IMRT Question..

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Regular Member

Date Joined Nov 2009
Total Posts : 212
   Posted 7/30/2010 7:08 AM (GMT -6)   
Sorry if this is a dumb question....
If you have spread to the seminal vesicles, and your main treatment is ADT & IMRT (so no surgery), when they do the radiation, do they actually radiate the seminal vesicles as well?
My father had gold seed markers implanted into his prostate to help guide the IMRT, but it never occurred to me to ask the rad oncologist about what they do about the cancer in the seminal vesicles...

Father 65 y/o at diagnosis November 2009
Gleason 9 & 10, stage 3 - seminal vesicle involvement
Two TURPs mid Nov. 2009
Foley Catheter
Casodex for last two weeks of November '09, then Lupron.
Suprapubic Catheter March 18th, but blocked right away, back to Foley...
Started IMRT March 25th, Chemo on hold due to catheter bleeding issues, etc.
Ended IMRT and Chemo (Taxotere) late May
Mid-July - pain finally better controlled with Fentanyl patch
Late July - Superpubic Cath. removed, peeing normal again
July 21 - PSA .1

Veteran Member

Date Joined May 2008
Total Posts : 1010
   Posted 7/30/2010 7:39 AM (GMT -6)   
Hello Gibson,
My primary treatment was IGRT/IMRT. I had possible lymph node involvement as well. So, the treatment consisted of 45 total doses. The first 25 were a combination treatment. I received what is called "full pelvic" radiation. I believe this is what they will do for seminal vesicle involvement as well. So, for the first 25 the machine would buzz a bit and then I could here the collimeters leaves reposition and it would buzz a bit more. The first buzz was the full pelvic. The second buzz was focused on the prostate. The machine would then move to the next station and repeat the process. There were seven stations in the treatment arc. The radiation machine was a Varian. The last 20 were only aimed at the prostate  and this cut the time for treatment in half. Although none of the treatment sessions took more than 20 minutes in to out.
I had minor bowel and urination issues the last five treatments of the full pelvic and things got better fast when we went to the prostate only. I have had no lingering effects from the treatment other than ED. Somehow, though, I think the ADT therapy is more to blame for that than the radiation. Of the two the ADT was the more unpleasant, but tolerable, treatment.
Good luck to you Dad. I hope his treatment is a benign as mine was.
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
Two years on Lupron completed 01/2010.
Started IMRT/IGRT on July 10, 2008. 45 treatments scheduled
First 25 were 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
PSA 06/09 .36 or .30 depending on who did the test
PSA 09/09 .33 one year after IMRT and 16 months into hormone
PSA 03/10 .32 18 months after IMRT Still on hormones
PSA 05/10 .42 Rising a little as the lupron wears off. Last lupron shot 01/10.
PSA 06/10 .322 Maybe the .42 reported in May was in error?

Veteran Member

Date Joined Dec 2008
Total Posts : 3149
   Posted 7/30/2010 7:47 AM (GMT -6)   
Hey Don good reply and always nice to be an informed patient, so as to mention and answer questions like this, since many times the docs don't take the time to inform the patient of the basic strategic plan.
Youth is wasted on the Young-(W.C. Fields)

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