salvage radiation doses

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cave88
Regular Member


Date Joined Jul 2008
Total Posts : 76
   Posted 1/22/2011 7:30 AM (GMT -6)   
What or is there a "normal dose" of radiation?
thanks

60Michael
Veteran Member


Date Joined Jan 2009
Total Posts : 2215
   Posted 1/22/2011 7:49 AM (GMT -6)   
Think mine was 70-72 gys but not sure if that is the typical amount.
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
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
Started IMRT Jan. 2010 72gys
7month post SRT PSA .2

Sonny3
Veteran Member


Date Joined Aug 2009
Total Posts : 2447
   Posted 1/22/2011 7:58 AM (GMT -6)   
I received 70Gys over 35 treatments @ 2Gy each. Monday through Friday for seven weeks.

Sonny
60 years old - PSA 11/07 3.0 PSA 5/09 6.4
da Vinci 9/17/09
Post Surgery Pathology: GS 4+3=7
Stage: T3a
Tumor Volume 12.5% positive margin, extra-prostatic extension
30 day PSA 0.4, 50 day psa 0.53, 64 day psa 0.6
IMRT completed 1/15/10 35 treatments- 70Gy
2/23/10 Post IMRT PSA 1.0
3/22/10 PSA 1.5
4/19/10 PSA 1.2
5/22/10 PSA 1.3
8/9/10 Completed Radiation for MET
9/7/10 PSA 2.2
1/5/11 PSA 3.9

BobCape
Regular Member


Date Joined Jun 2010
Total Posts : 416
   Posted 1/22/2011 8:27 AM (GMT -6)   
I'm currently in week 20+- out of 33 sessions. 66 Gy.
 
If I can read his handwriting from the other day....:
rads
1 Gray = 100 rads
1c gy = 1 rad
 
200CGy/ X 33
6600 cGy
_________
= 66 Gy.
 
As to my experience to date,
No pain, short time from in to out, everyone helpful and nice, respectful.
 
I did notice some slight soreness in the rectal area the other day, but that has subsided - while that could be expected, i'm note sure if it is absolutely related - it may be because of slight change in bowel movements, and an increased urge to pee.
 
I understand that each of these are/were potential results.. I am told the urgency may very well go away - again - as time passes.
 
While even those few minutes of hearing the rad shoot into you are disturbing to the mind, there is also the feeling that you are doing it for the right reason.. that killing the bad guys is worth injuring some of your own soldiers, who are better capable of healing than the cancer cells.
 
One thing that has been mentioned to me matter of factly is, come with your bladder full. They simply didn't mention it to me until 2-3 sessions in, and then as an aside. I guess it helps drop your bladder down via the gravity, keeping it further away from the rad.
 
The mentioned again yesterday "they DID tell you to fill your bladder?"..
 
If that is important, it should be treated accordingly by the ead onc team, I think. It should be mandatory discussion AND there should be a fountain in the waiting room.
 
Sorry if I went off base in replying here.
 
Good luck and thought to ALL.
 
 

compiler
Veteran Member


Date Joined Nov 2009
Total Posts : 7197
   Posted 1/22/2011 9:59 AM (GMT -6)   
I'm heading for SRT next month and it will be 68.4 (38 sessions at 1.8 each)
 
Mel

NCOBJIM
Regular Member


Date Joined Dec 2010
Total Posts : 35
   Posted 1/22/2011 10:13 AM (GMT -6)   
Had IMRT finised in Sept. 2010
38 dailey 180 cGy total of 6840 cGy
Was told bladder must be full & bowel must be empty before starting
Had to drink 16oz of water 1/2 hour before starting. Used benefiber & it worked quite well. No real side effects have shown up so far. Docter and Therapists were great. PSA down to 0.02 6 weeks after. go back again in May.

142
Forum Moderator


Date Joined Jan 2010
Total Posts : 6891
   Posted 1/22/2011 11:17 AM (GMT -6)   
Mine was 70.2Gy over 39 sessions.
 
I was expected to drink 500ml of water 35-40 minutes before the session.
 
The standard instruction was 45 minutes before, but that led to a couple of disastrous leaks in the car, so they adjusted a little.
 
I did get several pieces of instructions - as a separate handout that I had to initial for, and as part of the overall instructions and schedule. At each treatment, the techs greeted me with a smile, a "good morning", and a "had your water today?"
 
