IGRT Side Effect?

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SubicSquid
Regular Member


Date Joined Oct 2009
Total Posts : 252
   Posted 7/8/2010 4:27 PM (GMT -6)   
While in a dressing room changing for my daily treatment today, I got the sudden urge to pee and before I could do anything, my bladder emptied on the floor.  I haven't had this type of incontinece problem since right after surgery.  Fortunately I got it cleaned up before anybody noticed. My doctor did say to expect stronger side effects in my last few weeks of treatment. I hope this is not a sign of things to come.  I have been 99% incontinece free.  PCa sucks!!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
*ED - Yes 
*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.
 


60Michael
Veteran Member


Date Joined Jan 2009
Total Posts : 2243
   Posted 7/8/2010 4:47 PM (GMT -6)   
I hadn't wet a bed since I was 2 years old. Well maybe 4 years old. Hopefullly this will all pass, but I am 4 months out and still have lingering problems.
Michael
Dx with PCA 12/08 2 out of 12 cores positive 4.5 psa
59 yo when diagnosed, 61 yo 2010
Robotic surgery 5/09 Atlanta, Ga
Catheter out after 10 days
Gleason upgraded to 3+5, volume less than 10%
2 pads per day, 1 depends but getting better,
 started ED tx 7/17, slow go
Post op dx of neuropathy
T2C left lateral and left posterior margins involved
3 months psa.01, 6 month psa.4, 6 1/2 month psa.5 on 11/28/10
Starting IMRT on 1/18/10, Completed 39 tx at 70 gys on 3/12/10
6 week Post IMRT PSA .44 a drop from .5 but maybe more
Great family and friends
Michael


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25393
   Posted 7/8/2010 5:15 PM (GMT -6)   
Subic, "it" just happens sometimes, don't be too hard on yourself. If you had to go that bad, you had to go, plain and simple. Least you had the chance to get it cleaned up without making a scene. Hopefully that won't happen again, but if it does, it does. Just like when you had your surgery, your body right now and your immune system are going through heck as you work your way through the radiation treatments.

Right now, since you are able to go so freely, I would consider that a blessing, when radiation can cause stricture issues, which you have already been through in the past, and you know they are no fun either.

Good luck on the rest of yours.

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 cath #6 - 41 days, 8/9 2nd corr surgery, 8/9 cath #7 - 38 days, mapped  9/9, 10/1 - 3rd corr. surgery - SP cath, 10/5 - 11/27 IMRT SRT 39 sess/72 gys ,cath #8 33 days, Cath #9 35 days, Cath #10 43 days, 1/19 - Corr Surgery #4,  Caths #11 and #12 ,Cath #11 - 21 days,  Cath #12 - 41 days, 3/2- Corr Surgery #5, Cath #13 - 4 days, Cath #14- 27 days, Cath #15 - 26 days, Cath #16 - 31 days, Cath #17 - 39 days, 7/2 - Corr Surgery #6, 7/2 - Caths #18 & #19


142
Forum Moderator


Date Joined Jan 2010
Total Posts : 7078
   Posted 7/8/2010 5:50 PM (GMT -6)   
I went from one pad a day really used, (but I liked to fool myself that it was "just for insurance") before IGRT to three now (3 weeks after last treatment). I have also had the 5-10 second "leadtime" - I credit the radiation for it. The radiation oncologist says no, the urologist says yes. Two against one.

Fairwind
Veteran Member


Date Joined Jul 2010
Total Posts : 3887
   Posted 7/8/2010 6:13 PM (GMT -6)   
When radiation is required after surgery, the healing process at the bladder neck is stopped dead in its tracks and hoping that the incontinence will continue to improve is mostly wishful thinking..
Age today: 68. Married, 6', 215 pounds, active, no health issues.
PSA at age 55: 3.5, DRE negative. Advice, "Keep an eye on it".
PSA at age 58: 4.5
PSA at age 61: 5.2
PSA at age 64: 7.5, DRE "Abnormal"
PSA at age 65: 8.5, DRE " normal", biopsy, 12 core, negative...
PSA at age 66 9.0 DRE "normal", BPH, Finesteride. (Proscar)
PSA at age 67 4.5 DRE "normal" second biopsy, negative.
PSA at age 67.5 5.6, DRE "normal" U-doc worried..
PSA at age 68, 7.0, third biopsy positive for cancer in 4 cores, 3 cores Gleason 6, one core Gleason 9. Finesteride discontinued, still no urinary symptoms, never had any..From age 55 to 65 I had no health insurance.

