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

  1. #31
    Moderator Top User HighlanderCFH's Avatar
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    Nov 2011
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    Hopefully someone with experience in this will help out. In the meantime, the best thing to do is make sure that your treatments are with a HIGHLY experienced radiation oncologist and that the latest equipment is used.

    Good luck go you!
    Chuck
    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.
    Eight annual post-op exams 2012 through 2019: PSA <0.1
    Semi-firm erections without "training wheels," usable erections with 100mg Sildenafil.
    NOTE: ED caused by BPH, not the surgery.

  2. #32
    Senior User
    Join Date
    Mar 2015
    Posts
    149
    Hello Highlander,
    I PM you the link to BIDMC's RT equipment page hoping you could give me a sense of how new the equipment is.
    Thanks
    July 2012 DRE normal but the test was shallow and quick, no PSA
    May 2013 Doctor retired, new Doctor
    May 2013 PSA 5.7, DRE with significant hard lump left side
    July 2013 Biopsy 10 of 12 cores scored 4/4, CT abdomen, bone scan both negative
    Nov 2013 DaVinci prostatectomy at Beth Israel Deaconess Boston, non-nerve sparing - surgeon went wide, age 63
    seminal duct, urethra, and 3 of 26 lymph nodes positive, Gleason upgraded to 4/5 =9
    Post op exams 3/14 <.01, 6/14 .01, 9/14 .05, 11/14 .1
    Lupron injec 11/14 30 day, 12/15 90 day, 3/15 90 day, 6/15 90 day (T heads up after 9/15)
    With HT exams 12/14 <.1, 3/15 <.1
    Salvage IMRT 3/31 - 6/4/2015 34 X 2GY= 68GY
    6/2015 PSA <.1 (still on HT)
    9/2015 PSA <.1 (still on HT)
    12/2015 PSA <0.01 no HT, T normal

  3. #33
    Moderator Top User HighlanderCFH's Avatar
    Join Date
    Nov 2011
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    7,232
    Hi,

    I received the link you sent. While I am not very well versed in the different types of equipment, the Varian 21EX Dual Energy Linear Accelerator would seem to be pretty up to date. When you see the acronym of "IMRT" -- intensely modulated radiation therapy -- that is one of the clues that it is more advanced than the old, traditional radiation. This is much more narrowly focused and does not hit much of the surrounding, healthy tissue.

    Chuck
    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.
    Eight annual post-op exams 2012 through 2019: PSA <0.1
    Semi-firm erections without "training wheels," usable erections with 100mg Sildenafil.
    NOTE: ED caused by BPH, not the surgery.

  4. #34
    Senior User
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    Apr 2014
    Posts
    127
    hms03049, I did not have much of a problem from my 39 treatments. first 25 treatments only noticed a slight burning that only lasted 2 days. I attribute it to eating mexican food, stay away from spicey food and for me tomato based food. when I did feel some burning at my rectum it was always Friday night and Saturday but fine by Sunday. then it starts over again, make sure you have an empty colon and full bladder. I only had a 25 minute drive but no problems from sitting or driving. treatments were at 10:45am so I wold get up early, eat a bowl of fiber cereal and do a 2.5-4 mile walk. this would empty me and then I would drink a 20oz water on the way. doctor told me to watch what I eat to keep from having gas, to take gasX or something similar. I was one day from being 65 when I finished my last treatment. I think is going to be pretty tough to go to Boston for 8 weeks which is what seems to be the length for SRT. I became a thimble bladder with all this, don't know if i could ride that long without having to pee.

  5. #35
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    Mar 2015
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    149
    White - Thank you for your comments. I'm off the fence and have signed on with BIDMC Boston in-spite of the long drive or bus ride based on various inputs and especially this forum. While I haven't used them for 9 months it sounds like I should carry a few pads in my travel bag.