There is a reminder sign at the entrance, a water cooler, and cups with a fill and amount line.
DaVinci 10/2009
My IGRT journey (2010) -
www.healingwell.com/community/default.aspx?f=35&m=1756808

Post Edited (142) : 1/22/2011 10:32:01 AM (GMT-7)


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25364
   Posted 1/22/2011 11:21 AM (GMT -6)   
Mine was 72 gys over 39 sessions, IMRT
Age: 58, 56 dx, PSA: 7/07 5.8, 10/08 16.3
3rd Biopsy: 9/08 7 of 7 Positive, 40-90%, Gleason 4+3
open RP: 11/08, on catheters for 101 days
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos marg
Incont & ED: None
Post Surgery PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA: 1/10 .12, 4/8 .04, 8/6 .06 11/10 Not taking it
Latest: 6 Corr Surgeries to Bladder Neck, SP Catheter since 10/1/9, SRT 39 Sess/72 gy ended 11/09, 21 Catheters, Ileal Conduit Surgery 9/23/10

Magaboo
Veteran Member


Date Joined Oct 2006
Total Posts : 1210
   Posted 1/22/2011 12:12 PM (GMT -6)   
My dose was 66Gy over 33 days. Each session lasted only a few minutes. I was told to drink 12-16 oz of water 30 minutes before each appointment. All sessions were uneventful, except for for some anal discomfort and slight bleeding in the later sessions.
Good luck and all the best to you.
 
Mag

Born 1936
PSA 7.9, Gleason Score 3+4=7, 2 of 8 positive
open RP Nov 06, T3a, Gleasons 3+4=7, Seminal vesicles and lymph nodes clear
Catheter out 15 Dec 06, Dry since 11 Feb 07
All PSA tests in 2007 (4) <.04
PSA tests in 2008: Mar.=.04; Jun.=.05; Sept.=.08; at SRT Start=0.1,
Salvage RT completed (33 days-66Gy) 19 Dec 08
PSA: in Jan 09 =.05, all tests to date (Jan 11) <.04

larryandangieohio
Regular Member


Date Joined Jan 2010
Total Posts : 44
   Posted 1/25/2011 10:08 AM (GMT -6)   
I'll be doing #8 0f 33 later today. 66Gy total. I had a PSA test last week and the bad news came back yesterday 0.30 up from .18 in Nov 10. We meet tomorrow to discuss what this might mean and what we're to do.

Larry
Dx Age:58 PSA 8/06 8.74, 10/09 7.46, 12/22 6.50 Needle Biopsy 11/10/09: 16/16 cores positive 2 - 85% of tissue

Gleason score 7 (3+4 with tertiary pattern 5). CT,Bone, and PET scans all negative.
Da Vinci laparoscopic prostatectomy performed on Jan. 07, 2010 at IU Simon Cancer Center… Indianapolis, IN Prostate size: 42 g Gleason score (primary + secondary): 4 + 3 = 7

Primary pattern (%):4, 60% Secondary pattern (%): 3, 35% Tertiary pattern (%): 5, 5%

Histologic type: Adenocarcinoma Variant histology present: No Multifocality: Yes

Extraprostatic extension: Yes Seminal vesicle invasion: No Cancer at surgical margin:No

Bladder neck involvement: No Lymph-vascular invasion: No Perineural invasion: Yes

Catheter removed Jan-19-10 Dry Nights 1 pad/day as of 2/4/10 Baseline PSA 2/3/10 <0.04

Galileo
Veteran Member


Date Joined Nov 2008
Total Posts : 696
   Posted 1/25/2011 10:36 AM (GMT -6)   
I had 70.2, which seems pretty average for IMRT salvage.
Galileo

Dx Feb 2006, PSA 9 @age 43
RRP Apr 2006 - Gleason 3+4, T2c, NX MX, pos margins
PSA 5/06 <0.1, 8/06 0.2, 12/06 0.6, 1/07 0.7.
Salvage radiation (IMRT) Jan-Mar 2007
PSA 9/2007 and thereafter <0.1
pcabefore50.blogspot.com

michaeldc
New Member


Date Joined Dec 2010
Total Posts : 7
   Posted 1/25/2011 10:58 AM (GMT -6)   
I am having #10 today - 1.8/day for 40 days (treatments) for 72 Gy total

Dave
RRP 9/06, PSA 7.4, T1c, Gleason 3+3, a little positive margin- nothing else bad, post surgery psa <.1, 1/08-.08, 3/08-.09, ......12/09-.20, 11/10-.28 (abbreviated). Age 64

