SRT... Here I Come!!

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Kark60
Regular Member


Date Joined Jun 2008
Total Posts : 91
   Posted 11/28/2010 11:04 PM (GMT -6)   
After consulting with three radiation oncologists about my situation... one in a major city 200 miles away where I had surgery nearly 30 months ago, one in my local area highly recommended by three sources (including the radiation doc in the major city) who is considered "out of network" by my insurance company, and one local doc considered "in-network," I decided to go in-network primary due to convenience and MUCH less cost. After meeting with the third doctor she seems to know the disease well, has experience with the process, and is very confident the treatment will work. I also was amused when this high-energy and "motherly" Korean woman told me, in her Korean accent, to "assume the position" for the DRE (which was negative!!).

Anyway... I go in on Tuesday for the set-up and probably will start my first of seven weeks of treatment soon after. I was advised to have a Fleets enema and I will be have a catheter (oh boy... the memories!!) for the set-up. Can anyone let me know what else to expect that day beyond the things the doc told me?

Wish me luck...

Kark60
Regular Member


Date Joined Jun 2008
Total Posts : 91
   Posted 11/28/2010 11:08 PM (GMT -6)   
Here is my signature, that was not included with the original post.
Age 47 when diagnosed (currently 50). Pre-surgery PSA: 13.7 Pre-surgery Gleason: 4+3=7. CT Scan, Bone Scan, PET Scan: Clear. LRP May 28, 2008. Left nerve bundle removed. POST-SURGERY: Gleason: 4+3=7;10% of prostate all quadrants involved; EPE left base & apex; extensive PNI present. Bladder neck, lymphvasular space, seminal vesicles, 17 examined lymph nodes, and all surgical margins FREE of tumor. T3a. Four-week post-surgical PSA = 0.1; Seven-week post-surgical = .01; October 2008 – April 2010= 0.0; April 2010=0.1; May 2010 & August 2010 = 0.1; September 2010=.15; Prostiscint = negative.

English Alf
Veteran Member


Date Joined Oct 2009
Total Posts : 2215
   Posted 11/29/2010 3:30 AM (GMT -6)   
You mention having a catheter for your set up
I hope you mean the catheter will be used to fill your bladder as having an empty bladder is not recommended. (If I understood it correctly a full bladder will push the bladder away from the prostate bed, while conversely a full bowel will get pushed towards the prostate bed.)
Though my doc also said that it is also a case of it being best to just have everything inside you in exactly the same position during set up and during treatment sessions, so that the machine will be accurate when it comes to hitting the target area and avoiding the healthy tissue.

Otherwise hope the RT goes well and you have as few side effects as possible.

Alf
Born Jun ‘60
Apr 09 PSA 8.6
DRE neg
Biop 2 of 12 pos
Gleason 3+3
29 Jul 09 DaVinci AVL-NKI Amsterdam
6 Aug 09 Cath out
PostOp Gleason 3+4 Bladder neck & Left SVI -T3b
No perin’l No vasc invasion Clear margins
Dry at night
21 Sep 09 No pads daytime
17 Nov 09 PSA 0.1
17 Mar 10 PSA 0.4 sent to RT
13 Apr 10 CT
28 Apr 10 start RT 66Gy
11 Jun 10 end RT
Tired
BMs weird
14 Sep 10 PSA <0.1
Erections OK

142
Forum Moderator


Date Joined Jan 2010
Total Posts : 6947
   Posted 11/29/2010 8:20 AM (GMT -6)   
In my case, there was no enema (liquids the night before, however). I can see how that would assist in the planning CT scan.
 
The catheter has me wondering. For me, it was just drinking the water bomb as I would every day. My therapists insisted on identical conditions each day, including the planning scan.
A catheter would not have fit that scheme. Am scratching my head on that one.
DaVinci 10/2009
My IGRT journey (2010) -
www.healingwell.com/community/default.aspx?f=35&m=1756808

bsjoplin
Regular Member


Date Joined Feb 2010
Total Posts : 308
   Posted 11/29/2010 10:14 AM (GMT -6)   
?? i don't understand the catheter, or any other prep, also don't understand the need for a DRE, but maybe that's just my experience...
 
i got to the office, with no preparations at all. dude came over and gave me a liter of stuff, cooled down, and i drank it in the waiting room...the coolness of the solution, plus nerves, got me pretty shaky chilled by the end of the bottle....the solution fills your bladder, plus it has a chemical to make the bladder stand out more in the CT scan
the dude laid me down on the CT scan table.  and then they do two things to help with your positioning.  they make a rough foamy mold that holds your feet still, and prick you in 4 places (these make permanent dot "tatoos"). when they position you in all the next SRT procedures, they can put your feet in the molds, and line your tattos up with the laser scanners coming from the ceiling and walls, and they feel confident that you are in exactly the same orientation, time after time. 
you then go through a CT scan, and the rad doctors use that 3D information to set up the radiation machine to blast where the prostate used to be, and try to hit where the cancerous cells would be, and minimize damage to bladder and rectum.
absolutely no pain or discomfort, except full bladder, nerves, and a guy poking you real quick with a point, to make your tatoos.  you leave there thinking: what was i worrying about?? (oh, yeah, cancer....)
 
i don't like wishing you LUCK, but i'll join you in wishing/hoping that the doctors are able to knock it all down and you have many years of peaceful, low PSA's !
bob
 
