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Thread: Question for the guys that had radiation treatment.

  1. #1
    Senior User
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    130

    Question for the guys that had radiation treatment.

    Is it true that you have to have an empty colon before treatment. Some guys are lucky that they can get out of bed, drink a cup of coffee and do their business. What about guys who are not built that way. Do you get the treatment anyway.

  2. #2
    Experienced User
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    May 2019
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    80
    Hi 35Coupe,

    My RO told me he just needed my rectum empty - last two inches or so of the colon. That part isn't normally full until you are just about ready to go. That said, I did have to use a couple (2) Fleet enemas over the past 6 weeks of radiation therapy to get things moving along due to occasional constipation. As you pointed out, coffee normally did the trick for me BEFORE surgery but things have changed somewhat since. Also, Ducolax stool softener works pretty well to get things moving without giving one diarrhea. It's pretty gentle on your system.

    IG
    DOB: 10/1962

    6-01-15 PSA 2.5
    Having urination flow issue in first half of 2018. Flomax 6/1-6/21 - no help.
    6/25/18 PSA 14.25; Cipro 14 days
    8/1/18 PSA 17.44; rec. Urologist appt
    8/15/19 First Uro appt. + for bacteria. Cipro 4 weeks
    10/2/19 PSA 22.4; Still + for bacteria. Antibiotics 4wks
    12/28/19 PSA 27.5
    1/15/20 Biopsy results 6/12 cores positive - all left side; GS 4+3
    1/18/19 Bone scan and CT scan both negative
    2/15/19 Di Vinci RP
    2/18/19 Path report pT3a, GS 4+3 (60%+35%) 5% GS5, SM +, EPE +; LVI -, SVI -, LNI(9) - ; Tumor size: 3.5cmx3.5cmx1.5cm; single foci left side; right side nerves spared; SM+ at apex limited <1mm; benign prostatic cells at spared right nerve bundle. Prostate size 45gm.
    Cath out at 7 days: 100% continent with some ED; ok with 10mg Cialis.
    Decipher 0.73

    3/26/19 (6 weeks) 0.033
    5/10/19 (3 months) 0.010
    8/02/19 (6 months) 0.019
    8/30/19 (7 months-recheck) 0.024
    9/26-11/19/19 eSRT (70.2 Gy)

  3. #3
    I tried to have some small BM each morning, about 75% of the time it worked.
    YOB 1957

    DX 12/18, GS 8, 4+4 6/12 cores, LL Apex 100%, LM Apex 60%, LL Mid 50%, LMM 40%, LL Base 5%, LM <5%, Right side negative.

    3/6/19. Pathology - Grade Group 4 Intraductal Carcinoma
    T3aNO, 1 mm EPE, GS8, 21 mm uni-focal tumor involved 10% of prostate.

    7 Nodes, SV, SM, PNI, and BNI were negative.

    LVI and Cribriform pattern present.

    Decipher .86 High Risk.

    Post Surgery PSA
    3/25/19 .03. (<1 month)
    4/25/19 <.03. (2 months)
    5/25/19 <.02. (3 months)
    9/10/2019. <.02. (6 months)
    11/27/2019. <.02. T<3. (9 months)

    3 Part Modality Treatment

    2/25/19 Robotic Laparoendoscopic Single Site Surgery outpatient Cleveland Clinic,

    ADT - started 6/19, end date 6/21.

    ART - Completed 9/26/19. (78 Gy, yes, I glow in the dark)

  4. #4
    Senior User mostth's Avatar
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    Feb 2019
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    130
    I'm not sure if they would or not treat because you will end up supposedly with complications. but I was lucky and usually had a movement every morning, later in the series it was harder not having movements all day due to diareaha so I was usually pretty clean. I only once was told that I was close to not being acceptable and she said it was gas. I didn't feel gassed but if I had went to fart I would have peed so then it would have been back to the water fountain for a few minutes.
    Last edited by mostth; 11-06-2019 at 01:30 PM. Reason: add text
    DOB 9/6/59
    1/21/19 PSA 7.5.
    Bx 2/8/19
    G7 (4+3), 60% pattern 4
    Reffered to Mayo Clinic Rochester, MN
    RALP 4/3/19 Igor Frank
    Adenocarcinoma G8 (4+4)
    Mass (3 x 1.5 x 1.2 cm)
    Tumor involves both seminal vesicles.
    Extraprostatic soft tissues, SM, EPE, BNI, LNI (24): neg., SVI+
    pT3b pN0 Mx
    7/19 3mo PSA 0.74
    7/24 retest PSA 0.78
    8/14 3 mo. Lupron inj.
    9/10 Start radiation 38 doses
    10/31 Radiation complete
    11/5 2nd 3 mo Lupron inj.