BB_Fan
Veteran Member


Date Joined Jan 2010
Total Posts : 1011
   Posted 1/25/2011 1:58 PM (GMT -6)   
I had 66.6 Gy. 1.8 per day for 37 days.
Dx PCa Dec 2008 at 56, PSA 3.4
Biopsy: T1c, Geason 7 (3+4) - 8 cores, 4 positive, 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.
PSA's < .01, .01, .07, .28, .50. HT 5/10. IMRT 9/10.
PSA's post HT .01, < .01

michaeldc
New Member


Date Joined Dec 2010
Total Posts : 7
   Posted 1/25/2011 3:10 PM (GMT -6)   
I asked my Dr., after my treatment today, how his team came up with my total dose of 72. He feels that it is the maximum dose with no more side effects than 66 and in his opinion and various data bases the more the better. I looked at the IMRT dose programming and they shifted the area slightly to reduce exposure to the rectum and bladder (from the original proposed pattern). They did this programming and shifting with 6 CT scans, 1 MRI with and without contrast in the urethra and bladder, and 7 treatment machine CT scans. They continue to modify the dose pattern if necessary with treatment machine CT scan between treatments. The do keep the 7 dose angles constant - after initially confirming with the treatment machine x rays when in position for each of the 7 angles. The are just shifting the IMRT pattern by adjusting the lead leaves in the head - it seems they are doing about 4 patterns per angle.

They want an empty bladder and rectum for all treatments - they feel it is the most constant. They did put me on a low residue diet and Milk of Magnesia to keep the system purging. I have been taking Metamucil which seems to do the trick along with an occasional 1/2 dose of Milk of Mag.

So far minimal side effects.

Dave
RRP 9/06, PSA 7.4, T1c, Gleason 3+3, a little positive margin- nothing else bad, post surgery psa <.1, 1/08-.08, 3/08-.09, ......12/09-.20, 11/10-.28 (abbreviated). Age 64

Fairwind
Veteran Member


Date Joined Jul 2010
Total Posts : 3626
   Posted 2/8/2011 6:25 PM (GMT -6)   
72Gy. 40 X 1.8Gy. Last 7 treatments called "Boost". Beam now tightly focused on the prostate bed. I have 3 more to go. Only minor side effects, more frequent urination. This on a Varian RapidArc linac.
Age 68.
PSA at age 55: 3.5, DRE normal. Advice, "Keep an eye on it".
age 58: 4.5
" 61: 5.2
" 64: 7.5, DRE "Abnormal"
" 65: 8.5, " normal", biopsy, 12 core, negative...
" 66 9.0 "normal", 2ed biopsy, negative, BPH, Proscar
" 67 4.5 DRE "normal"
" 68 7.0 third biopsy positive, 4 out of 12, G-6,7, 9
RALP Sept 3 2010, pos margin, one pos vesicle nodes neg. Post Op PSA 0.9 SRT, HT NOW

BobCape
Regular Member


Date Joined Jun 2010
Total Posts : 416
   Posted 2/8/2011 7:16 PM (GMT -6)   
I dont get it?
 
I've noted in posts that they wanted me to have a full bladder, draws it down, away from trouble - type thing. And I was noting they should have made a bigger deal about that, if indeed that is what I should be doing. So I try and fill my bladder each time... i've only got Wed/Thu/Fri left!!!
 
Yet others say they were told "They want an empty bladder and rectum for all treatments - they feel it is the most constant.".
 
Is there a standard medical position on the ideal state of the bladder during salvage radiation treatment?

Galileo
Veteran Member


Date Joined Nov 2008
Total Posts : 696
   Posted 2/8/2011 7:52 PM (GMT -6)   
As I recall, my doctor didn't say anything about it, or maybe he said, when I asked him part way into treatments, not to worry about it too much. I think he might have said something like it's better to have something in it, but not to be uncomfortable. It wasn't a big point with him, and as it turned out, I didn't get much bladder irritation. Barely noticeable. Bowel, on the other hand...that did get tickled pretty good.
Galileo

Dx Feb 2006, PSA 9 @age 43
RRP Apr 2006 - Gleason 3+4, T2c, NX MX, pos margins
PSA 5/06 <0.1, 8/06 0.2, 12/06 0.6, 1/07 0.7.
Salvage radiation (IMRT) Jan-Mar 2007
PSA 9/2007 and thereafter <0.1
pcabefore50.blogspot.com

pasayten
Regular Member


Date Joined Mar 2007
Total Posts : 428
   Posted 2/8/2011 11:04 PM (GMT -6)   
I recieved 32 treatments of 2 gys each for a total of 64 gys... Worked like a charm with no long lasting side effects...
3/2007 - Dx 59 y/o - 12 point biopsy - Left 0/6 Right 1/6 Gleason 3+3 T1c
4/2007 - DaVinci RRP performed - Gleason 6 T2c Nx Mx
PSA 7/07 0.01, 6/08 0.02, 12/08 0.03, 10/09 0.13
11/09 Consult BCR and rec for SRT
1/2010 IMRT SRT - 32 sessions 2 gys for 64 gys total.
6/2010 3 mth PSA post SRT 0.02
1/2011 10 mth PSA 0.01
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