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Thread: What I Need to Know About External Beam Radiation Treatments

  1. #11

    ok, here is what the experts say

    "the comparison of biochemical recurrence-free survival outcomes following surgery and radiation for clinically localized prostate cancer is similar to the comparison of apples and oranges." so your zero is not ours.

    "•The 2005 ASTRO/RTOG Consensus Conference proposed a definition of failure after radiotherapy with or without short-term hormonal therapy as a rise by 2 ng/mL or more above the nadir PSA (nadir +2), "

    I will use a 2 then if you had no surgery.

  2. #12
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    Yes it should help to avoid effect of Radiation to have full bladder and clean colon. Full bladder as explained by YWW moves it away from the Prostate. Radiation therapist do check bladder and colon before starting the External Beam Radiation process to avoid any radiation to the Bladder and Colon and there is always some tolrance specs. to proceed with the procedure even if the bladder is not 100% full. Yes I have to run to the nearest wash room after the radiation which is normal. Take care and always believe in yourself, "HE COMFORTS US----" always.

  3. #13
    Experienced User BeeMan's Avatar
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    This will be the 4th day of radiation (IMRT)....yesterday was rough because the rectal balloon leaked and they had to do it twice! I am having trouble urinating and increased the Flomax to twice a day. Irritable bladder and frequency.
    It was never mentioned that I should have a full bladder prior to the treatment. I can barely hold it as is! I have been instructed to drink a lot of cranberry juice.

  4. #14
    Experienced User BeeMan's Avatar
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    TomoTherapy/IMRT: 23 down and 16 more to go! Just finished a 10 day round of Cipro to be on the safe side (prostatitis?) Still pee frequently, urgency, hard to empty my bladder, esp. right after each treatment. Urination and the hot flashes have been my only big issues. I go to bed an hour earlier. No rectal issues/diarrhea. Good spirits and a loving wife!
    (btw, no way could I have a full bladder going into treatment, the rectal balloon is enough. They use air instead of liquid).

    BeeMan

  5. #15
    Moderator Top User HighlanderCFH's Avatar
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    Here is an interesting article that I came across. The numbers might be skewed, though, because it appears that some of the data includes patients from the earlier years of EBR equipment, circa 1992.

    To be fair, it could be that the risk of secondary cancers from EBR is NOT as bad as the article suggests -- but I'm not sure. My understanding is that modern radiation equipment is much more fine tuned in that it does not hit healthy tissue as much as in the past, thereby rendering it safer than earlier years.

    I'll copy-paste the article, followed by the link to access it directly:

    Risk of secondary cancers increased following radiation for prostate cancer

    Tuesday 3 June 2014 - 1am PST
    Prostate / Prostate CancerRadiology / Nuclear Medicineadd your opinionemail
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    Risk of secondary cancers increased following radiation for prostate cancer
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    Among men treated for prostate cancer, those who received radiation therapy were more likely to develop bladder or rectal cancer, according to a new study from the University of Michigan Comprehensive Cancer Center.

    "Overall the incidence of these cancers is low. But when men have received radiation treatments, it's important to evaluate carefully any symptoms that could be a sign of bladder or rectal cancer," says senior study author Kathleen A. Cooney, M.D., professor of hematology/oncology and urology at the U-M Medical School.

    The study, which was presented at the American Society of Clinical Oncology annual meeting, looked at 441,504 men diagnosed with prostate cancer between 1992 and 2010. Men were identified from the Surveillance, Epidemiology and End Results (SEER) program, a network of National Cancer Institute-sponsored, population-based cancer registries that collect information on cancer diagnoses and treatment. SEER performs regular follow-up for survival and to capture new invasive cancer diagnoses.

    The researchers looked at the number of secondary cancers that developed 10 or more years after men were diagnosed with prostate cancer. As a whole, men diagnosed with prostate cancer were at a lower risk of developing a second cancer. But when researchers looked at patients who received external beam radiation therapy, they found these patients were estimated to be 70 percent more likely to be diagnosed with a rectal cancer and 40 percent more likely for bladder cancer than the general public.

