1. Cyberknife Therapy for Prostate Cancer David Spellberg M.D., FACS Naples Urology Associates, P.A.

2. Localized Prostate Cancer Effective treatment Safe treatment Minimal lifestyle changes

3. Radiation Options: IMRT BRACHYTHERAPY HDR COMBINATION

4. Advantages of Radiosurgery Outpatient No anesthesia Painless Over 5 years clinical experience Equal precision to surgery

5. CYBERKNIFE MINIMAL SIDE EFFECTS EASE OF TREATMENT UNIFORM TREATMENT PHYSICIAN FRIENDLY

6. PATIENT DRIVEN NON-INVASIVE MINIMAL SIDE EFFECTS MINIMAL DISRUPTION OF LIFE EFFICACY

7. PATIENT SELECTION 3 PROTOCOLS UP TO STAGE T2c –LOW RISK –INTERMEDIATE RISK –HIGH RISK

8. SEQUENCE OF EVENTS PATHOLOGY REVIEW CT/BS REVIEW DISCUSSION OF TREATMENT OPTIONS FIDUCIAL PLACEMENT CYBERKNIFE TREATMENT

9. FIDUCIAL PLACEMENT NPO IV SEDATION TRUS GUIDED TEMPLATE ANTIBIOTICS

11. Precise control limits dose to the rectal wall and urethra Automatic correction for target motion during treatment Prostate Radiosurgery Footage courtesy of St. Anthony’s Hospital

12. CODING TRUS/ FIDUCIAL PLACEMENT 76875, 55899 CYBERKNIFE TREATMENT 61793

13. SUMMARY Another treatment alternative Safe and effective Patient driven Physician friendly