  5. #5
    35coupe, yes the rectum should be empty, not for treatment to be effective, but to reduce the chance of possible side effects. My RO had me on daily Metamucil throughout the 8 weeks of salvage radiation. It mostly worked. There were a few instances that although
    I had a BM within an hour before the treatment, I had to go right after the treatment again. That had me worried. But so far (1 year later this week), no issues.

    Hope that helps, of course everyone is different. But maybe try a daily laxative drink.
    Diagnosed at age 64 (in November, 2014), PSA 4.3
    Nov 2014 BX 3 of 12 cores positive original pathology G8. Johns Hopkins second opinion, G6
    Surgery with Dr Ash Tewari Jan 6, 2015
    Post surgical pathology, stage T2c, bilateral disease, upstaged to G7(3+4)
    5% of Prostate involved in Tumor. Organ confined, Margins, SV, lymph nodes (9) all negative, PNI positive
    PSA <.02 until (uh-oh), 2/17 .02. Then 5/17-.033, 8/17-.033, 11/17-.046, 4/18-.060, 6/18-.068, 7/18- .082, 8/18-. 078.
    Decipher score low risk, .37
    ADT/Firmagon started August 2018. SRT SEPT 2018. Finished SRT November 2018, Finished ADT Feb 2019
    T=7, PSA <.05, 5/19 T=48 PSA <.05, 10/19 T=97 PSA=<.05

  6. #6
    Regular User
    Join Date
    Mar 2019
    Posts
    18
    Hi,

    During my radiation treatment the therapists/technicians used to perform a scan. And if they found issues with either bladder not being full, or colon not empty, they would ask me to wait. Taking Ducolax helped, but there were at least 2-3 times (out of 40) I had to wait and have a bowel movement before going back in. I also had upset stomach during radiation. The RO had advised to go on a very low fibre diet. That was difficult for me because I am diabetic. So eating white rice etc.. was a big change. Once the radiation treatments were stopped, it took about 4 weeks to get back to normal.

    The bladder 'not being full' happened at least 4-5 times. The staff was very helpful and patient. I had to drink some more water and wait. Normally drinking 2 bottles of water an hour before the treatment helped me keeping the bladder full.

    I dont think it is a big deal. Key is to relax. The staff is normally very helpful.
    I hope this helps.
    PSA 11/16 - 2.5; PSA 03/17 - 2.4; PSA 08/18 - 4.6; PSA 09/18 - 4.9;
    TISSUE PATHOLOGY 10/04/2018:12 samples - 4 with (4+4), 2 with (4+3), 6 benign

    BONE SCAN WHOLE BODY 10/15/2018: degenerative changes. No other findings
    CT ABDOMEN PELVIS W/ (ORAL/IV) CONTRAST 10/16/2018:no evidence of metastatic disease
    MRI PROSTATE WO/W CONTRAST 11/08/2018: suspicious for malignancy; Findings suspicious for a PI-RADS 5 lesion
    MRI THORACIC SPINE WO/W CONT 11/10/2018:no evidence of metastatic disease

    Surgery da Vinci Robotic Laparoscopic - 01/25/2019

    Post surgery Report:
    pT3a
    pN0
    EPE - Present, non-focal
    Margins - Involved by tumor at posterior mid and right anterior
    PNI - present
    No of lymph nodes examined 3; involved 0
    Total Gleason score 4+4 = 8
    Tertiary Gleason pattern 5(1%)

    PSA Post RP - 03/08/2019 - 1.6
    PSA - 03/22/2019 - 1.6
    Axumin PET Scan - 04/03/2019 - one positive lymph node

