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Bootheel
Regular Member


Date Joined Oct 2007
Total Posts : 300
   Posted 5/14/2009 1:25 PM (GMT -6)   
I already had a consultation last month with the Rad Doc prior to my high PSA .18. (See my other post). Can anyone out there who has completed IMRT tell me what the sequence of events are and the timeline before the actual treatment begins?   
Age 65
Diagnosed 10/12/07
PSA 6.3
Biopsy 18 core samples, 2 positive <5%
Stage T1a Gleason 6 (3+3)
LRP  1/29/08
Post-op
Gleason 7 (3+4)
1 positive margin (.3cm)
T2C
4/16/08- Started Bi-mix injections 
5/15/08- 1st Post-Op PSA 0.07 Undetectable
8/11/08 -2nd Post-OP PSA 0.02 Undetectable
8/15/08- No more pads as of today  Whoopee!!!
11/13/08- 3rd post-op PSA 0.02 Undetectable
03/02/09- 1 yr. post-op PSA .09 Undetectable


Pelahatchie
Regular Member


Date Joined Jul 2007
Total Posts : 86
   Posted 5/14/2009 1:42 PM (GMT -6)   

Hey Boot,

They will bring you in for a trial run to begin with where they will take a bunch of pictures that they will use to line you up on each of your subsequent visits.  I went five days a week for I believe 42 treatments after that initial visit;  that equated to I believe 72gy to the prostate bed and I am not sure how many grays went to lymph nodes.  The process itself is pretty simple, you lay on the table and they line you up using the images they took and the machine will whirl around you for about 5-10 minutes each visit.  The only side effect I experienced was mild fatigue and a little bit of rectal soreness which went away pretty quickly after the treatments stopped.

As far as the timeline it will probably depend on how flexible you are and how busy they are.  Being first everyday is probably a good idea if you can do it.

 

I think you are making the right call and I bet you are going to be fine, hang in there.

 

 


Age 45 at DX
 
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
 
PSA Jan 4th 2008= .1
 
Started Guided IMRT on January 7th, 2008 to treat prostate bed and lymph nodes, completed on March 6th, 2008
 
PSA April 18th 2008 =.03
 
PSA August 18th 2008 = .01 or less, test only goes down to .01


Galileo
Veteran Member


Date Joined Nov 2008
Total Posts : 696
   Posted 5/14/2009 4:36 PM (GMT -6)   
It didn't take long for me to get started. I remember a 3D CT of the pelvis, getting three very small tattoos (about the size of freckles), having some x-rays taken while in place on the treatment table, and a dry run for practice, then we got started. From the first meeting with the radiation oncologist to starting treatment I think it was about 3 weeks, maybe less. It all happened pretty quickly. Looking back at my blog, it went something like this:

Meet with rad oncologist
Following week: CT planning scan and tattoos
Week after that: dry run followed the next day by the first treatment.

I also had a bone scan done, but that was just because a medical oncologist wanted one. It was done right after treatments began and was clear, otherwise we would have stopped at that point. Here's a link to my blog during those days: http://tinyurl.com/rdvopo
Galileo

Dx Feb 2006, PSA 9 @age 43
RRP Apr 2006 - Gleason 3+4, T2c, NX MX, pos margins
PSA 5/06 <0.1, 8/06 0.2, 12/06 0.6, 1/07 0.7.
Salvage radiation (IMRT) total dose 70.2 Gy, Jan-Mar 2007@ age 44
PSA 6/07 0.1, 9/07 <0.1, 12/07 <0.1, 4/08 <0.1, 11/08 <0.1
http://pcabefore50.blogspot.com


Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 5/14/2009 5:14 PM (GMT -6)   
First we debated it, but once we made up our mind, oK once I made up my mind to proceed, we scheduled some imaging tests.

We did CT Scans and t took about an hour. The iodine cause metallic mouth, and the banana drink sucked, but if anyone asks about flavors ask for banana the others really suck.
We did Xrays and they took about a half an hour.
Then we did an MRI it took about an hour also.
After about 5 days they called me back in for another CT. During this visit two things were accomplished ~ first we were casted. A cast template was made to lock my leg positions to be the same every time I laid on the table. This took about 15 minutes. Then I was run under the CT scan again and mapped for the dots. Three dots were tattooed on my body. I still have them.

Once I was casted and marked my first treatment went like all of them except the Friday ones. The IMRT radiation device rotated around me and stopped at 7 positions. At each position the intensity modulation was shaped sevral times and radiation was delivered after each one. Each day took about 15 minutes.

On Fridays, we did a routine dose of radiation but before we started, xRays were taken of the pelvic region. Every Monday we also consulted the radiation oncologist.

I was told to drink a 16oz bottle of water before coming in for treatment. Do not urinate until after treatment. After treatment I walked 3 miles. After treatment 28 (I had 38) I was told it would be less intense. I still didn't feel a thing. Two week after treatment I noticed I had more energy. surprisingly, I realized I had fatigue and didn't even know it. I recovered very well.


I was fascinated about the radiation technology and actually spent quite a bit of time with my RO. One evening we were together until 9pm and I could tell he was very into his work. I liked that about him. Even today I could stop in on him and ask him what's new? I am an electronics engineer by trade (since in management and sales) and really wanted to see the screens and the programs. My RO really like showing them. It was an interesting experience for me.

I hope this helps.
 Age 46 (44 when Dx)
Pre-op PSA was 19.8 : Surgery at The City of Hope on February 16, 2007
Geason 4+3=7, Stage pT3b, N0, Mx
Positive Margins (PM), Extra Prostatic Extension (EPE) : Bilateral Seminal vesicle invasion (SVI)
HT began in May, '07 with Lupron and Casodex 50mg (2 Year ADT)
IMRT radiation for 38 Treatments ending August 3, '07
Current PSA (May 11, 2009): <0.1
 
My Journal is at Tony's Blog  
 
STAY POSITIVE!


Bootheel
Regular Member


Date Joined Oct 2007
Total Posts : 300
   Posted 5/14/2009 5:53 PM (GMT -6)   
Thanks Tony for such a complete narrative on your treatment with IMRT. It really helps to understand the procedure. We will be flying to Vegas after the treatments are done for some R&R. Might just look in on you and yours if you have the time. Thanks for the help. You are a real inspiration to all of us here at HW. I admire your courage.
Age 65
Diagnosed 10/12/07
PSA 6.3
Biopsy 18 core samples, 2 positive <5%
Stage T1a Gleason 6 (3+3)
LRP  1/29/08
Post-op
Gleason 7 (3+4)
1 positive margin (.3cm)
T2C
4/16/08- Started Bi-mix injections 
5/15/08- 1st Post-Op PSA 0.07 Undetectable
8/11/08 -2nd Post-OP PSA 0.02 Undetectable
8/15/08- No more pads as of today  Whoopee!!!
11/13/08- 3rd post-op PSA 0.02 Undetectable
03/02/09- 1 yr. post-op PSA .09 Undetectable

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