Radiation - how much is too much?

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BB_Fan
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Date Joined Jan 2010
Total Posts : 1011
   Posted 6/14/2010 9:48 AM (GMT -6)   
In the last 2 months I have had a bone scan, 2 MRI's, and 2 CT scans (one diagnostic and one for radiation prep). Now within the next month I will have 2 more CT scans (breast radiation prep and radiation prep at different hospital), as well as another MRI.
 
Do you get radiation from MRI's?
 
Should I be concerned about the bone scan and 4 CT scans in 3 months?
 
Is a CT scan needed for breast radiation?
Dx with PC Dec 2008 at 56, PSA 3.4


Biopsy: T1c, Geason 7 (3+4) - 8 cores taken with 4 positive for PCa, 30% of all 4 cores.

Robotic Surgery March 2009 Hartford Hospital, Dr Wagner
Pathology Report: T2c, Geason 8, organ confined, negitive margins, lymph nodes negitive - tumor volume 9%
nerves spared, no negitive side effects of surgery

One night in hospital, back to work in 3 weeks

psa Jun 09 <.01
psa Oct 09 <.01
psa Jan 10 .07 re-test one week later .05
psa Mar 10 .28 re-test two weeks later .31
psa May 10  .50

Aril 10 MRI and Bone Scan show lesion on lower spine, false positive. 
 
Started HT 5/25/10 with 3 month shot of Trelstar. SRT scheduled for late July


Herophilus
Veteran Member


Date Joined Sep 2009
Total Posts : 662
   Posted 6/14/2010 11:19 AM (GMT -6)   
As I understand things, no radiation from MRI but significant amount from CT.  How much is too much...that question is over my pay grade. Best of luck to you with the radiotherapy. 
 
Hero
Age 51, PSA 08/31/2009= 6.8, DRE Neg.
Biopsy 9/24/09 =10 of 12 positive. Gleason 6. involving up to 75%
da Vinci at Wash U, Barnes on 11/02/09 Non-Nerve Sparing on Rt.
Modified Pathology, Gleason 4 + 3 = 7. Gleason 7 present throughout Prostate involving 20% of the Gland. Surgical Margins Free of Tumor,
4 of 4 periprostatic Lymph Nodes Negative, 10 of 10 pelvic Lymph Nodes Negative. Seminal Vesicles tumor free. Extracapsular extension is absent Perineural Invasion is Identified, Vascular Invasion is not identified.
Post-op PSA 12/10/2009, Undetectable  <0.01
Post-op PSA 05/03/2010, Undetectable  <0.01
I hate this crap
Moved by individuals like Living1963

 


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 6/14/2010 11:59 AM (GMT -6)   
BB,

Yours is a great question. I asked the very question to my radiation oncologist, and got a fuzzy answer back. Still concerns me.

Had 35 treatments neck/throat radiation in 2000, for a total of 76 gys. At the time, the radiation dr. told me that each zap was equal to 40 standard chest x-rays. So that was 1,400 chest x-rays worth, if what he said was true.

Just finished 39 treatments for salvage for my PC in November, for a total of 72 gys.

Prior to either radiation treatments, I had plenty chest x-rays, dental x-rays, cat scans, bone scans, and 3 MRI's. Since then, have received plenty more cat scans.

I read somewhere, will look for source, there is a lifetime limit, but it varies from person to person. I would have never dreamed of having to need two major radiation treatments in a ten year period.

Hoping someone might have a good answer or a lead to an answer for your question. I am deeply concerned myself.

