Posted 6/12/2010 1:49 PM (GMT -6)
Well, after a sleepless night, I saw the rad oncologist yesterday, very sharp guy. I was surprised by a few things:
First, in spite of my negative margins, the working assumption for radiation therapy is that the margin was actually positive instead, and it just wasn't picked up in the pathology. He said this is much more common that you might expect. So, instead of what I expected, which is that the radiation was going primarily target lymph nodes, the IGRT is directed at the prostate bed. There are some lymph nodes that get hit, but my impression was that they are more as a matter of course. This is actually a good thing, in that they can do a better job of avoiding the rectum and other organs that we would prefer not to irradiate. I am particularly concerned about this, since I have colitis and am concerned about a flare-up.
Second, it was my impression that the 70-72 grays planned would be the lifetime dose for my body, and therefore radiation for any other reason in the future would not be an option. He said that the radiation is only a lifetime dosage for the organs/tissue hit, and therefore, if lymph nodes or bone are found to be involved in the future, and they have not yet been hit, they can be irradiated. I also found this as good news.
Third, their planned treatment, regarding filling the bladder, is different from what I have heard on the forum here. He said that they were having so much trouble getting guys to have and keep a full bladder for the treatment, that they have adopted a different strategy. They want you to have a half-full bladder: empty 1 hour before treatment, and immediately drink 8 oz of water, and then do not urinate before treatment. I suppose as long as this procedure is repeatable, it is effective.
Sooo... in spite of the odds being only 40-50%, and the potential and likely side effects, I have opted to start IGRT treatments beginning in early August. I am much more closely following each of your journeys that are now the same as mine, to get a better idea what to expect, with some trepidation. I am grateful for the information and support that is always present on this forum.