  7. #7
    Experienced User
    Join Date
    Apr 2019
    Posts
    79
    As others have said, empty rectum. One of the reasons that I scheduled my treatments to be at lunchtime was that I had fairly consistently timed bowel movements which usually finished by 9AM -- something to keep in mind when choosing a time slot. My RO had me take Gas-X and Milk-of-Magnesia the night before a treatment in order to help with the empty rectum. Keep sufficient fiber in your diet unless you have to go to a low residue one due to any bowel issues. Your RO should be able to give you some more information on daily prep for your RT treatments.
    6/18 New PCP asks "When was your last PSA level checked?" --> 11.5 so off to URO
    9/18 PSA 12.4, TRUS biopsy 10/18 yields 2 of 12 positive: LA GS6 <5%, RA GS7(3+4) 5% and the 4 is cribriform approaching 50%
    Clinical staging T1c, Decipher biopsy 0.94, 58 years old at DX
    12/18 RARP, pathology GS7(4+3) with cribriform, tumors in 10-15% of gland
    -SVI, -LVI, +EPE, +PNI, +BNI, +SM multifocal >=3mm pattern 4
    pT3a,pNx (lymph nodes inaccessible due to large mesh placement from 15 year ago bilateral hernia repair
    4/19 second opinion of pathology GS8, primary tumor composed of >95% cribriform (4+4), <1% pattern 5 and very minor focus comedo-necrosis, intraductal and postive margin at bladder resection
    still at pT3a,pNx and started six months of ADT 4/19, ART completed 9/13/19
    PSA <0.1 on 1/19, 4/19, 7/19, 10/19

  8. #8
    Senior User
    Join Date
    Feb 2019
    Posts
    292
    Since I knew I was always a first thing in the morning taking a dump kinda guy after my first cup of coffee ... I scheduled all my RT sessions for first thing in the morning at 0815 hours. Made sure I was up in the morning at 0500 hrs before heading out the door at 0745 hrs. Never had a problem not having an empty colon nor not having a full bladder. My RT sessions went very well for me.
    Age DX 63 dob 1955
    8/11/16 CT scan (blood/sand in urine). Prostate norm w/cent calcification.
    11/6/18 GP freq urine/retro ejact. PSA 7.1 (RX Proscar/Flomax)
    12/18 PSA 4.1 14.8% Free Proscar? MRI Lesion 1.6cm. Lymph nodes sim to 2016 CT, prostate norm size. Stage 3. PIRADS 4
    1/19 Biopsy 2/5/19 DX
    2/19 Bone/CT scans: No evid met chest/abd/pelvis
    3/2019 RALP Cath out/post-op path rpt week later:
    G9 (4+5) (65-70% + 15-20%)
    Dominant tumor: 4.3 cm apex to base, bilat.
    LNI+ (4 of 12 on R, largest 4mm, 1 of 8 on L, 9 mm)
    EPE+ (right lat., post. and L lat. aspects apex to base and at ant. mid aspect)
    Intaraductal component+, BNI-, SVI+, LVI+
    SM+ (carcinoma unifocally extends to ant. mid margin area of EPE (2mm)
    Prostate fat: neg. pT3b pN1
    5/2019 Casodex 2-weeks. uPSA 0.11
    5/24 uPSA 0.11 Lupron injection
    6/19 uPSA .02
    8/7 began 39 sessions RT 70.2 Gy (last session 10/1)
    8/23 uPSA .01 Lupron injection
    9/27 uPSA <0.01
    10/22 uPSA <0.01

  9. #9
    Experienced User
    Join Date
    Nov 2017
    Posts
    99
    Don’t worry, you will get it figured out. For me it was stool softener everyday, GasX, and a high fiber diet. I scheduled the therapy for 1:00 pm to give me time to go. Everyone has a different system, and everyone figures it out.

    Eric

  10. #10
    Senior User
    Join Date
    Apr 2014
    Posts
    128
    bowl of cereal then a take the dog for a brisk walk. worked for both of us. drank 16 oz. bottle of water on the way. only once in the 8 weeks had to wait and voided then had drink a bottle of water and wait about 20 minutes. got bumped by a emergency patient.

 

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