david in sc
Age: 57, 56 dx, PSA: 7/07 5.8, 7/08 12.3, 9/08 14.5, 10/08 16.3
3rd Biopsy: 9/08 - 7/7 Positive, 40-90% Cancer, Gleason 4+3
Open RP: 11/08, Rht nerves saved, 4 days in hospt, on catheters for 63 days, 5th one out 1/09
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos margin
Incontinence:  1 Month     ED:  Non issue at any point post surgery, no problem post SRT
Post Surgery  PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA: 1/10 .12, 4/8 .04, next one:  July
Latest: 7/9 met 2 rad. oncl, 7/9 cath #6 - blockage, 8/9 2nd corr surgery, 8/9 cath #7 out 38 days, 9/9 - met 3rd rad. oncl., mapped  9/9, 10/1 - 3rd corr. surgery - SP cath/hard dialation, 10/5 - 11/27 IMRT SRT 39 sess/72 gys ,cath #8 33 days, Cath #9 35 days, 12/7 - Cath #10 43 days, 1/19 - Corr Surgery #4,  Caths #11 and #12  same time, 2/8-Cath #11 out - 21 days, 3/2- Cath #12 out - 41 days, 3/2- Corr Surgery #5, 3/6 Cath #13 out - 4 days, Cath #14- 27 days, Cath #15 - 26 days, Cath #16 - 31 days, 5/24 put in Cath #17


Steve n Dallas
Veteran Member


Date Joined Mar 2008
Total Posts : 4829
   Posted 6/14/2010 1:09 PM (GMT -6)   
There's tons of info on the internet...

Excess medical radiation found a growing risk for Americans

http://www.boston.com/news/health/articles/2010/06/14/excess_medical_radiation_is_a_growing_risk_for_americans/?p1=Well_MostPop_Emailed4

The best guess at how much radiation is risky is based on the 1986 Chernobyl nuclear power plant accident and studies of Japanese atomic bomb survivors who had excess cancer risk after exposures of 50 to 150 millisieverts of radiation.

A chest or abdominal CT scan involves 10 to 20 millisieverts (a measure of dose), versus 0.01 to 0.1 for an ordinary chest X-ray, less than 1 for a mammogram, and as little as 0.005 for a dental X-ray. Natural radiation from the sun and soil accounts for about 2 millisieverts a year. A study last year estimated that 4 million Americans get more than 20 millisieverts a year from medical imaging. Two percent of people in the study had high exposure — 20 to 50 millisieverts.VIEW IMAGE


Age 55   - 5'11"   215lbs
Overall Heath Condition - Good
PSA - July 2007 & Jan 2008 -> 1.3
Biopsy - 03/04/08 -> Gleason 6 
06/25/08 - Da Vinci robotic laparoscopy
05/14/09  - 4th Quarter PSA -> less then .01
11/20/09 - 18 Month PSA -> less then .01
05/18/10 - 24 Month PSA -> less then .01
Surgeon - Keith A. Waguespack, M.D.


SubicSquid
Regular Member


Date Joined Oct 2009
Total Posts : 252
   Posted 6/14/2010 1:16 PM (GMT -6)   
Since my IGRT treatment involves a CT scan each day prior to the radiation for alignment purposes, I wonder just how much extra radiation I am absorbing. If CT scans are so bad, it would seem I am really getting a lot of extra radiation, and not specifically targeted to the area of treatment. Hopefully I won't start glowing at the end of the 39 zaps!!!! Squid
*Age 63, PSA July 2009 5.66
*Diagnosed July 2009, Biopsy: 2 of 12 cores positive, Gleason 3 + 5 = 8
*MRI and Bone Scan Negative.
*open Surgery October 22, 2009
*Prostate, both nerve bundles, seminal vessels, and lymph nodes removed during surgery.
*Post surgery Biopsy, Gleason 4 + 3; 2 positive margins
*Still slightly incontinant after 3 months - 1 pad per day (light). Dry at night. 1-2 trips to toilet.
*ED - Yes (will start Levitra possibly in January)
*30 day PSA (ultra-sensitive) .07
*90 day PSA (standard) <0.15
*01/10 - bladder neck stricture. opened during cysto exam. Cath #2 in for 5 days.
*03/01 - bladder neck stricture. Dilated during cysto exam. Cath #3 in place.
*03/11 - Bladder neck surgery. Cath #4 in place.
*03/15 - Cath #4 out. Great urine stream. Unfortunately, incontinence back to post surgery level.
*04/14 - Six month PSA - .21.
*05/15 - Incontinence basically under control.  99% dry.  Wear pad daily at work "just in case".
*06/10 - Started IGRT.   39 treatments scheduled.
 


