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Dr. Garber is a Urologist specializing in the following areas:
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Subspecialty Areas » CyberKnife® Treatment of Prostate Cancer
CyberKnife® Treatment of Prostate Cancer
Prostate cancer can be treated in a variety of ways, including:
- Observation (no immediate treatment);
- Radical prostatectomy (complete surgical removal of the prostate and seminal vesicles, through an incision in the abdomen or under the scrotum, or using laparoscopy with or without a surgical robot);
- Hormone therapy (anti-androgen treatments designed to lower the male hormone level and/or block the effects of male hormones);
- Chemotherapy (usually reserved for patients with extensive cancer); and
- Radiation therapy.
Radiation therapy for prostate cancer has undergone tremendous evolution in the past two decades and has included techniques such as:
- Four-field external beam treatment;
- 3D conformal radiation;
- Intensity-modulated radiotherapy (IMRT);
- Brachytherapy (low dose rate radioactive seed implantation, and high dose rate brachytherapy);
- Tomotherapy;
- Image-guided radiotherapy (IGRT);
- Proton therapy; and, most recently:
- CyberKnife® stereotactic radiosurgery.
CyberKnife® is a robotic radio-surgery system, which is used to treat a variety of benign and malignant tumors. It is composed of a compact linear accelerator (a source of radiation), which is mounted on a computer-controlled arm. The CyberKnife® System uses real-time continuous image guidance during each treatment session. It delivers multiple beams of high-energy radiation to the tumor from many different directions, and constantly adjusts for any movement of the target organ. The net result is a high dose of radiation delivered to the cancer, in the most precise way currently possible. Radiation treatments are accurately delivered to the prostate and a small amount of tissue surrounding the prostate, minimizing the amount of radiation received by sensitive nearby structures (such as the bladder, rectum, and penis).
A typical patient would proceed as follows:
- Prostate cancer is suspected due to an abnormal prostate exam or an elevated prostate-specific antigen (PSA) level;
- Prostate cancer is diagnosed by a prostate biopsy;
- X-rays (a bone scan, MRI or CT scan) may be ordered to evaluate the extent of the cancer;
- Treatment options are discussed. If CyberKnife® is selected, the patient is referred to Philadelphia CyberKnife® Center in Havertown, PA (610-446-6850, www.phillycyberknife.com) for evaluation by a CyberKnife®-trained radiation oncologist. When the decision to proceed with CyberKnife® treatment has been made, the patient returns to Dr. Garber for placement of 4 tiny gold markers (fiducials) into the prostate. This is done in the office with local anesthesia, and only takes a few moments. These 4 gold markers are important; they are used to track the position and movement of the prostate during CyberKnife® treatments, and allow pinpoint accuracy of the CyberKnife® therapy.
- Approximately 1 week after placement of the gold markers, the patient is scheduled for a CT and/or MRI scan of the prostate. Once this data is available, Dr. Garber and the radiation oncologist carry out computer-based treatment planning, so that the CyberKnife® targets the prostate and avoids the surrounding tissues.
- Once the treatment planning is complete, the actual treatments are scheduled. All treatments are outpatient. They are painless, and take 1-2 hours each. Typically only 5 treatments are needed, and are done over the course of a week. No anesthesia is required.
To see video animation of the CyberKnife® system, click here.
Typical advantages of CyberKnife® stereotactic radiosurgery include the following:
- Treatments are painless and non-invasive
- No anesthesia is needed
- Only 5 treatments needed, unlike the 6-7 weeks of daily treatment needed for standard radiotherapy
- Quick return to normal activities
- Radiation is directed precisely at the prostate, with maximal sparing of the bladder, rectum, urethra and penis, thus minimizing radiation cystitis and proctitis
- No scalpel, no surgery, no blood loss, no risk of infection
- Proton therapy, widely touted in the news media, cannot compensate for prostate movement and cannot be targeted as precisely as CyberKnife®.
Dr. Garber has pioneered CyberKnife® treatment of organ-confined prostate cancer in the Philadelphia area, and is featured on the Philadelphia CyberKnife® website (www.phillycyberknife.com). To find out more about this treatment option, schedule a confidential consultation with our office: 610-613-9251. Please refer to the "Your Initial Visit" section of this website, so that you bring all of the necessary information with you.
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Dr. Bruce B. Garber
Box 686
Bryn Mawr, PA 19010
610-613-9251 Phone
urologicsurgeons@comcast.net Email
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