IMRT here I come.

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kdnole
Regular Member


Date Joined Jun 2007
Total Posts : 152
   Posted 2/4/2008 11:57 AM (GMT -7)   
Finally met with a Radiation Oncolongist @ Duke last week and I am getting ready to experience a new journey that includes Radiation therapy. I am scheduled for my CT Scan & MRI this coming Monday and the treatments will probably follow within 10 days. Any thoughts from others on what to expect and side effects would be helpful.
Sorry I've been away from the board but my wife has been having a tough time with her auto immune disease and a bleeding bladder which was a result of her chemo therapy. Way to much sh-tuff going on.

Age 44
PSA 4.8
Gleason 3+3=6
T2
Biopsy - 3 of 12 (2@20% / 1@80%
Da Vinci 7/31/07 @ Duke
2.5 hr. surgery, released from Duke with in 14 hrs.
Saved both nerve bundles. 
Foley out 8/10/08
Positive Pathology Report 
Near left side nerve bundle
New Gleason 7
Oncology visit in the near future for radiation
Back to work 3 weeks following surgery - Sales
 
9/13/07 - 1 Post PSA Undetectable less than 0.1 
 
9/17/07 - Pad Free! 
 
10/11/07 - ED, Trimix injection .2cc Tooo much but it worked. Now on .05cc, 3 times a week
No luck with viagra or pump. 
 
11/19/07 - 5 mth. PSA 0.1 (Ouch)
12/14/07 - 1st Appt. with Medical Oncologist - Radiation here I                 come. (This sucks)  


War-eagle
Regular Member


Date Joined Sep 2007
Total Posts : 219
   Posted 2/4/2008 1:45 PM (GMT -7)   

KD,

So sorry to hear about the problems your wife is having. We will be praying for you both.

On to the RT. How many treatments did the docs say you would have? I had 38. My biggest problem was fatigue. But that didn't start until about treatment 20 or so. Then there was the ever present constipation issues. No problem there. Fiber is your friend. I would recommend starting some exercise before you start. Walking is great. It will hold back the fatigue.

Others here will have great advice also.

Good luck brother,

Walt


Age: 54
PSA 43 7/2005
Biopsy 12/14 Gleason 7 & 9
Divinci 9/2005 - spread to bladder
HT - 10/2005 (Eligard every 6 months)
RT - 10/2005 (38 treatments)
PSA 0.12 to 1.9 2/2007
Bone Scan and CT 4/2007 Bone mets
Casodex 4/2007
Zometa infusions 4/2007
PSA 4.8 8/2007
PSA 6.34 12/2007
Radiation (15 treatments) started on bone mets 12/2007
PSA 6.72 1/2008
PSA 8.23 2/2008 - Starting prednisone for 30 days
 
 
"I will persist without exception - I will find a way where there is no way"


Ken S
Regular Member


Date Joined Nov 2006
Total Posts : 120
   Posted 2/4/2008 2:40 PM (GMT -7)   
kdnole,

I finished my 37 treatments of radiation (IMRT) last June and have had minimal side effects. I stopped wearing pads a few weeks before radiation treatments (5 1/2 months after RP) but now I have to wear 5 or 6 a week, mostly stress incontinence with very little leakage. I thought I was going to have problems with diarrhea and fatigue after 4 or 5 weeks but was told that at my age I wouldn't have any fatigue issues and fortunately I had no diarrhea.

The treatments are like getting a dental x-ray but longer. I'm sure everyone is different but my treatment consisted of being lined up on the table (using 3 period sized tatoos for guides - 1 on each hip and 1 at the base of the penis) and then having 2 or 3 x-rays to be sure I'm properly positioned. I was then "zapped" for about 30 seconds each from 7 different angles (360 degrees at every 45 degree angle except 180 degrees). You should have a full blatter during the procedure so I drank 24 oz. of water 1 to 1:15 hours before my treatment time. I only live 20 minutes away so I called before I left the house (self employed, home based business) to make sure they're weren't backed up. If they were I just partially emptied my bladder and drank more water. They did a blood test once a week to check my blood cell count and I saw my radiologist once a week also.