Steve n Dallas
Veteran Member


Date Joined Mar 2008
Total Posts : 4829
   Posted 6/14/2010 1:23 PM (GMT -6)   
No need to worry about glowing...It the things that fall off you should be concerned about smhair
Age 55   - 5'11"   215lbs
Overall Heath Condition - Good
PSA - July 2007 & Jan 2008 -> 1.3
Biopsy - 03/04/08 -> Gleason 6 
06/25/08 - Da Vinci robotic laparoscopy
05/14/09  - 4th Quarter PSA -> less then .01
11/20/09 - 18 Month PSA -> less then .01
05/18/10 - 24 Month PSA -> less then .01
Surgeon - Keith A. Waguespack, M.D.


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 6/14/2010 4:19 PM (GMT -6)   
subic, that's a good point.

during each of my 39 SRT zaps, they did 2 "snap-shot instant x-rays each and every day as part of the alignment process, so that would be another 78 xrays on top of the daily zap. geez.
Age: 57, 56 dx, PSA: 7/07 5.8, 7/08 12.3, 9/08 14.5, 10/08 16.3
3rd Biopsy: 9/08 - 7/7 Positive, 40-90% Cancer, Gleason 4+3
Open RP: 11/08, Rht nerves saved, 4 days in hospt, on catheters for 63 days, 5th one out 1/09
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos margin
Incontinence:  1 Month     ED:  Non issue at any point post surgery, no problem post SRT
Post Surgery  PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA: 1/10 .12, 4/8 .04, next one:  July
Latest: 7/9 met 2 rad. oncl, 7/9 cath #6 - blockage, 8/9 2nd corr surgery, 8/9 cath #7 out 38 days, 9/9 - met 3rd rad. oncl., mapped  9/9, 10/1 - 3rd corr. surgery - SP cath/hard dialation, 10/5 - 11/27 IMRT SRT 39 sess/72 gys ,cath #8 33 days, Cath #9 35 days, 12/7 - Cath #10 43 days, 1/19 - Corr Surgery #4,  Caths #11 and #12  same time, 2/8-Cath #11 out - 21 days, 3/2- Cath #12 out - 41 days, 3/2- Corr Surgery #5, 3/6 Cath #13 out - 4 days, Cath #14- 27 days, Cath #15 - 26 days, Cath #16 - 31 days, 5/24 put in Cath #17


goodlife
Veteran Member


Date Joined May 2009
Total Posts : 2691
   Posted 6/14/2010 5:45 PM (GMT -6)   
one CT scan is equivalent to 150 to 250 chest xrays !
Goodlife
 
Age 58, PSA 4.47 Biopsy - 2/12 cores , Gleason 4 + 5 = 9
Da Vinci, Cleveland Clinic  4/14/09   Nerves spared, but carved up a little.
0/23 lymph nodes involved  pT3a NO MX
Catheter and 2 stints in ureters for 2 weeks .
Neg Margins, bladder neck negative
Living the Good Life, cancer free  6 week PSA  <.03
3 month PSA <.01 (different lab)
5 month PSA <.03 (undetectable)
6 Month PSA <.01
1 pad a day, no progress on ED.  Trimix injection
No pads, 1/1/10,  9 month PSA < .01
1 year psa (364 days) .01


BB_Fan
Veteran Member


Date Joined Jan 2010
Total Posts : 1011
   Posted 6/14/2010 7:01 PM (GMT -6)   
If that is the case I'm in deep s**t with 5 CT scans in 3 months.
Dx with PC Dec 2008 at 56, PSA 3.4


Biopsy: T1c, Geason 7 (3+4) - 8 cores taken with 4 positive for PCa, 30% of all 4 cores.

Robotic Surgery March 2009 Hartford Hospital, Dr Wagner
Pathology Report: T2c, Geason 8, organ confined, negitive margins, lymph nodes negitive - tumor volume 9%
nerves spared, no negitive side effects of surgery

One night in hospital, back to work in 3 weeks

psa Jun 09 <.01
psa Oct 09 <.01
psa Jan 10 .07 re-test one week later .05
psa Mar 10 .28 re-test two weeks later .31
psa May 10  .50

Aril 10 MRI and Bone Scan show lesion on lower spine, false positive. 
 
