Prostate Cancer Treatment Stories

Prostate Cancer

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  • Bob
  • Charles

    Charles knew just who to turn to when he was diagnosed with prostate cancer. His daughter Janice isn’t a surgeon or a urologist, but she is a radiation therapist who works everyday with cancer patients at Baylor University Medical Center at Dallas.

    In January 2007, Charles – who with his wife Dorothy, learned that he might have prostate cancer. A routine physical showed that Charles’ prostate specific antigen levels had risen considerably since his last examination. His doctor told him this could be indicative of prostate cancer. A biopsy in May confirmed his worst fears. “I was scared to death,” said Charles.

    His family doctor presented several treatment options, including a relatively new procedure with a CyberKnife® Robotic Radiosurgery System, a groundbreaking non-invasive treatment that delivers radiation in high doses over a short period of about one week. “I told the doctor, I know where I can get that done – Baylor University Medical Center in Dallas,” said Charles. The doctor warned that he may face a long wait to see a specialist for evaluation for such a specialized treatment. But, much to the doctor’s surprise – and with a little help from his daughter Janice – Charles had an appointment scheduled for his treatments just a few weeks later.

    As fate or luck would have it, Janice was one of a handful of radiation therapists who had trained on the CyberKnife System. Janice had seen radiation oncologists for more than a decade successfully treat tumors with the CyberKnife throughout the body, including the head, spine and lung. And now Baylor Dallas was about to begin providing the CyberKnife System as treatment for prostate cancer.

    Janice asked the doctors if her father could be the first patient. “I told them that he needed to come here because I wanted to make sure it was done right,” said Janice. “A lot of people asked how I could treat my father, but I wanted him to come to Baylor because I wanted to be sure it was done right.” she added. “It reinforced the confidence I have in the CyberKnife technology. If I didn’t believe in it completely, I wouldn’t be recommending it to my dad.”

    Charles admits he was a little nervous to be the first patient treated for prostate cancer with Baylor’s CyberKnife System. But he took solace in the fact that prostate cancer treatments with the CyberKnife System were being done successfully at other facilities around the country.

    One month after receiving a prostate cancer diagnosis – and just a few days before Father’s Day – radiation oncologist Brian Berger, M.D., started treatment on Charles’ cancer. Dr. Berger’s treatment plan consisted of CyberKnife radiosurgery for five consecutive days with each treatment lasting about one hour.

    “I had never had radiation, so I didn’t know what to expect,” Charles said. The treatment was amazing. It’s like an X-ray; you feel nothing.” Charles also was pleased that he had no side effects afterward from the CyberKnife treatment. “I had no impotency, no urination problems, no burns, no problems whatsoever,” he stated.

    Within days of his treatment, Charles and Dorothy, his wife of 50 years, were back on the road in their RV to spend another summer in Ohio.

    As of the creation of this patient profile, Charles found his CyberKnife treatment to be successful.

  • Clyde

    Prostate cancer is the most common cancer in men living in the United States. The American Cancer Society estimates that 233,000 men will be diagnosed with prostate cancer in 2014. Men with a family history of prostate cancer, Vietnam veterans exposed to Agent Orange, and African–Americans are especially at–risk for diagnosis, but Clyde fit none of these categories.

    In many respects Clyde was like other retired men his age. He spent time outdoors and on hobbies he loved, volunteered in the community and had an annual prostate–specific antigen (PSA) test. But when his PSA level rose to a 13 and a biopsy revealed he had prostate cancer, Clyde was able to call on his former work experience to guide him while he explored treatment options. Clyde had been employed in the medical imaging industry throughout his career and while radiotherapy equipment was not his specialty, he did have a good understanding of how it worked.

    “I’ve been retired for a long time, so I wasn’t surprised that time had marched on and improvements in radiation treatments had taken place,” Clyde said. “But if someone had told me 30 years ago that someday equipment would be able to accurately deliver radiation beams with pinpoint precision within the thickness of a dime, and from hundreds of angles to treat most types of cancer, I wouldn’t have believed it. Well, there is such a machine. The CyberKnife® System.”

    Through extensive research Clyde learned the CyberKnife technology uses real–time image guidance to target radiation beams to the prostate, continually adjusting beam delivery for normal movement of the prostate in order to treat the cancer and spare healthy tissue. This precision helps to minimize negative side effects on urinary, bowel, and sexual function that may reduce a man’s quality of life. Clyde thought about the potential benefits and risks associated with this system and decided it was the right approach for him.

