 512 - YouTube

Watch Matthew McCurdy, M.D., radiation oncologist at Austin CyberKnife, discuss prostate cancer, how it is treated with the CyberKnife® Robotic Radiosurgery System and CyberKnife treatment benefits for patients, on KXAN’s Studio 512.

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Dr. Rivera and Dr. Chhikara Discuss Prostate Cancer on Studio 512 - YouTube

Watch Douglas J. Rivera, M.D. radiation oncologist and Medical Director at Austin CyberKnife and Subir Chhikara, M.D., urologist at Austin Urological Associates discuss the risk factors, signs, symptoms, and stats associated with prostate cancer, prostate cancer screenings, and how prostate cancer is treated with the CyberKnife® Robotic Radiosurgery System on KXAN’s Studio 512.

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Last week, the American Urological Association (AUA), the American Society for Radiation Oncology (ASTRO), and the Society of Urologic Oncology (SUO) released collaborative clinical guidelines for managing localized prostate cancer which offers a framework for shared decision-making between physicians and patients.  Through this collaboration, the committee provided guidance on active surveillance and on which treatments are appropriate for cancers warranting intervention.  The guidelines also include specifics for implementing care options, managing side effects, and administering post-treatment follow-up.

The guidelines are comprised of 68 statements grouped into six categories and include topics such as shared decision making, care options by cancer severity/risk group, recommended approaches/details on specific care options, outcome expectation and management, and future directions.

While the guidelines are inclusive of all treatment options, they contain several positive statements on radiation therapy and are supportive of the use of stereotactic body radiation therapy (SBRT) for low- and favorable intermediate-risk prostate cancer.

The guideline position on single modality external beam radiation for low- to favorable intermediate-risk prostate cancer, which includes IMRT and SBRT, reads: Clinicians may offer single modality external beam radiotherapy or brachytherapy for patients who elect radiotherapy for low-risk localized prostate cancer.  Clinicians may offer external beam radiotherapy or brachytherapy alone or in combination for favorable intermediate-risk localized prostate cancer.

The committee deemed these statements as clinical principles, which are statements about a component of clinical care that is widely agreed upon by urologists or other clinicians for which there may or may not be evidence in the medical literature.

At Austin CyberKnife, men diagnosed with prostate cancer are treated with SBRT with the CyberKnife® Robotic Radiosurgery System.  CyberKnife is 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 Austin CyberKnife treats prostate cancer with CyberKnife technology, please click here.  To read the AUA/ASTRO/SUO prostate guidelines in its entirety, please click here.

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Dr. Heuser's Prostate Cancer Story - YouTube

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.

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Dr. Cox Discusses Prostate Cancer on Studio 512 - YouTube
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A recent research paper in Oncotarget, a weekly peer-reviewed open access medical journal covering research on all aspects of oncology, reported that researchers from UR Medicine’s Wilmot Cancer Institute and Roswell Park Cancer Institute have discovered a possible new tool for predicting whether prostate cancer will reoccur following surgery based on the expression patterns of four genes.

Since prostate cancer is the most common cancer in men and the incidence is expected to rise with an aging population, detecting a way to predict the course of prostate cancer is vital.

“Our study sought to improve upon the prediction tools used in these types of cases so that oncologists would know with more certainty when to recommend additional treatment, such as radiotherapy, immediately after surgery,” said Hucky Land, Ph.D., lead researcher.

Land’s lab discovered a large group of non-mutated genes that are actively involved in cancer development.  After analyzing expression of this gene set in frozen prostate cancer tissue samples, researchers discovered the four-gene signature, which was expressed differently in prostate cancer that later returned.

The Wilmot/Roswell Park tool was able to predict recurrence, based on human tissue samples and known patient outcomes, with 83 percent accuracy.  Currently, the only other way to estimate tumor aggressiveness is with a Gleason score, a grading system for prostate tumors.

At Austin CyberKnife, we treat men for prostate cancer using the CyberKnife® Robotic Radiosurgery System.  CyberKnife 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 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 find out more about how Austin CyberKnife treats prostate cancer, including a video on prostate cancer treatment, please click here.

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