Started HT 5/25/10 with 3 month shot of Trelstar. SRT scheduled for late July


tatt2man
Veteran Member


Date Joined Jan 2010
Total Posts : 2842
   Posted 6/14/2010 8:37 PM (GMT -6)   
... I have been concerned about the 20 leg / pelvic area (no lead shield) x-rays to my broken right leg (4 spiral fractures) in a 5 month period in 1998 - which resulted in more surgery 9 years later to remove excessive bone growth on the screws in the upper femur ( the doctor took out a "large chunk of bone") - and possibly the reason for my more aggressive form of PCa compare to my father ( 12 years with PCa and dying from Parkinsons).... just food for thought... or maybe just a sequence of events....

thoughtful hugs
BRONSON
.................
Age: 54 - gay - with common-law spouse of 13 years, Steve - 60
PSA: 04/2007- 1.68 - 08/2009 - 3.46 - 10/2009 - 3.86
Confirmation of Prostate Cancer: October 16, 2009 - 6 of 12 cancerous samples , Gleason 7 (4+3)
Doctor: Dr. Mohamed Elharram -Urologist / Surgeon - Peterborough Regional Health Centre
Radical Prostatectomy Operation: November 18, 2009 , home - November 21, 2009
Post Surgery Biopsy: pT3a- gleason 7 - extraprostatic extension - perineural invasion - prostate weight - 34.1gm -
ED Prescription: Jan 8/2010 - started daily 5mg cialis - girth back to normal -but not much length - will go for trimix in April when I see doc
Incontinence: Feb 2010- 3-5 pads/1-2 clothes changes/day- March 3, 2010 - week 14 after surgery -finally seeing improvement - March 29- incontinence better - 1-2 pads a day - one pad at night - May 25 - 1 pad during day - 1 pad at night for security (barely needed at all) - stress incontinence at work - lifting trees and shrubs...
location: Peteborough, Ontario, Canada
Post Surgery-PSA: - April 8, 2010 - 0.05 - I am in the ZERO CLUB - hooorah!
Next PSA - October 8, 2010 - TBA -
............


goodlife
Veteran Member


Date Joined May 2009
Total Posts : 2691
   Posted 6/14/2010 8:49 PM (GMT -6)   
I read that a ct scan has a 1 in 4000 chance of causing cancer. When I consulted on adjuvent therapy,, they said there was a 1.5 % chance of radiation tumors fron the radiation.

We tend to kind of gloss over it sometimes.
Goodlife
 
Age 58, PSA 4.47 Biopsy - 2/12 cores , Gleason 4 + 5 = 9
Da Vinci, Cleveland Clinic  4/14/09   Nerves spared, but carved up a little.
0/23 lymph nodes involved  pT3a NO MX
Catheter and 2 stints in ureters for 2 weeks .
Neg Margins, bladder neck negative
Living the Good Life, cancer free  6 week PSA  <.03
3 month PSA <.01 (different lab)
5 month PSA <.03 (undetectable)
6 Month PSA <.01
1 pad a day, no progress on ED.  Trimix injection
No pads, 1/1/10,  9 month PSA < .01
1 year psa (364 days) .01


142
Forum Moderator


Date Joined Jan 2010
Total Posts : 6949
   Posted 6/14/2010 9:25 PM (GMT -6)   
I've had four CTs so far. Maybe my Calypso GPS really is good stuff (I trust the doctor). I don't have the pre-IGRT CT, they just put the Calypso panel over my gut, and it confirms in a few seconds that my target area is in the right spot. For those mornings that is wasn't, they have adjusted.

Just can't see why my insurance would pay for a CT each day that guarantees problems in the future, but refuse to pay the $170 or so per treatment for the locator. Interesting logic, if you can call it that.

Anyway, from what I have seen, the Calypso accomplishes something. So far, apparently to my benefit. We will see when I next go through the detector at the airport (the transponders go with a notification card).