    Clyde experienced minimal side effects from his treatment and went about his daily routine both during and after his CyberKnife treatment sessions. His PSA has been less than one for more than two years. Says Clyde, “It was like it never happened. I wish all prostate cancer patients could have a similar experience to mine.”

    Clyde wants other men to know that while the CyberKnife System may not be appropriate for everyone, they should be aware that it’s an option and available in most large cities in the United States. He also believes it’s important for men to be their own advocate and research treatment options, including CyberKnife. Having an informed discussion with his physician helped Clyde to identify a treatment that worked for him.

    Says Clyde, “To my surprise, I learned that eliminating the tumor is the easy part. Most prostate cancer if found in its early stages can be cured. The long–term side effects following treatment are what you need to think about. With CyberKnife, you have a pretty good chance of taking control of the cancer without long–term issues that may impact your daily life.”

    As of the creation of this patient profile, Clyde found his CyberKnife treatment to be successful.

  • Jeff

    Jeff, a NASA engineer and golf enthusiast, found himself working for the Apollo Space Program in Texas forty-five years ago. Jeff was involved in all of the Apollo/Saturn space launches up until the now infamous “Apollo 13” mission.

    After his tenure with the Apollo Space Program, Jeff worked as a venture capitalist with various universities and companies to apply the technologies created for the space program to medicine and other parts of the economy. He worked with some of the major pioneering universities in the United States, including Stanford University where the first CyberKnife System was created.

    A few years ago, Jeff’s younger brother was diagnosed with prostate cancer and underwent surgery to remove the cancerous cells. Since his brother’s diagnosis, Jeff has been diligent in staying on top of his PSA testing. He continued to have a clean bill of health until a routine round of tests in November, 2008. Jeff’s PSA results came back higher than normal and after a biopsy determined he had a Gleason score of 6, he was diagnosed with early stage prostate cancer.

    Jeff’s urologist at Overlook Hospital in Summit, New Jersey felt that surgery wasn’t a viable option for 72-year-old Jeff, and Jeff wasn’t interested in “watchful waiting”. Jeff was then offered three radiation treatment options: insert radioactive seeds into his prostate, conventional radiation therapy or CyberKnife radiosurgery.

    “To me, I read these options as “slow, faster, fastest” as far as treatment times go,” Jeff said.

    Wanting to get rid of the cancer as quickly as possible, Jeff opted for CyberKnife radiosurgery.

    Jeff underwent five CyberKnife treatments during the course of a week. As there are minimal to no side effects with CyberKnife treatments, Jeff was able to maintain his daily routine during his treatments, including daily rounds of golf.

    “The treatment was wonderful. No side effects, no problems, and, per my urologist, no cancer,” said Jeff.

    Today, Jeff is cancer free and without the pressure of safely landing space shuttles, he is able to enjoy life and focus on improving his golf handicap.

    As of the creation of this patient profile, Jeff found his CyberKnife treatment to be successful.

  • NEW!! Gerhard

    Watch the video here: https://www.youtube.com/watch?v=UJiqLQ08SWw&t=2s

    (Gerhard Hirsbrunner; 00:23 – 00:38)
    My name is Gerhard, I’m in my 70's and have been retired for almost 10 years.
    I spend my free time with my beloved wife and grandchildren, and working on photography and films.

    (Gerhard; 00:41-01:40)
    During a regular routine check-up, my family doctor told me that my blood values were not good anymore and that they could indicate there was a problem. She then referred me to the Inselklinik Bern to investigate this more closely. When I was told that I had prostate cancer, of course I was shocked, but I hoped that they would help me in Bern. After the diagnosis, a doctor laid out everything in detail and explained to me what would happen and could happen as well as how and when. And I went home relatively reassured because I knew they would do everything to make it turn out all right.

    (Prof. Aebersold; 01:43-02:15)
    Prostate cancer is the most common malignant tumor in men. Approximately 30% of all men are affected by it at some point in their lives. In the beginning, we always have to decide whether there’s any need for treatment at all. If we decide that treatment is necessary, there are two established procedures: one is the surgical removal of the prostate and the other is radiotherapy. There are various radiotherapy procedures, including the CyberKnife, which has been installed here since 2014. We have had many and very good experiences with it.

