radiation and incontenence

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Regular Member

Date Joined Feb 2010
Total Posts : 38
   Posted 2/25/2010 5:17 PM (GMT -6)   
Well I've got my adjunct radiation scheduled starting 4-13-10 which is about 11 wks post surgery.My surgen said 3 months to allow healing from the surgery,the radiation onocologest seemed to want to start sooner so we compromised a little.I'm back to work about 3/4 time and tommorow is 5 wks.As I become more active my incontence is getting worse I seem to leak all day.When I'm at home sitting I do better but as soon as start walking around the leaking starts.I hope by waiting a while for radiation it will help allow me to improve before the radiation beats me up again.My schedual also will allow my wife and I to do our anual spring Florida Keys Trip which we've been luckey enough to do for about 25 of the last 30 years.Any thoughts on the incontence would be appreciated.Thanks DICK
age 55 /psa 10-09 5.4/biopsy 11-09 Gleson 3+3=6 3+4=7/ Radical prostateectomy 1/22/10/pathology positive margins and extraprostatic extension pY3a

Regular Member

Date Joined Aug 2009
Total Posts : 152
   Posted 2/25/2010 7:09 PM (GMT -6)   
My Uro Doc didnt want me in Radiation for a full 6 months after surgery, should I choose that route (no proven need to do so but I had a close margin on the path report). So since you are going in much earlier I cant say what efffects you will have, but I found it to tire me down a notch for a few hours after getting zapped starting at about the three week mark. A bit of mild incont and 'urgent need to go" in the fourth or fifth week and that was all. As the Rad Doc said, "learn to trust your bladder and rectum", they don't lie.

Veteran Member

Date Joined Aug 2009
Total Posts : 670
   Posted 2/25/2010 7:38 PM (GMT -6)   
Research I did, and also a word from my urologist, was that if you are still incontinent from surgery when you start radiation you will have more trouble with incontinence during and after radiation. However, treatment may trump choice. I wish you the best and hope you prove this to be wrong.
Gleason, 3+4; PSA, 7.9
Robotic Prostatectomy, March 2008 (Age 48 then), nerves both sides spared, post surgery analysis confirmed 3+4 Gleason,
pT2c, prostate 60.2g, margins: negative; perineural invasion: present; lymphatic invasion: present; 3 lymph nodes removed, clear; seminal vesicle invasion: absent; Gleason 4 comprises 5-10% of carcinoma
PSA consistently <0.1 since surgery until Oct 09, 0.1; retested Oct 09, <0.1,
Jan 10, 0.2
retest Feb 1 confirmed 0.2

Forum Moderator

Date Joined Jan 2010
Total Posts : 7084
   Posted 2/25/2010 8:54 PM (GMT -6)   
My urologist/surgeon said he wanted no less that 18 weeks between DaVinci surgery and radiation (+18 for me is today). He stretched it 4 weeks for my good post-op PSA, but I am on the books for 1 April (seems like the ultimate joke). He is very concerned that my incontinence, if it continues, will become long term and worsen after the radiation, so might delay everything again.

But then we trust them to offer the proper advice.

Cajun Jeff
Veteran Member

Date Joined Mar 2009
Total Posts : 4119
   Posted 2/25/2010 9:29 PM (GMT -6)   
Bemis: Shoot me an e-mail please I have some questions about the Keys.
Jeff T Age 57

9/08 PSA 5.4, referred to Urologist
9/08 Biopsy: GS 3/4=7
10/08 Nerve sparing open RRP- Path Report: GS 3+3=7 Stg. pT2c, margins clear
3 mts: PSA .05 undetectable

10th month PSA <0.01
1year psa <0.01
ED- 5 mg Cialis daily, pump daily, going to try MUSE next. Next step injections.
15 months out injections Caveject (success)

Regular Member

Date Joined Feb 2010
Total Posts : 38
   Posted 2/26/2010 10:43 AM (GMT -6)   
Jeff I'LL e-mail you after this post.I was getting discuraged about the leaking yesterday, I knew that coffee was on the bad list but I could'nt start the day without it .I was drinking 1 mug [probably 2 cups].Anyway this morning I've had no coffee and no leaks so far.Any other suggestions on what I can do to help?  Thanks DICK 
age 55 /psa 10-09 5.4/biopsy 11-09 Gleson 3+3=6 3+4=7/ Radical prostateectomy 1/22/10/pathology positive margins and extraprostatic extension pY3a

Regular Member

Date Joined Nov 2009
Total Posts : 206
   Posted 2/26/2010 4:52 PM (GMT -6)   
Hi there, Dick:

Started with Casodec and a 90 day Lupron back in November.

Just got back from my first visit with the radiation oncologist.

My surgery was on Jan. 20th, so today is 5 weeks +2 days. The path. report indicates more work needs to be done, that's the reason for todays appointment.

External beam radiation PLUS ongoing HT (Lupron) for another 90 days AT LEAST. Got my second Lupron today.

Initual measuring/ct scan is sheduled for three weeks from now. I can start 7 weeks of 5 X per week, starting the following week.

Here is the catch: (according to my doc) my current incontinance is rather bad, but ever so slowly getting better. He claims that: "At whatever level of my inconcenance on THE DAY of my first radiation, it will always (for life) stay that way. Ouch!

So he suggested we wait and see how I'm coming along and then perhaps postpone the start of radiation for up to 8 weeks. I'm hoping for only about 4 weeks delay so I'll be finished by Mid-June. The hospital is 75 miles from my home so that ads up to a lot of mileage. Hope (depending on weather) to do some of the trips on my Goldwing.

Age, only 71.
July 2009, PSA 9.1, free ratio 0.16
September GLEASON 4+4=8, T2A
Prostate 44cc.
Calcium: 2.46  (range: 2.20 - 2.65 mmol/L)
25 Hydroxy Vitamin D: 102 (range: sufficiency:
76 - 250 nmol/L)
Bone Scan: Negative
CT Scan scheduled for Dec. 1st. Negative.
Started Casodex 50mg. on Nov. 6, first pill of 30.
Got Lupron 22.5mg ( 90 day ) on  November 19.
No real side effects as of Dec. 15 except dry skin and hair but getting quite 'porky' in the belt area even though now I go to the gym, three times a week. Also I dont have a need to shave anymore so now I can save my 'shaving' allowance and direct it to my stash of Depends !
Christmas Day got my first hot flashes. Thanks Santa!
Open surgery scheduled for Jan. 22 by Dr. J. Chen
Open surgery done on Jan. 20th. by Dr. J. Chin at London's University Hospital.
Cath removel scheduled for Feb. 8th. Yes, I know,
that will be 19 days. Dr. is out of country until then.
Pathology Report:
Gleason Score: cannot be determined due to therapy effects.
Extraprostatic Extension:
present, left radial, multifocal
present, left basal, multifocal
Resection Margins:
Apical: involved by invasive carcinoma, multifocal
Bladder Neck: involved by invasive carcinoma, unifocal on left side.Other: non-tumoural prostatic present at resection margin.
Perineural Invasion: present.
Seminal Vesicle Invasion: absent
Lymphovascular Invasion: absent
Lymph Node Status: no malignancy in regional lymph nodes
Additional path. findings:
high grade prostatic intraepithelial neoplasia
Pathology Stage: yp T3a NO MX
Radialogist appointment is on Friday Feb. 26 with
Dr. Glenn Bauman in London.
First PSA test since surgery on March 30th.
Next appointment with the surgery Doc is April 13.

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