    I figure between parking lots, bus terminals, the T (subway), and then 2 blocks to the hospital I'll get a hour per day of walking whether I feel like it or not. I'm assuming exercise is part of the treatment. With local treatments I'd probably just eat something and take a nap.
    July 2012 DRE normal but the test was shallow and quick, no PSA
    May 2013 Doctor retired, new Doctor
    May 2013 PSA 5.7, DRE with significant hard lump left side
    July 2013 Biopsy 10 of 12 cores scored 4/4, CT abdomen, bone scan both negative
    Nov 2013 DaVinci prostatectomy at Beth Israel Deaconess Boston, non-nerve sparing - surgeon went wide, age 63
    seminal duct, urethra, and 3 of 26 lymph nodes positive, Gleason upgraded to 4/5 =9
    Post op exams 3/14 <.01, 6/14 .01, 9/14 .05, 11/14 .1
    Lupron injec 11/14 30 day, 12/15 90 day, 3/15 90 day, 6/15 90 day (T heads up after 9/15)
    With HT exams 12/14 <.1, 3/15 <.1
    Salvage IMRT 3/31 - 6/4/2015 34 X 2GY= 68GY
    6/2015 PSA <.1 (still on HT)
    9/2015 PSA <.1 (still on HT)
    12/2015 PSA <0.01 no HT, T normal

  6. #36
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    Mar 2015
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    Mar 31 I had my planning session at BIDMC, here is my experience. I was notified of the appointment on line and via a phone call. I did not receive prep instructions. Once there I removed everything from the waist down and put on a Johnny. I was asked about prepping, specifically about a fleet enema, I said didn't know I was suppose to. I had just gone so the Dr. said ok, I was put on the MRI table. A tube up the rear and dye in the urethra and bladder via the penis. From reading the forums here the dye is unique to post surgery patients getting adjuvant or salvage RT so they can see where the prostate used to be. The dye burned going in, and later coming out. All was set, felt tip pin marks were placed on me, and I made two trips thru the MRI. Laying there I had to wait 10-15 minutes while they reviewed the image. They had never seen such an empty bladder. After 7 cups of water and a wait it was back to the MRI for another two trips through. All was good this time. They replaced the felt tip marker lines with permanent tattoos. I was done.
    The lesson learned is to ask about prepping instructions prior to any procedure if you have not received anything ahead of time. March 16 I get the first of 38 treatments.
    July 2012 DRE normal but the test was shallow and quick, no PSA
    May 2013 Doctor retired, new Doctor
    May 2013 PSA 5.7, DRE with significant hard lump left side
    July 2013 Biopsy 10 of 12 cores scored 4/4, CT abdomen, bone scan both negative
    Nov 2013 DaVinci prostatectomy at Beth Israel Deaconess Boston, non-nerve sparing - surgeon went wide, age 63
    seminal duct, urethra, and 3 of 26 lymph nodes positive, Gleason upgraded to 4/5 =9
    Post op exams 3/14 <.01, 6/14 .01, 9/14 .05, 11/14 .1
    Lupron injec 11/14 30 day, 12/15 90 day, 3/15 90 day, 6/15 90 day (T heads up after 9/15)
    With HT exams 12/14 <.1, 3/15 <.1
    Salvage IMRT 3/31 - 6/4/2015 34 X 2GY= 68GY
    6/2015 PSA <.1 (still on HT)
    9/2015 PSA <.1 (still on HT)
    12/2015 PSA <0.01 no HT, T normal

  7. #37
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    Apr 2014
    Posts
    127
    hms, I had neither an enema or dye my first planning session. I did get 3 tattos and a mold of lower extremities. each session they would line me up and do a CT scan, then the table would move and get me in the precise position. full bladder and empty colon, had routine every morning to accomplish this. high fiber cereal and brisk walk of 3-5 miles till I felt some movement. worked every time then a bottle of water on the way to the session. I was told that a full bladder helped with moving the colon and to keep from the bladder. the only thing unexpected was my RO did a DRE. I asked why, she wanted to feel how I healed, looking for it to be smooth and no lumps. strange looking at myself when I get out of the shower, the radiation ridded my body of hair and also the HT caused be to lose alot of body hair also. pubic started coming back pretty quick but not my lower belly. you will do fine, good luck.