    (Gerhard; 02:18- 02:50)
    The different treatment options were explained to me very precisely and professionally. An operation was not an option for me at all, because I had had enough surgeries before and did not want to take the risk. They then recommended the CyberKnife. They showed that this would actually be the best solution for me and would cause the least problems.

    (Prof. Aebersold; 02:51 -03:23)
    Treatment with the CyberKnife has several advantages. First and foremost the system’s high precision is in the submillimeter range. This allows us to give higher doses per session, which means that we can finish the treatment after the fifth session. Another advantage of a CyberKnife treatment is that it does not require anesthesia, the patient can undergo the treatment as an outpatient procedure and go home immediately after the treatment session. That was also the case for Gerhard.

    (Gerhard; 03:27-04:02)
    Five sessions were scheduled with the CyberKnife System. They went really well. The first time I looked around to see what was happening. The next four times I was sleeping. During the treatment, I didn’t feel anything negative. I only experienced the good treatment by the staff. The CyberKnife really impressed me with all its modern technology. Simply fantastic. Today, I'm doing great. I can’t express it any other way.

  • Paul

    It takes a village to handle and survive metastatic prostate cancer, a prostate cancer that has spread to bones or lungs or lymph nodes and elsewhere. And one of the crucial aspects of that village, for me, has been the CyberKnife, a form of radiation that has been specific and accurate for many of my metastatic lesions, a treatment that has minimized collateral damage.

    I was first diagnosed in 1984 at the ripe age of 35, turning 36. Surgery, a radical prostatectomy, was the only real option at that time. Even though my surgeons were convinced they got it all – I loved their optimism – the margins of the cancer were not clear; there appeared to be some rogue cells that had gone beyond the capsule of the prostate.

    Indeed the newly developed PSA (prostate specific antigen) in 1989 showed that the tumor had reappeared, at least microscopically. Then the fun began. An intermittent androgen blockade helped me avoid permanent surgical castration, but it meant intermittent castration to stop the cancer cells from being constantly fueled by testosterone, the male hormone.

    In 2004 I found my first palpable metastatic prostate cancer. The CyberKnife treatment then saved my life: A lesion in the lung had shown up in a CT Scan – an unusual spot for prostate cancer to spread to. An astute thoracic surgeon pointed out that I did not have to have my ribs and lungs splayed open in order to respond to the cancer. Instead let’s go, she, the surgeon, said to me, to the CyberKnife, available at Georgetown University near my home in Washington, D.C.

    And, voila! It worked beautifully.

    Subsequently, since 2010, I have had the CyberKnife treatment to several oligometastases, single lesions found here and there when off the androgen withdrawal treatment. Lesions in the thoracic spine, one in the lumbar spine, two separate ones in the skull (the parietal-occipital area) – and one especially sensitive lesion along the edge of the parietal-occipital brain, some rogue cells near where the skull lesions had been active.

    Since I make my living using my brain as a psychiatrist, it was crucial that the treatment not create any collateral damage. And with five treatments in 40 minute five day periods, again voila! The CyberKnife treatment has allowed me to live a full life, professionally, recreationally, and family-wise. What a gift!

    Yes, now it’s been 31 years of living with prostate cancer, 25 years of living with chemical evidence of metastatic disease, and 11 years of dealing with palpable disease, with CyberKnife continuing to lead the way.

  • Peter
  • Scott

    What he thought was an ordinary drive home from watching a spring training baseball game in Ft. Myers, Fla., turned out to be a defining moment in Scott’s life.

    On March 24, 2006, Scott, his wife Cathy and a couple of friends enjoyed an afternoon watching the New York Yankees take on the Minnesota Twins. While returning home to Naples, Fla., Scott answered a call on his cell phone from his urologist.

    Just a couple months before, Scott, also a doctor, had been referred to the urologist because, during a routine physical, his family physician discovered that Scott’s Prostate-Specific Antigen (PSA) level had gone up by more than a point and a half, to 3.68, in just a year. That fateful March day, the urologist called with Scott’s biopsy results. He had prostate cancer. “I was devastated,” said Scott, who had just turned 61. “I thought I was too healthy and too young. I thought I was invincible and that there was no way my biopsy would show cancer.”

    At the time of his diagnosis, Scott had been retired for about six years and was enjoying fly fishing, golfing and traveling with his wife. He had four young grandchildren who he expected to spend time with as they grew up. “As a doctor, I imagined the worst possible outcome,” he said. “I was afraid it was one of the types of prostate cancer that might spread quickly.”