They'll give you a consent form to sign with all kinds of nasty side effects listed but the worst of them are rare. You'll get to know your radiation technicians very well. I can't say enough good things about the group that took care of me, they were fantastic. Good luck and keep us posted.
Age 54 (2006)
PSA - 2005 - 3.2, 2006 - 3.7
Biopsy 8/06, Gleason 6 (3+3), T1c
Radical Retropubic Prostatectomy 11/3/06
Post-Op Biopsy, still Gleason 6 (3+3),
T2c, right apical margin positive
CT Scan 1/07, tumor discovered on right
kidney (unrelated to PCa)
Partial Nephrectomy 3/9/07
IMRT (37 Treatments) started 4/23/07
PSA 11/07 - less then 0.01


kdnole
Regular Member


Date Joined Jun 2007
Total Posts : 152
   Posted 2/4/2008 3:06 PM (GMT -7)   
I'll have 30 treatment's so I'll be going 6 weeks every day. I work out 4-5 days a week so I'm hoping the fatigue is not too bad because with my wifes illness I some what run the house. Now for the treatments are you on the table exposed for all the world to see or are you covered up, and are the tattoos permanent? I'm not worried about being exposed because as all of us know with PCa you seem to be always over exposed. :-)
I a bit nervous about finding that middle ground when filling the bladder. I'm worried I might get on the table and have to pee.
Age 44
PSA 4.8
Gleason 3+3=6
T2
Biopsy - 3 of 12 (2@20% / 1@80%
Da Vinci 7/31/07 @ Duke
2.5 hr. surgery, released from Duke with in 14 hrs.
Saved both nerve bundles. 
Foley out 8/10/08
Positive Pathology Report 
Near left side nerve bundle
New Gleason 7
Oncology visit in the near future for radiation
Back to work 3 weeks following surgery - Sales
 
9/13/07 - 1 Post PSA Undetectable less than 0.1 
 
9/17/07 - Pad Free! 
 
10/11/07 - ED, Trimix injection .2cc Tooo much but it worked. Now on .05cc, 3 times a week
No luck with viagra or pump. 
 
11/19/07 - 5 mth. PSA 0.1 (Ouch)
02/11/08 - Scheduled for CT Scan and MRI
Radiation treatments to start at the end of Feb. (6 weeks, 5 days a week)  


Pelahatchie
Regular Member


Date Joined Jul 2007
Total Posts : 86
   Posted 2/4/2008 3:39 PM (GMT -7)   
I am going into my fifth week of salvage/adjuvant, I am not sure how to classify it because it is 2.5 years since the Da Vinci but my PSA when I started treatment was .08.  Consitipation has been my biggest issue but I have gone back to my normal diet which seems to have resolved the issue.  I do feel fatigued and it is actually worse the further I walk each day.  Really tired at the end of the work day if I do four miles at lunch. 
 
I do not have to fill my bladder which is nice and they work off three pen marks that they refresh as necessary for alignment.  The machine stops nine different times each visit and beams me for different periods of time at each stop.  The doctor told me the length of time can vary based on the quality of electrictiy that is being provided to the facilty by the utility company.  I am concerned about side effects down the road such as ED and incontinence but I guess we will deal with that if and when it comes.  As I told a friend of mine, if my penis can survive everything it has been through the past 2.5 years then if should be a candidate for cloning.
 
My hope and dream is that I will come out of this and be able to close the Prostate Cancer chapter in my life but that may not happen. 
The phsyological impact of cancer has been the toughest part for me to deal with.  I have been blessed to have lead a relatively healthy life to this point but I am a worrier and it stays on my mind alot which creeps into work performance and my home life.  Everyone is different but no one should under estimate the impact cancer has in someones life, it is profound for most.
 
I am scheduled for 40 treatments up to a total dose of 70.20.  I questioned why not 80 when the latest research says the higher the dose the better the results.  My doctor said that without an intact prostate and the presumed low tumor volume this dose should be more than adequate and greatly reduce the chance of side effects.  I hope he is right.
 