  8. #38
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    Mar 2015
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    Hello white,
    Thanks for some good ideas. The fiber/walk would work for me. I have a hour and a half trip into Boston every morning. I plan to go in very early to beat the traffic and get back to work. Early, rushing, and setting while driving are counter to being regular.
    They let me play with the MRI scan on the screen and the urethra stood out tip to bladder due to the dye.

  9. #39
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    Dec 2014
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    232
    Quote Originally Posted by LIBMRDUCKS View Post
    Hi BeeMan, How are you feeling after completing the (IMRT)? Are you still on HT? Are you experiencing any side effects that are new? Prior to my (IMRT) it was explained to me that I would lose most if not all of my body hair. Well I had seen and talked to people with various types of cancer and they all lost their hair after Radiation Treatment, so I figured I would as well. However, I had no loss of hair during or after treatment. How about you were you able keep it or lose it? OK, last question, if you could go back before (IMRT) with what you know now, would you make the same choice or take another option? Very personnel I know but I appreciate your directness with these issues. Thank You, Rob
    I've not heard of hair loss from radiation, chemo, yes. How are you now, six or so months along?
    Age 70, ( now 73 ) consistent low psa till now, dre's are very important as this got way ahead of me without them!
    PSA rise 3.8 to 4.3 ( 10/2014 )
    No family history, one of eleven siblings.
    Biopsy 11/20/14 Gleason 9 with 5+4, T2c score
    9 or 10 of 12 positive 12/04/14
    Cat scan, bone scan, m r i show confined to prostate gland
    Two weeks intensive research....HT and radiation decision made
    First HT 12/16/14 lots of side effects ( Degarelix ) (3/11 pain and bruising at injection site, sleep issues, sweats and maybe some dark thoughts)
    Second HT 1/13 no side effects ( Eligard )( much easier than the 30 day, no pain or bruising, only sweats and sleep issues )
    Cat scan and tattoos 3/6/15 Dry run 3/18 actual radiation on 3/19
    Wrapped up the radiation on 5/22 and met the Memorial Day goal!
    Second six month Eligard on 7/14/15. If follow up PSA test goes well may opt out.
    .01 PSA at 90 day follow up, opted out of h t after a year. Still undetectable after three years.

  10. #40
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    My RT starts next Thursday - I've got the bowels must be empty and no farting, ah, I meant flatulence, else you get sent to the back of the line.
    I'd like to get an early start on a diet that will work but can only find snippets like no habanero peppers, creekrat mentioned GasX, WebMD suggest low fiber and beans (now how does one do that?). I like the suggestion of an early run to get things moving.

    For you that have been through it I suspect you settled into a diet that worked for the 40 days and 40 nights. I'd like to hear what worked from you trail blazers.

    Thanks!

    hms
    July 2012 DRE normal but the test was shallow and quick, no PSA
    May 2013 Doctor retired, new Doctor
    May 2013 PSA 5.7, DRE with significant hard lump left side
    July 2013 Biopsy 10 of 12 cores scored 4/4, CT abdomen, bone scan both negative
    Nov 2013 DaVinci prostatectomy at Beth Israel Deaconess Boston, non-nerve sparing - surgeon went wide, age 63
    seminal duct, urethra, and 3 of 26 lymph nodes positive, Gleason upgraded to 4/5 =9
    Post op exams 3/14 <.01, 6/14 .01, 9/14 .05, 11/14 .1
    Lupron injec 11/14 30 day, 12/15 90 day, 3/15 90 day, 6/15 90 day (T heads up after 9/15)
    With HT exams 12/14 <.1, 3/15 <.1
    Salvage IMRT 3/31 - 6/4/2015 34 X 2GY= 68GY
    6/2015 PSA <.1 (still on HT)
    9/2015 PSA <.1 (still on HT)
    12/2015 PSA <0.01 no HT, T normal

 

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