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Hi, David. Cyberknife is a type of very tightly-focused radiotherapy that is still being evaluated for prostate cancer as there is some evidence that it might increase the incidence of urinary side-effects such as urethritis, urinary incontinence, and urinary obstruction compared to conventional radiotherapy (44% versus 36% at 6 months following treatment). The theory is very appealing (less collateral damage because of more accurately targeted radiotherapy) but patients with more aggressive tumours might actually benefit from having a larger volume of tissue treated. For instance, the risk of having microscopic spread of prostate cancer in the pelvic lymph nodes in a man with a Gleason 7 tumour is 7% so having his pelvic lymph nodes (on either side of the prostate) treated with radiotherapy as well as his prostate is likely to benefit him.
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