Good luck!
DX 8/05 Gleason 5, Mayo clinic Second Opinion Gleason 6, PSA 2.8
 
Da Vinci surgery Dr. Dasari, Centennial Nashville 9/24/05
 
Pathology Report Gleason 6, 15 % on left side only very near to the edge of capsule, too close to call on margins, doc's said to watch it very closely, final decision T2A
 
PSA's have basically ranged from <.04 to .05 for two years.
 
no E.D. and no Incontinence, feel very blessed
 
PSA Nov 07 = .06
 
PSA Dec 10th 07 =.07
 
Started Guided IMRT on January 7th, 2008 to treat prostate bed and lymph nodes


mvesr
Veteran Member


Date Joined Apr 2007
Total Posts : 823
   Posted 2/4/2008 5:27 PM (GMT -7)   
KD. Sorry about having to do the radiation thing. I will be praying for you and your wife, and hope she does better.

Mika

Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8122
   Posted 2/4/2008 6:35 PM (GMT -7)   
Hi KD,
Good to see you, but sorry you're back. I went through 38 IMRT sessions and was side effect free. I did notice a couple weeks after we finished that I was feeling more energy, but I didn't notice it duting treatment. Hopefully you can avoid the HT as well. That has side effects. I have tolerated them well but they are there from time to time.

Tony
Age 45 (44 when Dx)
Pre-op PSA was 19.8
Surgery on Feb 16, 2007
Post-Op Pathology was poor: Gleason 4+3=7, 4 positive margins, Stage pT3b (Stage III)
HT began in May, '07 with Lupron and Casodex 50mg
IMRT radiation for 38 Treatments ending August 3, '07
 
My PSA did drop out after surgery to undetectable.  It has not returned and I will continue HT until January '08.
 
My Life is supported very well by family and friends like you all.
 
Visit my journey at:
 
STAY POSITIVE!


jetguy
Veteran Member


Date Joined Sep 2006
Total Posts : 741
   Posted 2/4/2008 6:49 PM (GMT -7)   

KD, I did 43 treatments.  The above posts seem to me to be about right.  My tatoos are permanent.  The simulation leaves you exposed while certain things like shaving are being done, but then it's over.  If your center doesn't do the balloon, that's the last time.  Close, so the lazer can see the tatoos, but that's it.

Expect fatigue toward the end.  Usually resolves itsself within a couple of weeks.  Unlikely to have any urinary issues.  Maybe a loose bowel for a bit. 

I highly recommend the water.  Drink it before your simulation and the same amount before each treatment.  That way everything is close to the same every day.  I drank my water 90 minutes before treatment and practiced hold it.  Got pretty good at it, actually.

Best to you,

Bill


August of 2006, PSA up to 4.2 from 2.7 one year ago. 
October free and total PSA 12% free and 5.0 total.
A month, or so later, 4.7.
Late in the year decide on Image Guided IMRT.
Begin 43 treatments on January 23, 2007 and finish on March 23.
Four month post treatment PSA is 1.9.
Seven month PSA is 0.8.


maldugs
Veteran Member


Date Joined Jun 2007
Total Posts : 782
   Posted 2/4/2008 10:07 PM (GMT -7)   

Hi KD, I finished my treatments on 24th Jan, the treatment itself is a breeze, drop your pants, they line up the tattoos, machine buzzes you for about 5 min (in my case top bottom, and both sides.)

Was a drag getting there, as every day was a different time, so I could not plan anything around it.

Symptoms I experienced, tiredness, loose bowels, constipation, big red patch like sunburn on the backside, I am still fatigued, but it's only been 10 days, and still having a nap in the afternoon, still I am a lot older than you.

I wish you all the best with your treatment.

Regards Mal.


age 67 PSA 5.8 DRE slightly firm Rt
Biopsy 2nd July 07 5 out of 12 positive
Gleason 3+4=7  right side tumour adenocarcinoma stage T2a
RP on 30th July,
Post op Pathology, tumour stage T3a 4+3=7, microcsopic evidence of capsular penetration, seminal vessels, bladder neck, free of tumour, lymph nodes clear, no evidence of metastatic malignancy, tumour does not extend to the apical margins.
Post op PSA 0.5 26th Sept. next PSA 26th Oct. seeing Radiation Onocologist 31st Oct. PSA 0.5 23rd October. Started radiation treatment on 5th Dec, to continue until 24 Jan. 08. Finished treatment, PSA on 25th Feb.


mgl
Regular Member


Date Joined Feb 2007
Total Posts : 122
   Posted 2/5/2008 5:24 AM (GMT -7)   

I had imrt last fall 37 treatments, the only side effect I had was a sore rectum at times Dr gave me some suppostiories for it and they helped.

