Cyberknife Compared to Robotic Surgery

Cyberknife and da Vinci surgery are two different treatment methods that may be recommended by a urologist when a man is diagnosed with prostate cancer.  Deciding which method is  appropriate for achieving the end result of a eliminating the cancer will depend on various factors that a physician will base his recommendation on.

What is cyberknife?

Cyberknife robotic-assisted radiosurgery is a robotic radiation therapy that sounds like surgery but is not – it is simply an alternative for patients with localized prostate cancer and it can also be used to treat prostate cancer that has recurred after a radical prostatectomy or previous treatment. 

Cyberknife delivers high doses of radiation to the prostate gland and is recommended for men with prostate cancer limited to the prostate and at a low to moderate risk.

What is da Vinci surgery?

There used to be limited options when it came to prostate cancer and surgery choices.  Historically, the only prostate surgery option was open prostatectomy, involving large incisions and post-operative side effects. 

Today, there is another option called da Vinci robotic prostatectomy that is less traumatic and minimally invasive.  This procedure uses finely controlled robotic instruments to perform the prostatectomy safely in which the physician can control the device consisting of high-resolution cameras and micro-surgical instruments. 

How do cyberknife and da Vinci surgery compare to one another?

All men diagnosed with prostate cancer will have their own unique treatment designed for them depending on the PSA test and their Gleason score along with whether their cancer is considered slow-growing, localized to just the prostate and not likely to spread or if their tumor is considered fast-growing and likely to spread.

A man’s physician will make the ultimate decision and recommendation on which treatment a man should do and from there, each man should thoroughly have a complete understanding of whichever treatment is chosen and to feel confident in that choice.

Here is how the two treatment methods compare to one another:

·         Are either treatment considered experimental?

No, Cyberknife was cleared by the FDA in 2001 and da Vinci was cleared in 2001 also.

·         Which one involves surgery?

Da Vinci is a surgical procedure in which the prostate is removed by surgical resection.  Cyberknife is a non-invasive high-dose irradiation of the prostate.

·         Does either method involve anesthesia?

Da Vinci typically involves general anesthesia.  Cyberknife does not require anesthesia.

·         Is the treatment performed by a robot?

The da Vinci surgery cannot act on its own and the treatment is performed by a surgeon.  Cyberknife robot automatically delivers a pre-planned treatment under expert supervision.

·         Is a hospital stay required?

With da Vinci surgery, there is typically a 1-3 day hospitalization.  With Cyberknife, treatment is performed as an outpatient visit.

·         Are there risks of surgical complications?

Risks from da Vinci can include infection, bleeding, cardiac or pulmonary complications.  Cyberknife does not involve surgery.

·         Is a urinary catheter required after treatment?

With da Vinci, patients are sent home with a urinary catheter for 7-10 days after surgery.  Cyberknife may use a catheter during treatment but is not required once treatment is completed.

·         Will patients experience urine incontinence after treatment?

About 20-50% of patients using da Vinci will have persistent urine leakage in the first 6 months and 4-20% have permanent urine leakage.  Cyberknife typically does not cause urinary incontinence.

·         Are there any significant risks of serious rectal injury?

Da Vinci surgery reports only 0-2% of patients having serious rectal injury during surgery and only 0-5% of patients using Cyberknife experience mild rectal bleeding or urinary urgency.

·         Is sexual function preserved in a majority of patients?

There can be a large reduction in sexual function immediately after da Vinci surgery but current nerve sparing techniques preserve erectile function in 61-90% of men.  With cyberknife, there is little effect on sexual function immediately after treatment and current MRI targeted techniques preserve erectile function in 60-87% of men.

·         Is the treatment effective in treating prostate cancer?

Both da Vinci and Cyberknife have a 93% PSA recurrence-free at 5 years post cancer diagnosis.