    Radiation therapy is a standard treatment for prostate cancer and the researchers stressthat their findings should not prohibit anyone from choosing this treatment, in particular men who are not good candidates for surgery.

    "Prostate cancer has an excellent prognosis. But because patients typically survive a long time, it raises concerns about the risk of second cancers," says study author Elizabeth J. Davis, M.D., a fellow at the U-M Medical School. "Long-term survivors who have undergone treatment with radiation and their physicians should be careful to monitor for symptoms of bladder and rectal cancer."

    Full results of the study were published online in Cancer.

    http://www.medicalnewstoday.com/releases/277604.php
    July 2011 local PSA lab reading 6.41 (from 4.1 in 2009). Mayo Clinic PSA 9/ 2011 = 5.7.
    Local uro DRE revealed significant BPH, no lumps.
    PCa Dx Aug. 2011 age of 61.
    Biopsy DXd adenocarcinoma in 3/20 cores (one 5%, two 20%). T2C.
    Gleason 3+3=6. CT abdomen, bone scan negative.
    DaVinci prostatectomy 11/1/11 at Mayo Clinic (Rochester, MN), nerve sparing, age 62.
    Surgeon was Dr. Matthew Tollefson, who I highly recommend.
    Final pathology shows tumor confined to prostate.
    5 lymph nodes, seminal vesicules, extraprostatic soft tissue all negative.
    1.0 x 0.6 x 0.6 cm mass involving right posterior inferior, right posterior apex & left
    mid posterior prostate. Right posterior apex margin involved by tumor over 0.2 cm length,
    doctor says this is insignificant.
    Prostate 98 grams, tumor 2 grams.
    Catheter out in 7 days. No incontinence, minor dripping for a few weeks.
    Seven annual post-op exams 2012 through 2018: PSA <0.1
    Semi-firm erections without "training wheels," usable erections with 100mg Sildenafil.
    NOTE: ED caused by BPH, not the surgery.

  6. #16
    Experienced User BeeMan's Avatar
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    HighlanderCFH, that is very concerning......I have my LAST radiation treatment (IMRT) this coming Monday, June 23, 2014 (# 39!)

    I will ask my expert radiation oncologist his thoughts on this.

    Thanks for the post.

    BeeMan

  7. #17
    Moderator Top User HighlanderCFH's Avatar
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    You're welcome BeeMan. Ask him if the equipment being used is newer. If so, you should be okay.
    July 2011 local PSA lab reading 6.41 (from 4.1 in 2009). Mayo Clinic PSA 9/ 2011 = 5.7.
    Local uro DRE revealed significant BPH, no lumps.
    PCa Dx Aug. 2011 age of 61.
    Biopsy DXd adenocarcinoma in 3/20 cores (one 5%, two 20%). T2C.
    Gleason 3+3=6. CT abdomen, bone scan negative.
    DaVinci prostatectomy 11/1/11 at Mayo Clinic (Rochester, MN), nerve sparing, age 62.
    Surgeon was Dr. Matthew Tollefson, who I highly recommend.
    Final pathology shows tumor confined to prostate.
    5 lymph nodes, seminal vesicules, extraprostatic soft tissue all negative.
    1.0 x 0.6 x 0.6 cm mass involving right posterior inferior, right posterior apex & left
    mid posterior prostate. Right posterior apex margin involved by tumor over 0.2 cm length,
    doctor says this is insignificant.
    Prostate 98 grams, tumor 2 grams.
    Catheter out in 7 days. No incontinence, minor dripping for a few weeks.
    Seven annual post-op exams 2012 through 2018: PSA <0.1
    Semi-firm erections without "training wheels," usable erections with 100mg Sildenafil.
    NOTE: ED caused by BPH, not the surgery.

  8. #18
    Experienced User BeeMan's Avatar
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    HighlanderCFH, I do know for a fact that the Methodist Radiation Oncology Dept. uses the latest equipment for prostate cancer treatment: TomoTherapy High Art. "tomo" is the Greek word for "slice". This machine has a built in CT scan that lines the prostate up each time and the radiation oncologist checks it each time. I believe they are the only two machines in Houston. Even M.D. Anderson does not have one!