    After taking a few days to deal emotionally with his diagnosis, Scott began extensive research on prostate cancer and the various treatments. He spoke with a number of prostate cancer patients about their treatments and the problems they encountered. He conferred with several internists and urologists. He also spoke with his youngest son, a cardiology resident in Boston, who asked his colleagues about their thoughts on the options available to his father. Around the same time, one of Scott’s friends attended a prostate cancer seminar at Naples Community Hospital and brought him back information about the CyberKnife® Treatment Delivery System.

    “When I read the brochure, I was excited to talk more to my urologist about whether I was a candidate for the CyberKnife,” Scott recalled. Together they decided that CyberKnife treatment was the best option to meet Scott’s needs.

    “What convinced me to choose this treatment were two main things. The first was the sub-millimeter precision of the radiation beam. The second was how the CyberKnife technology can detect slight motion of the prostate during treatment and then stop to recalibrate. These features enable the tumor to be treated accurately, with little risk of radiation to the normal adjacent tissues,” he said. The convenience of needing just five days of treatment was an additional factor that appealed to him. “Once I made the decision to go ahead with the CyberKnife, I felt a calmness and relief that I wouldn’t have to deal with the potential serious complications of radiation therapy.”

    On April 27, 2006, Scott had a CT scan and MRI so that his radiation oncologist could locate the 40 gram tumor and develop a treatment plan. Treatment with the CyberKnife System began on May 8 at Naples Community Hospital and lasted for five consecutive days. “Throughout the treatment I was able to relax and listen to my own music in a pleasant room,” Scott said. “And after the treatment with the CyberKnife was finished, I rested for no more than a day or two before resuming my normal activities.”

    The treatment didn’t slow Scott down. Scott said that although he was told to expect fatigue, he never felt overly tired. Only in the short-term did he experience urinary urgency and a one-day bout of diarrhea immediately after his course of treatment was complete. Just two days after the treatment ended, he was back out on the golf course, playing 18 holes with his friends.

    The results of CyberKnife treatment exceeded Scott’s expectations. Within six months of his treatment, Scott’s PSA level was down to 0.7, and seven years later had gone even lower, averaging between 0.1 and 0.4 at his regular check-ups. Now in 2018, 12 years after treatment, Scott continues to do well with no recurrence of cancer and no complications.

    “If the patient is the right candidate,” Scott added, “the decision to go with the CyberKnife is a no-brainer.”

    As of the completion of this patient profile, Scott found his CyberKnife treatment to be successful.

  • Warren
    Video Transcript

    VIDEO TRANSCRIPT

    WARREN: My name's Warren Forman. I'm 67 years old, here with my wife, Connie, and my two boys, Tivon and Jordan.

    CONNIE: We've been married 32 years and now we're taking care of the medical things in our lives [LAUGHTER].

    WARREN: Going back about a year and half ago I had a PSA level of 5. A year later it was up to 8. The biopsy came back with no cancer on the left side and two out of four specimens on the right side had cancer cells. They were Gleason 8.

    CONNIE: So you start thinking about your relatives and he also had forgotten that his Uncle Solly had died of prostate cancer.

    WARREN: I wasn't terribly alarmed. I was more concerned about what would fit into my lifestyle in matters of side effects, which is one of the reasons why I eliminated surgery really from the beginning.

    CONNIE: He did a lot of research and he was able to speak to other people who went through the procedure that he's having now, CyberKnife.

    KATZ: I'm Dr. Alan Katz and we're standing here at the CyberKnife in Flushing, Queens. The CyberKnife is actually an ideal tool to treat prostate cancer because it turns out that prostate cancer, unlike most other cancers, has a great sensitivity to dose per fraction. That is a very high dose and fewer fractions seems to work better biologically than a lot of little doses, which is the standard way of treatment. So in order to deliver the five treatments that we do with very high doses you need to have what CyberKnife does for you. You need to have great accuracy and you need to have great conformality, that is you want the dose to hug the prostate and have as little dose as possible to the bladder and the rectum.

    WARREN: Your mother and I will go into Flushing to the CyberKnife.

    MAN: What time will you be done?

    WARREN: I think it takes about 45 minutes the first day. It may take a little longer to set up and everything else, but.

    KATZ: Hi, Mr. and Mrs. Forman. Good to see you again.

