CyberKnife “most promising” weapon in fight against prostate cancer

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NEW BRUNSWICK – Men with prostate cancer no longer need to travel far from Middlesex County to receive the “most promising, highly effective and rapid treatment’’ that is available, according to Anthony Catanese, M.D., a central New Jersey urologist. Instead, those men can go to Saint Peter’s University Hospital, which boasts the central New Jersey region’s only CyberKnife.
CyberKnife is an external radiation therapy that attacks hard-to-reach tumors anywhere in the body with sub-millimeter accuracy and offers a non-surgical alternative to cancer treatment. CyberKnife requires no incisions, anesthesia or inpatient hospital stays, and its use has few or no side effects. CyberKnife treatments are pain-free and completely non-invasive, with no recovery time.
CyberKnife is able to attack cancer from all angles by using a focused beam of radiation with pinpoint accuracy and can treat tumors previously thought to be inoperable, including brain, head, neck, liver, lung, pancreas and spine. CyberKnife is especially useful against prostate cancer, not only for its ability to eradicate the tumor but for its ability to spare the healthy surrounding tissue.
“It locks on to the tumor like a guided missile,’’ said Dr. Gopal Desai, M.D., chairman of the Radiation Oncology Department and medical director of the Saint Peter’s CyberKnife Department.
And, more so than any other treatment option, CyberKnife lowers the incidence of damage to the rectum and to the bowels, enabling many men to return to their normal lifestyles, Catanese said.
Prostate Cancer Facts and the Symptoms
If you are a man of age 50 or older, your urge to urinate may have become more frequent of late. If that is the case, the most likely culprit is your prostate gland, or, to be more precise, the growing size of your prostate gland. An enlarged prostate commonly leads to a weak or interrupted urinary stream, the urge to urinate more frequently, and the repeated interruption of a solid night’s sleep.
An enlarged prostate gland, what is otherwise known as BPH, or benign prostate hyperplasia, is a typical part of the aging process for most men. Nevertheless, it is possible that those symptoms,  especially when they surface in close association with other related physical ailments, could signal something else – something far more serious and threatening – the possibility of prostate cancer.
One in six men will get prostate cancer by the age of 65. Most early cases of prostate cancer are asymptomatic, but signs of prostate cancer may include a painful or burning sensation during urination or ejaculation, as well as blood in the urine or semen. More advanced stages of prostate cancer may also be accompanied by a dull or deep pain in the lower back, upper thighs, ribs or pelvis; chronic fatigue; weight loss; poor appetite, or swelling in the legs.  
If you experience any of these symptoms, please get checked by a physician. Should you have prostate cancer, however, there are two treatment options for most men in their 50s through their 70s: radiation therapy or surgery. A third course of action – to do nothing – is usually reserved for much older men in their 80s to their 90s, in whom prostate cancer tends to advance very slowly. 
Why CyberKnife for Prostate Cancer?
Radiation therapy for prostate cancer is administered in two principal forms: external beam radiation, in which a high-energy X-ray machine directs radiation to the prostate tumor, and the implantation of radioactive seeds into the prostate gland, a procedure known as brachytherapy.
Radiation treatment for prostate cancer has significant downsides and side-effects, however.
External beam radiation involves as many as 40 radiation sessions of 20 minutes apiece delivered over the course of several months. And radiation treatment may do physical damage, including possible harm to the bowels and bladder, sometimes resulting in impotence and incontinence.
CyberKnife is different. Though rectum and bladder damage is possible, the incidence is very low, said Catanese, who has treated more than 3,000 prostate cancer patients in his career. Catanese added that CyberKnife enables most prostate cancer patients to be treated in just five visits over a matter of just several weeks, a significant advantage over radiation therapy and the several months that it takes to complete its course of treatment.
The CyberKnife Process
CyberKnife technology is appropriate for use on patients in which their prostate cancer remains localized, according to the size and extent of the tumor, and where it has spread, Catanese said.
Treatment is started by the implantation of marker seeds into the tumor. The surgical team includes a urologist, a physicist, a radiation oncologist, a machine technician, a nurse, and the CyberKnife itself. Those clinicians design a custom plan fitted to each patient by first producing a series of very high-quality X-rays. Those X-rays are merged together to form a high-quality, three-dimensional composite image of the prostate gland as well as a high-quality, three-dimensional composite model of the tumor.
Areas of treatment are next marked by color, showing areas of need, from cancerous tissue – the highest, marked in red – to healthy tissue – the lowest, marked in blue. The complex plan is customized to the size of the tumor, its extent and the grade of severity of the tumor. The computer software next checks the plan, producing alternatives, each crafted to avoid healthy tissue.
The Patient Knows Best
Raymond Facinelli, 80, a Green Brook resident, is a CyberKnife fan. As an older patient, Facinelli had two CyberKnife treatments, augmented by a follow-up series of radiation treatments. Though his cancer “was particularly aggressive,’’ today he is cancer free and he credits CyberKnife.
“CyberKnife at Saint Peter’s has represented a strong addition to the prostate cancer armamentarium,’’ said David H. Koota, MD, a urologist located in Hillsborough. “My prostate cancer patients have greatly appreciated CyberKnife for its efficiency and effectiveness.’’
Urologists Who Perform CyberKnife Surgery at Saint Peter’s 
1 – Marc Feder, M.D., Genitourinary Surgeons of NJ, Surgery/Urology, 211 Courtyard Drive, Suite 201, Hillsborough, NJ, 08844, 908-685-0080
2 – David H. Koota, M.D., Genitourinary Surgeons of NJ, Surgery/Urology, 211 Courtyard Drive, Suite 201, Hillsborough, NJ, 08844, 908-685-0080
3 – Michael J. Solomon, M.D., Genitourinary Surgeons of NJ, Surgery/Urology, 211 Courtyard Drive, Suite 201, Hillsborough, NJ, 08844, 908-685-0080
4 – Anthony Catanese, M.D., Partners in Urology Group, Surgery/Urology, 315 E. Main St., Somerville, NJ, 08876, 908-722-6900
5 – Richard Ioffreda, M.D., P.F. Ioffreda, MD, PA, Surgery/Urology, 1250 Marigold Street, North Brunswick, NJ, 08902, 732-545-8259
6 – Ramon E. Rodriguez, M.D., P.F. Ioffreda, MD, PA, Surgery/Urology, 1250 Marigold Street, North Brunswick, NJ, 08902, 732-545-8259
7 – Edward C. White, M.D., Urology Group of Central New Jersey, Surgery/Urology, 4 Auer Court, Suite A&B, East Brunswick, NJ, 08816, 732-390-4447.