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cyclenomad
New Member


Date Joined May 2009
Total Posts : 4
   Posted 5/21/2009 4:19 PM (GMT -6)   
Recently diagnosed with PCa. PSA 6.1 then 5.1 Gleason 3+4=7. Bone scan clear

Anyone with experience with IMRT/IGRT? specifically with the aftermath. Erections afterward, etc?

don826
Veteran Member


Date Joined May 2008
Total Posts : 1010
   Posted 5/21/2009 5:26 PM (GMT -6)   
Hello Cyclenomad,
 
I had my last IMRT/IGRT session about eight months ago. I had only minor urinary and bowel problems for about a week in the middle of the 45 sessions. I have had no urinary nor bowel problems since that time.
 
On the issue of erections I am not sure. I am on hormones and really have about zero sex drive. I am also single with no partner at this time. I have had some spontaneous erections in the morning and yes they were good enough for sex. However, my oncologist has said that I would probably lose the ability to have erections as time goes on. The literature says about a 50/50 chance on regaining potency after radiation.
 
In general the radiation treatment was fairly benign. I have had more side effects from the ADT than the radiation and they will continue until the hormone is stopped a year from now.
 
Good luck with your treatment regardless of what you  choose.
 
Take care,
Don
Diagnosed 04/10/08 Age 58 at the time
Gleason 4 + 3
DRE palpable tumor on left side
100% of 12 cores positive for PCa range 35% to 85%
Bone scan clear and chest x ray clear
CT scan shows potential lymph node involvement in pelvic region
Started Casodex on May 2 and stopped on June 1, 2008
Lupron injection on May 15 and every four months for next two years
Started IMRT/IGRT on July 10, 2008. 45 treatments scheduled
First 25 to be full pelvic for a total dose of 45 Gray to lymph nodes.
Last 20 to prostate only. Total dose to prostate 81 Gray.
Completed IMRT/IGRT 09/11/08.
PSA 02/08 21.5 at diagnosis
PSA 07/08 .82 after 8 wks of hormones
PSA 10/08 .642 one month after completion of IMRT, 6 months hormone
PSA 03/09 .38 six months post radiation and nine months into hormones 
 
 
 


cyclenomad
New Member


Date Joined May 2009
Total Posts : 4
   Posted 5/22/2009 11:51 AM (GMT -6)   
Glad to hear it is going reasonably well for you. It is the "down the road" loss of erectile ability that I worry about. I am starting to look at Proton beam therapy. I would have to travel some 400 miles to Loma Linda for treatment, if I could get in.

Your numbers look good. smilewinkgrin

Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 5/22/2009 12:42 PM (GMT -6)   
Hi cyclenomad,
Welcome to HealingWell. 400 miles to Loma Linda places you somewhere in the southwest or coastal region. As my screen name would indicate, I live in Vegas. I grew up near LLUMC and have many roots planted in the area. My case was looking severe when I started out so I elected to have surgery at the City of Hope. All went well but we were not done with therapy and I eventually went through IMRT radiation as well. I think any form of treatment can result in ED. It just takes time for it to be a problem. I think choosing an option should include risk and age. If you don't mind, please post your age. It will help relate to your treatment choices.

HealingWell has been a great site for thousands. Plenty of support here. Keep asking questions and you will get great responses. Peace and again, welcome...

Tony
 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!


cyclenomad
New Member


Date Joined May 2009
Total Posts : 4
   Posted 5/22/2009 12:59 PM (GMT -6)   
64 years. Just got the info on Proton Beam therapy. I live in Northern CA. strongly considering if I can get in, Otherwise it will likely be IMRT. Worried about radiation killing support arteries for erectile nerves.

don826
Veteran Member


Date Joined May 2008
Total Posts : 1010
   Posted 5/22/2009 4:33 PM (GMT -6)   

Hello Cyclenomad,

If you are considering proton beam and want some feedback from some folks who have had that procedure try prostatepointer.org under the EBRT section. I think there are a few there who can speak to the treatment.