    WARREN: Hi.

    KATZ: OK, why don't we come back and talk a little bit before the treatment. You're going to feel nothing. You're going to see that robot moving around you. During the treatment if you have any problem of any sort you can raise your hand, just yell and we'll be able to stop the treatment and continue it.

    MAN: You take a look at the monitor. The machine looks like an arm and it's able to bend and move all over the patient so that it's not just in a fixed position. It's all around all the points that need to be treated with the prostate. Usually after the first day the patient is very nervous. After the second day they kind of see how the machine is working inside the room and they usually are just very relaxed after that.

    WARREN: Well, we had our first treatment last night. After the first procedure with CyberKnife I felt fine. I felt really nothing. I didn't feel tired. I didn't feel fatigued. Had to get up rather early this morning for day two of the CyberKnife treatment. Again I had to do a Fleet enema to empty myself out. My wife Connie will be staying home. There's really no reason for her to have to go with me because I feel fine going by myself. Fortunately we just got out of the worst part of the traffic and we should be arriving in plenty of time.

    MAN: CyberKnife. We'll want to know how long the treatment will last. We'll have a, once we bring up the patient's plan at the console it will give us an estimated time. Warren is doing exceptionally well right now. He's very relaxed. There's not a lot of movement at all. It's a very smooth treatment right now.

    WARREN: Staying still for the 45 minutes of the CyberKnife treatment is a little difficult. You hear the roaring of the machine and the movement of the machine. You look around and it's kind of odd. It's really kind of strange. This machine is moving around your body. You start playing mental games, as when is it radiating me and when is it not radiating me? But it's kind of silly because there's no way of your knowing.

    MAN: The mechanics of the machine when they're rotating to the next position can be kind of loud. So we do put on some music to help the patient relax, so that he has less movement if possible. A wonderful feature about the CyberKnife is the chances of not treating the wrong patient with the wrong plan. Each plan is designed for every particular patient, where it's pretty difficult to treat the wrong patient with the wrong plan. We go through a series of checks. I think that's an awesome safety mechanism that we have with this treatment.

    WARREN: I feel fine. It's really very, very uneventful. Now I'm going to go home and have something to eat and then get to my home office and start doing some work. Nothing much. I'm back in the house. I had my second treatment this morning.

    MAN: My father's been a real estate lawyer I think since the early '60s.

    WARREN: It's quarter to eleven and I just returned from my second treatment and I'm already here at work.

    MAN: His work ethic is far above the average person.

    WARREN: I got a delivery of mail from the office, which we've gone through.

    JORDAN: When I found out my father was diagnosed with prostate cancer obviously I was very concerned.

    WARREN: Going over my emails. I'm probably going to put in the better part of a full day's work today.

    JORDAN: We'll all be here for him, try to make it go by smoothly, but I'm sure he'll be on the phone as often as he can be.

    WARREN: And I'm looking forward to getting it done. Then we'll move on to day three tomorrow.

    Day three of my CyberKnife treatment and aside from being dark out this morning it's also nasty out. So our trip in this morning will be a little bit more adventurous than usual. When I see Dr. Katz today I'm just going to review the Fleet enema issues because it is a little burdensome having to do it every single day.

    KATZ: Warren, so far you've had three treatments. Today is your third. How have you been feeling?

    WARREN: I feel fine.

    KATZ: Good. Any problems with the urination?

    WARREN: No.

    KATZ: Nothing? OK. You've been taking the Dulcolax the night before and a Fleet enema. Has that been upsetting your stomach at all?

    WARREN: Yes, it has.

    KATZ: OK. So I think since you're getting some cramps and you clean out so good we could probably back off on the Dulcolax. I'd just take the Fleet enema in the morning. That should be sufficient. Two more days of the same thing and you're done.

    MAN: Prior to the patient coming in the doctor implants the seeds within the patient. The seeds that are used for tracking with the machine. It lets us know where his prostate is. When the doctor implants the seeds we're able to track where exactly the prostate is by using the seeds and fiducials that are in place. That's letting the machine know that this is where the prostate is and it's able to track every movement that's going on.