I have a date with the robo surgeon on Sept 3 but I'm keeping my options open. A "top" radiation oncologist here in Denver, equipped with the latest IMRT/IGRT/RapidArc machine says he can do better by me..


Im_Patient
Veteran Member


Date Joined Aug 2009
Total Posts : 669
   Posted 7/8/2010 11:54 PM (GMT -6)   
You guys are making it sound like so much fun... I can hardly wait...
I don't even remember if I kept any pads or not
Jeff
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
CT scan, bone scan Feb 10 both clear
PSA after, 2010: March, 0.17; April, 0.17; May, 0.24; June, 0.31; July, 0.29
Starting salvage IGRT on August 4, plan 72Gy


142
Forum Moderator


Date Joined Jan 2010
Total Posts : 7078
   Posted 7/9/2010 12:10 AM (GMT -6)   
I never got off pads long enough to have the opportunity to get rid of them, just changed from heavy Walgreens to Depends guards. Was hoping to make it to the lighter Tena, but we can't always get what we dream for.

Buy stock in Depends - I'm still a frequent buyer. Oh, well....

English Alf
Veteran Member


Date Joined Oct 2009
Total Posts : 2217
   Posted 7/9/2010 1:44 AM (GMT -6)   
Subic,
Just a query, did your bladder empty like that before or after the RT given you need to be done with a full bladder?

There was one occasion towards the end of RT, when just before it started I really felt like I was going to burst, so I mentioned this to the nurses and they simply put a large absorbant square on the table underneath my backside. They also said it was no bother if I made a puddle as they were more than used to cleaning up all kinds of mess, and they also offered to place an empty container nearby in case I needed to go before I could get to the WC.

We also made a point of not doing my RT earlier than scheduled to make sure my drink had had time to get into my bladder.
(there were several occasions when the team at my machine were running ahead and offered to zap me early)

I would not want bladder cancer, but I was kind of jealous of the guy I met a few times in the waiting room who did have bladder cancer and who had to have his RT with an empty bladder.

It really ought to be easier. for instabnce I can't remember who it was, but someone posted something recently about photon treatment and he said that they put a "balloon" inside him that was inflated to keep things pushed out of the way.

Hope you stay dry or drier from now on.

Alf
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)
June 11th 2010 finished RT - main side effect tiredness, but also the occasional small leak
June 27th My 50th Birthday - feeling better but still not 100% okay


SubicSquid
Regular Member


Date Joined Oct 2009
Total Posts : 252
   Posted 7/9/2010 11:24 AM (GMT -6)   
Alf, it happened with the full bladder, while I was putting on the hospital gown prior to the procedure. Realy don't know what brought it on. I was right on schedule time wise for my treatment. I drink a bottle of water 30 minutes prior on the drive to the hospital. We'll see how it goes today. Maybe just a fluke (I hope). Other than urgency problems and fatigue, things are going well. I have noticed that while filling a pitcher of water at the sink, the bladder suddenly gives the signal to go. Must be psychological. Running water equals urination. 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
*ED - Yes 
*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.
 


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25393
   Posted 7/9/2010 11:40 AM (GMT -6)   
Any running water will trigger an instant bladder spasm with me ,subic, I think that mental connection is there for all of us.
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 cath #6 - 41 days, 8/9 2nd corr surgery, 8/9 cath #7 - 38 days, mapped  9/9, 10/1 - 3rd corr. surgery - SP cath, 10/5 - 11/27 IMRT SRT 39 sess/72 gys ,cath #8 33 days, Cath #9 35 days, Cath #10 43 days, 1/19 - Corr Surgery #4,  Caths #11 and #12 ,Cath #11 - 21 days,  Cath #12 - 41 days, 3/2- Corr Surgery #5, Cath #13 - 4 days, Cath #14- 27 days, Cath #15 - 26 days, Cath #16 - 31 days, Cath #17 - 39 days, 7/2 - Corr Surgery #6, 7/2 - Caths #18 & #19

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