Good luck,

Don


Diagnosed 04/10/08 Age 58 at the time
Gleason 4 + 3
DRE palpable tumor on left side
100% of 12 cores positive for PCa range 35% to 85%
Bone scan clear and chest x ray clear
CT scan shows potential lymph node involvement in pelvic region
Started Casodex on May 2 and stopped on June 1, 2008
Lupron injection on May 15 and every four months for next two years
Started IMRT/IGRT on July 10, 2008. 45 treatments scheduled
First 25 to be full pelvic for a total dose of 45 Gray to lymph nodes.
Last 20 to prostate only. Total dose to prostate 81 Gray.
Completed IMRT/IGRT 09/11/08.
PSA 02/08 21.5 at diagnosis
PSA 07/08 .82 after 8 wks of hormones
PSA 10/08 .642 one month after completion of IMRT, 6 months hormone
PSA 03/09 .38 six months post radiation and nine months into hormones 
 
 
 


Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 5/22/2009 4:42 PM (GMT -6)   
You can run this risk with either treatment. Many of the guys who have proton beam are very happy with the treatment in the early going. We just don't have meny that had it ten years ago telling their story. IMRT is good too. When Proton came out in the early 90's IMRT was not yet available. Thus Proton offered a huge relief from side effects of EBRT which was basically a wide beam of radiation. But with IMRT, IGRT and tomotherapy there is far less side effects that what there used to be. I underwent IMRT and have no noticable SE's. But I am not a good example. I am on hormone therapy as well and that stuff shuts ya down quick as it pertains to ED. I will be stopping by the end of the year and if things go well, then I will be back in action. I am very optimistic and I understand that having surgery/HT/RT may leave me permanently flat, but my alternatives were not good either.

At your age you have a full slate of options including brachytherapy. And you should understand that surgery is not a guarentee that you will be impotant. Most guys recover in the first year very well. many need ED drugs, and many don't. In time these SE's balance out between RT and other treatments.

Good luck in your decisions...

Tony
 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!


Dirtmover
Regular Member


Date Joined Apr 2008
Total Posts : 158
   Posted 5/22/2009 11:24 PM (GMT -6)   
HI CYCLE, I TOO LIVE IN NORTHERN CALIFORNIA, I WENT THE SAME ROUTE AS OUR BROTHER TONY, I WENT TO CITY OF HOPE FOR THE ROBOTICS 1YR OUT THIS MONTH AND EVERYTHING WORKS , IVE HEARD GOOD THINGS about LLUMC, IF PROTON IS YOUR GIG ,THEY ARE CONSIDERED THE BEST AT WHAT THEY DO,GOOD LUCK AND WERE ALWAYS HERE TO HELP....................................DIRT

Diagnosed November 2007   (43 years old )
PSA 3.9 / Gleason 6 / TC1 6 cores 1 shows 25%
Sugery scheduled 5/29/08 - City of Hope - Dr. Mark Kawachi
 "First show of the day"
 and now for the new ive been waiting for
 FINAL PATH REPORT:gleason upgraded to 3+4 T2c bilateral disease,tumor involvment 5%
extra prostatic extention:absent
seminal vesical invasion :absent
pathological staging:pTNM pT2 ORGAN CONFINED
margins free of carcinoma
usable erections ;6-6-08 with little blue pill
continence; 1 pad a day, dry at night
continence a non issue at 10weeks
 1 year p.s.a. undetectable


farfel
New Member


Date Joined May 2009
Total Posts : 6
   Posted 5/29/2009 4:15 PM (GMT -6)   
Cycle:

I was diagnosed with PCa in April '08 and Loma Linda was booked for way too many months out (one of their gantries was down). I ended up going to Jacksonville (UFPTI) and it was a fantastically positive experience. My wife and I continued a very healthy sex life all during treatment (2-3x/wk). Although I was 64, I hadn't experienced any ED. At about 3 months after treatment, I had some ED, which was readily fixed with a bit of Cialis. I'm hoping as the healthy cells regenerate, I won't need any at all. It seems like I am getting more "normal" by the week in that regard. If you're considering proton, don't be fixated on Loma Linda. The staff and equipment at Jacksonville are state of the art. There is also a new center opening this summer in Oklahoma City. I think it will be online in July, and they are already booking patients. One of the main docs there was at JAX when I was there, and he is terrific!
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