what to do while undergoing SRT

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compiler
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Date Joined Nov 2009
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   Posted 3/19/2011 11:28 AM (GMT -6)   
As part of the patient education portion of my simulation (I'll be starting SRT early this week or more likely early next week) they mentioned:
 
1) Drink a lot of water every day (not just in advance of the SRT tx).
 
2) Exercise
 
3) Eat a high protein diet.
 
Now, I do have a thick folder to look through, but any advice from those who have been there will be appreciated. For example, what is a high protein diet? I mean, steak and eggs are high protein (am I correct?) but that doesn't seem to be advisable (at least not a lot of steak -- I sure miss eating a good steak).
 
They didn't mention anything about vitamins, but I still have to go through all the written material they gave me.
 
Well, please advise
 
Mel
PSA-- 3/08--2.90; 8/09--4.01; 11/09--4.19 (PSAf: 24%), PCA3 =75 .Biopsy 11/30/09. Gleason 4+3. Stage: T1C. Current Age: 64. Surgery: Dr. Menon @Ford Hospital, 1/26/10. Pathology Report: G 4+3. Nodes: Clear. PNI: yes. SVI: No. EPE: yes. Pos. Margin: Yes-- focal-- 1 spot .5mm. 100% continent by 3/10. ED- yes.. PSA on 3/10/10-: 0.01. PSA on 6/21/10--0.02. 9/21/10--0.06; 1/4/11-0.13,3/1/11--0.27

F8
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Date Joined Feb 2010
Total Posts : 3804
   Posted 3/19/2011 11:55 AM (GMT -6)   
>>3) Eat a high protein diet.<<
 
Mel -- you might want to back off the roughage and greens.  i have to be careful when commenting on these types of threads because when i was receiving IGRT i also had side effects from BT and HT.  in looking back i think that flomax really aggravated side effects too but it was a necessary evil.
 
i'd also recommend a good lotion every day after treatment.  i used udderly smooth but i didn't use it daily and i got burnt pretty good in the last week of my 28-day treatment.
 
ed
 
 

age: 55
PSA on 12/09: 6.8
gleason 3+4 = 7
HT, BT and IGRT
received 3rd and last lupron shot 9/14/10
2/8/11 PSA <.1, T= 6 ng/dl

compiler
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Date Joined Nov 2009
Total Posts : 7205
   Posted 3/19/2011 12:05 PM (GMT -6)   
The fibre situation creates a dilemma for me. I eat All-Bran cereal because that seems to helo me avoid really bad constipation. That's the last thing I need during SRT. However, since I might be getting diarrhea or very soft stools, All-Bran might be counterproductive. I may just have to play it by ear.
 
Did others get burned during SRT? Where were you burned, specifically? Was your groin area burned in front and back?
 
I also have used heating pads for back problems. They said don't do that. Again, I'll have to play it by ear, although hopefully my back will be fine (it is now) and that will be a moot point.
 
The other thing they suggested is for me to use Prep. H pads in lieu of TP from the start of SRT. I suspect I'll use mostly TP since I'll be feeling okay to start...maybe.
 
Did any of you have problems in the first few (say 3) weeks?
 
Mel
PSA-- 3/08--2.90; 8/09--4.01; 11/09--4.19 (PSAf: 24%), PCA3 =75 .Biopsy 11/30/09. Gleason 4+3. Stage: T1C. Current Age: 64. Surgery: Dr. Menon @Ford Hospital, 1/26/10. Pathology Report: G 4+3. Nodes: Clear. PNI: yes. SVI: No. EPE: yes. Pos. Margin: Yes-- focal-- 1 spot .5mm. 100% continent by 3/10. ED- yes.. PSA on 3/10/10-: 0.01. PSA on 6/21/10--0.02. 9/21/10--0.06; 1/4/11-0.13,3/1/11--0.27

F8
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Date Joined Feb 2010
Total Posts : 3804
   Posted 3/19/2011 12:17 PM (GMT -6)   
Mel --  you can get medicated wipes from any drug store.  i was burnt in the front only i think because the beam hit that spot twice during a session.  i didn't have any side effects in the first three weeks. right after that i was up 7-8 times a night to pee.  more of as hassle if anything.  bowel stuff started near the end. 
 
ed
 
 
age: 55
PSA on 12/09: 6.8
gleason 3+4 = 7
HT, BT and IGRT
received 3rd and last lupron shot 9/14/10
2/8/11 PSA <.1, T= 6 ng/dl

JNF
Veteran Member


Date Joined Dec 2010
Total Posts : 3753
   Posted 3/19/2011 12:45 PM (GMT -6)   
I didn't change my diet. I eat very little land animal meat, a lot of seafood and fish, no eggs or dairy, a lot of tomatoes, salads and vegetables, no sweets, a lot of good whole wheat multi grain bread, rice and pastas. I drink green tea, not coffee; red wine every night, and loads of tomatoe juice, no orange juice, and loads of water. I use soft toilet paper, not wet ones.