    BeeMan

    PS: So far, I have had 9 different female techs stick that balloon up my butt (sorry for being so graphic)......I feel used, abused, exposed and sometimes they just don't know when to quit pushing! lol It's like being in the movie, "Ground Hog Day" 39 times!!! (I told the head tech about the treatment being like Ground Hog Day and she said, Wasn't that an old movie?)

    5/4/2014: age 67
    (1st Biopsy done 04/16/2002 was Negative. Reason for biopsy, elevated PSA 5.30 (04/02/2002) from a PSA 2.8
    U/S prostate size 38.6ml
    Diagnosed at age 65: Active Surveillance
    03/05/2012
    Gleason 6 (3 & 3) Left Apex <8% positive (small volume of a single core/ low grade cancer)
    Second Prostate biopsy T1c
    U/S Prostate size 45.2 ml
    PSA 6.41 (Free PSA 30)
    Third biopsy, age 66: Active Surveillance
    March 20, 2013
    Gleason 7 (3 & 4)
    Second opinion: Gleason 6 (3 & 3)
    PSA: 6.85
    Fourth Prostate biopsy done on (01/16/2014 )because was PSA 9.29 on 12/20/2013:
    Two core samples came out positive.
    Left lateral base a Gleason of 7 (3+4) High-grade prostatic intraepithelial neoplasia.
    Left Lateral Apex: Prostatic Adenecarcinoma, Gleason 7 (4+3)
    Hormone Therapy started on 02/24/2014: Casodex for one month. ED (a first!)
    Eligard injection on 03/02/2014
    Bone Scan good.
    MRI of the prostate showed an 8 mm nodular area (lateral left peripheral zone near the mid gland).
    Prostatic capsule intact.
    Periprostatic fat, semi vesicles, and periprostatic neurovascular bundle clear.
    Prostate measures 5.5 x 3.7 x 5.6, volume 57ml.
    Considered a T1c-T2c
    IMRT (Tomo-therapy) started on April 28, 2014 for a total of 39 treatments.

  9. #19
    Moderator Top User HighlanderCFH's Avatar
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    Glad to hear you've got the latest equipment. Should bode well for you in the future.

    I had a cystocopy the day before my surgery and a gorgeous blonde medical student was in the room with us to observe. I obviously wasn't at "my best" for this "meeting," but I didn't mind seeing her at all. Have to say I was a bit disappointed when she stood behind me in the back of the room as the test began. Might have been easier for me if I could have kept staring at her beautiful face. LOL
    July 2011 local PSA lab reading 6.41 (from 4.1 in 2009). Mayo Clinic PSA 9/ 2011 = 5.7.
    Local uro DRE revealed significant BPH, no lumps.
    PCa Dx Aug. 2011 age of 61.
    Biopsy DXd adenocarcinoma in 3/20 cores (one 5%, two 20%). T2C.
    Gleason 3+3=6. CT abdomen, bone scan negative.
    DaVinci prostatectomy 11/1/11 at Mayo Clinic (Rochester, MN), nerve sparing, age 62.
    Surgeon was Dr. Matthew Tollefson, who I highly recommend.
    Final pathology shows tumor confined to prostate.
    5 lymph nodes, seminal vesicules, extraprostatic soft tissue all negative.
    1.0 x 0.6 x 0.6 cm mass involving right posterior inferior, right posterior apex & left
    mid posterior prostate. Right posterior apex margin involved by tumor over 0.2 cm length,
    doctor says this is insignificant.
    Prostate 98 grams, tumor 2 grams.
    Catheter out in 7 days. No incontinence, minor dripping for a few weeks.
    Seven annual post-op exams 2012 through 2018: PSA <0.1
    Semi-firm erections without "training wheels," usable erections with 100mg Sildenafil.
    NOTE: ED caused by BPH, not the surgery.

  10. #20
    Experienced User BeeMan's Avatar
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    HighlanderCFH.....now you know I am face down and all they can see is my back side (up close and personal).

 

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