    KATZ: This is the only form of radiation that I've ever worked with where we're able to actually ascertain through the use of the fiducial seeds that we constantly track exactly what the position of the prostate is. To be able to follow this and to correct for this during the treatment really gives us unparalleled accuracy. So today is the third day of Warren's treatment. We don't see any side effects yet from the CyberKnife treatment. He's not having any urinary problems. He is having one side effect which really comes from the cleanout. We do this fairly rigorous cleanout to insure that there's no gas or stool in the rectum, because gas or stool in the rectum can make the prostate move. So we're doing this to keep the prostate very still. It will be next week when he starts to get some of the side effects from the CyberKnife treatment, which will be some urinary frequency, a slower stream, maybe some urgency and some bowel frequency. And they generally last about ten to 12 days. Most patients when they seek out CyberKnife treatment generally have looked at other forms of radiation and one of the things that they find is say with surgery that there's this risk they could have, incontinence of urine, that they may lose erectile function. So obviously the first thing that most people are concerned about is will my cancer be cured, of course. So far our results have been very, very good in that department. But secondarily then the patients are concerned about these possible side effects. The chance of getting any significant incontinence with our treatments has been very low, less than 1%, much better than surgical [series?]. We've had a very, very high success rate in preserving erectile function. We're seeing about 80% of preservation.

    WARREN: I am pleased with the way things have been going so far with the CyberKnife treatment. I'm looking forward to finishing off the last couple of days.

    We're getting ready to start Day Four of the CyberKnife treatment and I'm just getting some paperwork together because after the treatment I'm going to go into the office. The people in the office are anticipating my coming in just to make sure that I'm being honest and that I'm fine, because they are concerned. They keep on asking me, anything wrong? Do you feel anything?

    MAN: Today Mr. Forman's here for his fourth day of treatment. One of the advantages of the CyberKnife for radiation is the amount of time that it takes to be treated. Mr. Forman will be done with his treatment in five days. Most patients who do come in for the CyberKnife treatment have a lot of daily tasks that they have to do, a lot of them work. So this is a great option for them for their treatment.

    OK, Mr. Forman. The fourth treatment is finished. One more tomorrow.

    FORMAN: My firm consists of six of us. So it's myself, a paralegal and support staff. I know when I walked in they were all very happy to see me back. I'm back. I feel back.

    GINA: I think he looks great. I think he looks better than when he left the office. The treatment seems to be successful. I think he looks awesome.

    ERICA: I was happy to see him and we gave him a hug. I gave him a hug, Gina gave him a hug. I asked him how he was doing and he's like I'm fine.

    GINA: Working with Warren during the course of his treatment was really no different than any other time when he's been on vacation or medical leave. Basically we communicate over the phone, via email. We get him his mail and documents by messenger or personal delivery from one of the staff members. Really nothing has changed.

    MAN: And you feel good?

    WARREN: I feel fine. Just one more day, that's all and I'll be back to normal.

    [SONG for second night of Chanukah]

    WARREN: This is the second night of Chanukah, which reminded me that it was a night that a very dear friend of ours, Michael Clark, passed away. He died of cancer. Not prostate, stomach cancer. Having had my fourth CyberKnife treatment today and having it coincide with his death, it made me think and be thankful for the CyberKnife treatment. He unfortunately didn't have that opportunity. Tomorrow's my fifth and last CyberKnife treatment. I'm looking forward to it being over with it, not that it was a drudge or it was difficult or I felt any pain or suffering from it, but just knowing that it's behind me.

    This is day five, the last day of CyberKnife treatment. I went to bed last night realizing that I only had to get up at this early hour one more time.

    MAN: His treatments went really well. He hasn't had any issues. If everything is fine from there then he'll make a six-month follow up with the doctor and if he has any other questions [UNINTELLIGIBLE].

    KATZ: I've studied 600 to 700 patients now that I've treated with CyberKnife for prostate cancer. In those patients that have four years follow up we're seeing extremely low levels of PSA. If you have an excellent PSA level, very low, at four to five years you pretty much are cured.

    MAN: After the last day of treatment we find the patients are very appreciative of our service here. They're very appreciative that it's only been five days and they are finished with their treatment.

    WARREN: Just finished my fifth and last day treatment with CyberKnife, which is behind me here. I'm done. It's been an interesting week. Probably if anything stays with me it's the reaction of my employees and the people I work with in the office when I came back, how happy they seemed to be that I was there and gratified that I was well. That was really kind of nice. Tomorrow night we'll be having family over to celebrate Chanukah and I think everybody will be happy to be there with my treatment having ended. So I think that we'll have two reasons to celebrate tomorrow.