Cyberknife Treatment of Prostate Cancer

James Derbyshire* is one of the first patients to have the state-of-the-art Cyberknife treatment in Birmingham. The intensive and extremely accurate technology reduces the number of sessions from 37 to just five. Mr Derbyshire, who is 72, describes his experience.

“My prostate cancer was diagnosed purely by chance and persistence. It started with some slightly irregular blood tests, although at the time, it wasn’t my prostate that was the focus of concerns. There was some pain in my lower back and I had a number of tests and as part of those assessments, my PSA was also measured. The result was 3.5 which was within my age related threshold and I was told there was nothing to worry about.

“But there is a strong history of prostate cancer in my family. I wasn’t convinced that my PSA result was sufficient to rule out prostate cancer, asked for a referral to a specialist and saw Mr Alan Doherty at the Birmingham Prostate Clinic. Mr Doherty carried out another test, called a PCA3, which measures your prostate cancer risk in a different way, looking at how genes are expressed. Mine came back at a reading of more than 100, which indicated that I almost certainly had prostate cancer and a biopsy showed this was indeed the case. I will always be grateful to Mr Doherty for getting to the bottom of things, diagnosing my cancer, then also supporting me to have a full choice of different treatments.

“I was fortunate that the diagnosis was made while the cancer was confined to my prostate. Looking at the options, I wasn’t keen on surgery or on waiting and monitoring. My brother had prostate cancer, did a lot of research and told me about the Cyberknife. It instantly seemed a very good option – my work is in engineering, so the technology appealed to me and the idea of five intensive treatments rather than 37 for traditional radiotherapy was an obvious advantage.

“I initially thought the Cyberknife was only available in London, but my oncologist, Dr Ahmed El-Modir at the Birmingham Prostate Clinic, explained that I could have the treatment at the Queen Elizabeth Hospital, Birmingham.

“The first step is to have tiny gold ‘markers’ inserted in your prostate to map out the treatment. There is no pain or incision – you have a general anesthetic and they are inserted using a needle using ultrasound guidance. I didn’t really know what to expect when I arrived for my first Cyberknife treatment. My first impression was how friendly the staff were, helping me to feel relaxed and how new and pleasant the treatment room was with nice music. In fact, on a couple of occasions I nodded off during treatment.

“You don’t feel anything during treatment which takes about one hour each time. I went back to work after each of my five treatments – I didn’t miss any time at work at all, apart from a few hours for appointments. There were no side-effects: I felt fine and after each treatment, had lunch then returned to work. The only noticeable thing was when I went to the toilet, my flow was a little slower, which I understand is due to a little prostate swelling from the treatment. But there is no pain, discomfort or any obvious tiredness and within two to three weeks, my flow was back to normal.

“This might seem a surprising thing to say about cancer treatment, but it was a really pleasant experience which had no adverse effect on my life whatsoever. It is early days for me as it is only three weeks since my treatment, but I know this is a very effective, intensive treatment with very high cancer clearance rates. My brother very sadly passed away in August, dying before he was able to benefit from the Cyberknife. I feel very fortunate that he told me about it and that the treatment is available in Birmingham. I hope many more men will be able to have this treatment too.

“It is a frightening thought that for me, PSA was useless. My GP told me that my reading just before I was diagnosed was 2.6 – it had gone down and would not appear anything to worry about for a man of my age. It was my family history and my gut feeling that I needed to see a specialist that made all the difference. Things could have been very different for me. My advice would be – if you are worried at all, make sure you see a really good specialist and that you have the most advanced tests and treatments.”

*The patient wishes to remain anonymous so his name has been changed.