I was able to work everyday and I would go running when I got home, from treatments I was never tried from treatments

I just went to the urologist last week and my psa dropped from 0.28 to 0.1

hopefully you will have the same


50 years old
gleason 3+4=7 psa5.8 clinical stageT3a
Da vinci surgery April10 2007 Mayo clinic Rochester, Mn.
extraprostatic extension Gleason -same
pelvic lymph nodes -negative
Catheter out April 19
37 treatments IMRT ended 10/26/07


kdnole
Regular Member


Date Joined Jun 2007
Total Posts : 152
   Posted 2/5/2008 6:15 AM (GMT -7)   
Thanks to you all for sharing your experiences as they will help me prepare for the treatments. Hopefully they will go quick and easy becasue I just have way too much stuff going on to mess with this PCa anymore. ;-)
Age 44
PSA 4.8
Gleason 3+3=6
T2
Biopsy - 3 of 12 (2@20% / 1@80%
Da Vinci 7/31/07 @ Duke
2.5 hr. surgery, released from Duke with in 14 hrs.
Saved both nerve bundles. 
Foley out 8/10/08
Positive Pathology Report 
Near left side nerve bundle
New Gleason 7
Oncology visit in the near future for radiation
Back to work 3 weeks following surgery - Sales
 
9/13/07 - 1 Post PSA Undetectable less than 0.1 
 
9/17/07 - Pad Free! 
 
10/11/07 - ED, Trimix injection .2cc Tooo much but it worked. Now on .05cc, 3 times a week
No luck with viagra or pump. 
 
11/19/07 - 5 mth. PSA 0.1 (Ouch)
02/11/08 - Scheduled for CT Scan and MRI
Radiation treatments to start at the end of Feb. (6 weeks, 5 days a week)  


bluebird
Veteran Member


Date Joined May 2006
Total Posts : 2542
   Posted 3/4/2008 3:28 PM (GMT -7)   

  :-) Hey ~ kd,

Just wanted to let you know our thoughts are with you as you step on a new stepping-stone in your path.  2/27/08 - Started IMRT Radiation treatments  (6 weeks, 5 days a week)  

 

Amazing the strength we’ve all garnered from each other as we travel together.

   Sharing is Caring ~ thanks for staying close to all of us.

       Warm thoughts and Gentle Hugs as you continue to move forward in your treatment….

Hugs coming to you from Lee & Buddy

 

Helping to keep kd’s journey together! yeah  

Threads started by: kdnole

 

02-29-08  Focal Cryosurgery

02-04-08  IMRT here I come.

11-19-07  5 mth. PSA

10-11-07  The Shot!

09-15-07  Before and After PCa Surgery Pictures

09-13-07  Kdnole's - 1st Post PSA

09-12-07  1st Post PSA Question

08-09-07  Positive Pathology Result

08-02-07  Back from Surgery

07-26-07  Post Surgery Check list

06-04-07  New Here


kdnole
Regular Member


Date Joined Jun 2007
Total Posts : 152
   Posted 3/4/2008 5:29 PM (GMT -7)   
Thanks Bluebird and I hope you are doing okay while we have these wonderful storms in Central NC tonight.
Age 44
PSA 4.8
Gleason 3+3=6
T2
Biopsy - 3 of 12 (2@20% / 1@80%
Da Vinci 7/31/07 @ Duke
2.5 hr. surgery, released from Duke with in 14 hrs.
Saved both nerve bundles. 
Foley out 8/10/08
Positive Pathology Report 
Near left side nerve bundle
New Gleason 7
Oncology visit in the near future for radiation
Back to work 3 weeks following surgery - Sales
 
9/13/07 - 1 Post PSA Undetectable less than 0.1 
 
9/17/07 - Pad Free! 
 
10/11/07 - ED, Trimix injection .2cc Tooo much but it worked. Now on .05cc, 3 times a week
No luck with viagra or pump. 
 
11/19/07 - 5 mth. PSA 0.1 (Ouch)
02/11/08 - Scheduled for CT Scan and MRI
2/27/08 - Started IMRT Radiation treatments
(6 weeks, 5 days a week)  

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