It is just a bit freaky to hear John Denver in the background of your mind as they position Calypso. Maybe better than something darker.....

fogball
Regular Member


Date Joined Mar 2006
Total Posts : 31
   Posted 6/14/2010 11:15 PM (GMT -6)   
Check Out - hps.org/hpspublications/articles/dosesfrommedicalradiation.html

Fogball

Post Edited By Moderator (James C.) : 6/15/2010 6:04:06 AM (GMT-6)


fogball
Regular Member


Date Joined Mar 2006
Total Posts : 31
   Posted 6/14/2010 11:30 PM (GMT -6)   
WHOOOOOOA - I screwed up somewhere! I apologize but it is late in my day & I have to

tend to some pressing things before I hit the hay. I'll see what went wrong

in the AM & repost. Perhaps the cyber fairy will fix it & link it before I wake up.

English Alf
Veteran Member


Date Joined Oct 2009
Total Posts : 2215
   Posted 6/15/2010 1:24 AM (GMT -6)   
Interesting and important query BB.

First point to mention is that we all have about a one in forty chance of getting cancer in our lifetimes.

This site had a good list of comparisons of xray doses:
www.radiologyinfo.org/en/safety/index.cfm?pg=sfty_xray

and at this one you can input your own data to work out your totatl dose from all sorts of sources:
www.ans.org/pi/resources/dosechart/

During my RT 2 xrays at right angles were taken at regular intervals to check the position of things. This was done on day one, and then after every 5 sessions. At the beginning of the last week two additional xrays were taken after something was found to have moved by two millimetres.

The beep made by the machine when taking these xrays was very very short compared to the beep during each dose of RT, indicating that the dose was much smaller.

From what I have read the initial CT scan used for mapping the whole area gives a 3D image, that used for targetting before RT uses a 2D image. I was under the impression that the CT scan prior to RT was simply enough to locate certain specific reference points in the target area. Worth asking about it though I think. And again the time the CT scan takes is an indication of how big a dose you are receiving. (I cannot imagine anyone could be getting 35 big CTscans in a row)

Equivalence is also relevant. The dose given/absorbed must also be seen in terms of the percentage of your body (by weight) to which that dose is given. 20gy is a fatal dose for a human if given to the entire body thus when we get say 70Gy that is on the basis that the prostate/prostate bed is only a few ounces of a body that weighs many pounds.

This radiaton is at least trying to make us better. Radiation from things that are no benfit are much worse. I wanted to play a RT joke on folk by painting my belly with fluorescent make-up but that is no longer sold here as it gives off too much dose. And I remember using a Geiger-counter to test radioactive samples in a labm, and though we had to handle them with special gloves and tongs, the dials of our wrist-watches actually gave bigger readings.

I mustn't get too scientific about stuff I don't know a lot about. My RT team were happy to answer all questions I asked them, so ask the experts.

Alfred
Age at Dx 48 No Family history of Prostate Cancer
Married 25 years, and I cannot thank my wife enough for her support.
April 2009: PSA 8.6 DRE: negative. Tumour in 2 out of 12 cores. Gleason 3+3.
RALP (nerve-sparing) at AVL-NKI Hospital Amsterdam on 29th July 2009. Stay 1 night.
Partial erections on while catheter still in. Catheter out on 6th Aug 2009.
Dry at night after catheter came out
Post-op Gleason 3+4. Tumour mainly in left near neck of bladder.
Left Seminal Vesicle invaded, (=T3b!)
no perineraul invasion, no vascular invasion. clear margins,
Erection 100% on 15th Aug 2009, but lots of leaking of urine
Stopped wearing pads on 21st Sept 2009
Pre-op style intercourse on 24th Oct 2009 !! No use of tablets, jabs, VED etc. but...
Nov 17th 2009 PSA = 0.1
Can still get erections okay, and almost no leaking of urine, but since December 2009 I don't have orgasms, instead I just have intense pain in place where prostate used to be.
Mar 17th 2010 PSA = 0.4!!! referred to radiation therapist
April 13th 2010 CT scan.
April 28th 2010 Started Radiation Therapy (66Gy - 33 sessions)