Age@dx:55
5/05 PSA:1.8
12/07 PSA:3.7
7/08 PSA:4.7
8/08 Biopsy#1:3 of 6 irreg
11/08 PSA:6.5
12/08 Biopsy#2:of 12,3 cancer,other 9 irreg;Gl:3+3=6
1/22/09 RRP
1/25/09 Released
1/28/09 Path: PCa on 10%, lymph & SV benign, Gl:3+4=7,stage T2c
2/13/09 PSA:0.1
6/09 PSA:0.1
10/09 PSA:0.1
2/10 PSA:0.3
4/10 PSA:0.4 Referred to RO
5/4/10 First RT
6/25/10 Final RT;ended up 36 treatments,64.8 Gy.
8/10 PSA:0.2
11/10 PSA: 0.1

F8
Veteran Member


Date Joined Feb 2010
Total Posts : 3800
   Posted 11/29/2010 10:29 AM (GMT -6)   
i had to do a laxative or enema (my choice) before the set-up scan for IGRT.  the only catheters i saw during that course of radiation treatment were on other men who weren't tolerating side effects well.
 
ed
age: 55
PSA on 12/09: 6.8
no symptoms, no prostate enlargement
12/12 cores positive....gleason 3+4 = 7
HT, BT and IGRT
received 3rd and last lupron shot 9/14/10

Kark60
Regular Member


Date Joined Jun 2008
Total Posts : 91
   Posted 11/30/2010 3:10 PM (GMT -6)   
I went for the set-up today. They used two catheters on me- one to the bladder, the other to the rectum. Both were used to inject dye so the bladder and rectum would show clearly on the pelvic CT. My radiation doc is using "tomo-therapy" which relies on a CT scan each time I am treated.

Anyway... I survived the experience and am tentatively scheduled to begin treatment on December 13.
Age 47 when diagnosed (currently 50). Pre-surgery PSA: 13.7 Pre-surgery Gleason: 4+3=7. CT Scan, Bone Scan, PET Scan: Clear. LRP May 28, 2008. Left nerve bundle removed. POST-SURGERY: Gleason: 4+3=7;10% of prostate all quadrants involved; EPE left base & apex; extensive PNI present. Bladder neck, lymphvasular space, seminal vesicles, 17 examined lymph nodes, and all surgical margins FREE of tumor. T3a. Four-week post-surgical PSA = 0.1; Seven-week post-surgical = .01; October 2008 – April 2010= 0.0; April 2010=0.1; May 2010 & August 2010 = 0.1; September 2010=.15; Prostiscint = negative.

bsjoplin
Regular Member


Date Joined Feb 2010
Total Posts : 308
   Posted 11/30/2010 3:43 PM (GMT -6)   
glad to hear you're still with us! hang in there, and check back now and then and update us
wishing you the best
bob
 

bsjoplin
Regular Member


Date Joined Feb 2010
Total Posts : 308
   Posted 11/30/2010 3:50 PM (GMT -6)   
Kark, look at a parallel thread, something about "Anyone SRT using VARIAN TRILOGY RAPIDARC", in that thread, a posting by Pogmo-something sounds very similar to what you are discribing, with the dual catheters..
 
bob

pogmothoin
Regular Member


Date Joined May 2010
Total Posts : 84
   Posted 11/30/2010 4:32 PM (GMT -6)   
Bob,
Yes, I had the two cath's. It was uncomfortable with the one in front but i got over it and as of today I have had my first official treatment. They used the cath's to insert dye and to make sure the bladder was full for the CT.

BTW, you did pretty well with remembering my user name. It's pog mo thoin, basically Gaelic for kiss my, ummm, loin (though most translations use a slightly different word than "loin").
Age at diagnosis 5/10: 49
PSA: 5/08 1.6, 5/10 4.7
Initial GS 7 (4+3)
Biopsy: 14 out of 15 positive, up to 95%
Bone scan and CT clear
RRP on 7/20/10 by Dr William Catalona at Northwestern
about 40% nerve-sparing on each side, with bilateral nerve graft performed
Final GS 7 (4+3) with a tertiary amount (less than 5%) showing at 5
PSA 8/23/10 1.59, confirmed 8/26/10 1.7

bsjoplin
Regular Member


Date Joined Feb 2010
Total Posts : 308
   Posted 12/1/2010 7:44 AM (GMT -6)   
i guess my Gaelic is a little rusty; sometimes i try to decipher where the usernames come from (like vanity license plates) but yours shot right past me...
 
wishing you (and Kark) a fruitful RT series..keep us posted!
bob
Age@dx:55
5/05 PSA:1.8
12/07 PSA:3.7
7/08 PSA:4.7
8/08 Biopsy#1:3 of 6 irreg
11/08 PSA:6.5
12/08 Biopsy#2:of 12,3 cancer,other 9 irreg;Gl:3+3=6
1/22/09 RRP
1/25/09 Released
1/28/09 Path: PCa on 10%, lymph & SV benign, Gl:3+4=7,stage T2c
2/13/09 PSA:0.1
6/09 PSA:0.1
10/09 PSA:0.1
2/10 PSA:0.3
4/10 PSA:0.4 Referred to RO
5/4/10 First RT
6/25/10 Final RT;ended up 36 treatments,64.8 Gy.
8/10 PSA:0.2
11/10 PSA: 0.1
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