SubicSquid
Regular Member


Date Joined Oct 2009
Total Posts : 252
   Posted 6/15/2010 11:35 AM (GMT -6)   
The daily CT scan I get is definately different from the one I got during my simulation. It is just one circle around the body and then the table is adjusted to align me with the image in the computer. Hopefully not a very high dose because it is done before each RT procedure. The Calypso GPS seems to be a way of doing IGRT without the risk of the CT scan. Squid.
*Age 63, PSA July 2009 5.66
*Diagnosed July 2009, Biopsy: 2 of 12 cores positive, Gleason 3 + 5 = 8
*MRI and Bone Scan Negative.
*open Surgery October 22, 2009
*Prostate, both nerve bundles, seminal vessels, and lymph nodes removed during surgery.
*Post surgery Biopsy, Gleason 4 + 3; 2 positive margins
*Still slightly incontinant after 3 months - 1 pad per day (light). Dry at night. 1-2 trips to toilet.
*ED - Yes (will start Levitra possibly in January)
*30 day PSA (ultra-sensitive) .07
*90 day PSA (standard) <0.15
*01/10 - bladder neck stricture. opened during cysto exam. Cath #2 in for 5 days.
*03/01 - bladder neck stricture. Dilated during cysto exam. Cath #3 in place.
*03/11 - Bladder neck surgery. Cath #4 in place.
*03/15 - Cath #4 out. Great urine stream. Unfortunately, incontinence back to post surgery level.
*04/14 - Six month PSA - .21.
*05/15 - Incontinence basically under control.  99% dry.  Wear pad daily at work "just in case".
*06/10 - Started IGRT.   39 treatments scheduled.
 


pasayten
Regular Member


Date Joined Mar 2007
Total Posts : 437
   Posted 6/18/2010 3:44 AM (GMT -6)   
The glowing part is a benefit as you do not need a nightlight to find the bathroom at night... :-)
After 3-4 years of annual PSA 4-6, biopsy recommended
59 y/o
3/13/2007 - 12 point biopsy - Left 0/6  Right 1/6 Gleason 3+3 T1c
4/24/2007 - DaVinci performed at Virginia Mason hospital in Seattle
5/2/2007 - Catheter Out! Final pathology of Gleason 6  T2c Nx Mx, approx 20% of prostate involved, positive margin, but only at 2 focal points.  
6/28/2007 9 weeks incontinance... Overnite, went from 4-6 soaked pads a day from prev 8 weeks to 2 barely wet pads a day.
7/12/2007 11 weeks post-op  Minimal leakage...  one small pad a day
7/18/2007 First Post-Op PSA...  0.01 !!! 
9/10/2007 Pad free and ED at 75% with 100mg Viagra generic
6/26/2008 2nd Post-OP PSA at 14 months...  0.02 
12/2/2008 3rd Post-OP PSA at 20 months...   0.03
10/30/2009 4th Post-OP PSA at 31 months...   0.13 (moved and diff lab)
11/3/2009 Retest at my original lab...  0.11  (followup with Doc sched 11/10)
11/10/2009 Discussion indicated biochemical reccurrence and need for salvage radiation treatment. 
1/21/2010 Another PSA test at 34 months...  0.14
1/26/2010 IMRT Salvage Radiation Treatment started
                  32 sessions for 64 gys total.
3/12/2010 Finished 32 sessions...  No side effects to date except a little
tiredness.  Slight changes in bowel movements the last week...  
4/8/2010  Some rectal prostitis, but no change in urgency.  No urinary effects at all.  Now just waiting for the upcoming PSA test in June.
6/7/2010 First 3 month PSA result after SRT = 0.02   WAHOO!  as good as could ever be expected at the 3 month mark!  Thank You Jesus!
 


142
Forum Moderator


Date Joined Jan 2010
Total Posts : 6949
   Posted 6/18/2010 7:37 AM (GMT -6)   
Talking to one of the therapists, I understood that the mini-CT just covers a tiny area at minimal exposure. They seemed to think that the mini-CT was a great advantage for the tech, as they can verify the position of the bladder each day, and hopefully avoid damage.

English Alf
Veteran Member


Date Joined Oct 2009
Total Posts : 2215
   Posted 6/18/2010 10:33 AM (GMT -6)   
The balance would thus seem to be that the small extra bit of radiation that results from the mini-CT is off-set by the fact that because of the mini-Ct the actual RT is directed more accurately and less radiation damages surrounding healthy tissue.
Alf
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