I had no problems through radiation. Absolutely no burning. My machine zapped me in 9 different places. Mel, I remember you are on the new Varian machine that doesn't stop so you shouldn't burn. My bowel and urinary was more frequent but never a problem and was back to normal withion three weeks after radiation. No diarehia, hemmies, or anything.

Mel have you developed any mental imagining as to what is going on while the radiation is being delivered? My wife and her experience with cancer taught me the importance of imaging. My image was based on Rice Crispies Snap, Crackle, and Pop. During radiation when the zap was going I would chant.... snap... crackle.... pop.... burn the hell out of those ******s.....! Of course the therapists could hear me and they always laughed and would join in the chant to help. I also took my own cds for them to play the music I wanted to hear that I knew would be damaging to the cancer cells. Attitude in this fight means everything.

Best wishes...you will do well. Remember full bladder...empty bowel.
PSA 59 on 8-26-2010 age 60. Biopsy 9-8-2010 12/12 positive, 20-80% involved, PNI in 3 cores, G 3+3,3+4,and 4+3=G7, T2b.
Eligard shot and daily Jalyn started on 10-7-2010.
IMRT to prostate and lymph nodes 25 fractions started on 11-8-2010, HDR Brachytherapy 12-6 and 13-2010.
PSA <.1 and T 23 on 2-3-2011.

142
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Date Joined Jan 2010
Total Posts : 6949
   Posted 3/19/2011 12:52 PM (GMT -6)   
Mel,
 
The wet-wipes or Prep-H type pads are to help you NOT develop a problem. If you should have irritation or bleeding during RT, it won't heal very quickly, and I can just see you in front of a class trying to deal with that (been there myself). Radiation hurts good tissue as well as cancer, which slows healing. That's why there is a minimum wait between surgery and adjuvant RT.
 
If you wait until you need them, it is too late.
 
 
 

John T
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Date Joined Nov 2008
Total Posts : 4227
   Posted 3/19/2011 1:10 PM (GMT -6)   
Mel.
Try taking Metamucil, it's good for softening stools and also making very soft stools a little firmer. Excercise as much as you can. Stay away from alcohol and caffine. Discontinue all supplements as some antioxidents reduce the effect of radiation.
65 years old, rising psa for 10 years from 4 to 40; 12 biopsies and MRIS all negative. Oct 2009 DXed with G6 <5%. Color Doppler biopsy found 2.5 cm G4+3. Combidex clear. Seeds and IMRT, no side affects and psa .1 at 1.5 years.

Fairwind
Veteran Member


Date Joined Jul 2010
Total Posts : 3747
   Posted 3/19/2011 1:10 PM (GMT -6)   
There is a lot of cellular damage going on and the high-protein diet is to help repair this damage. This cellular damage is why some men suffer fatigue..The exercise is keep all systems tuned up and moving...

With the RapidArc I never got a "suntan" or skin burns..Not a sign of it..Half-way through, urinary frequency / urgency became slowly apparent..Then, at the very end, rectal itching was noticed but only just after a BM. Also, the perineum area became a little sore, doing a kegel produced a dull throbbing feeling and still does. Things don't heal as fast at our age, especially after being nuked..So recovery from this takes a while..Some tissue is NEVER going to recover. You just hope the permanent side-effects are tolerable and you don't slip back into incontinence..I'm one month post-treatment and I'm holding my own...
Age 68.
PSA age 55: 3.5, DRE normal.
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 3rd 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. 2-15-'11 PSA 0.0

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 3/19/2011 1:36 PM (GMT -6)   
Well, you know my story too well, started burning on the 4th treatment (internal, not external)

I was told to eat all the proteins that I wanted , and that the during the radiation treatments, not to be real worried about
diet issues.

I was told, if you smoke, a good time to quit (I wasn't smoking anyhow).

And lots of rest on the off-radiation days.

david
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 2/11 1.24
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 9/10,

compiler
Veteran Member


Date Joined Nov 2009
Total Posts : 7205
   Posted 3/19/2011 1:39 PM (GMT -6)   
I've now started on the mountain of reading stuff they gave me. I stopped after about an hour as it just got too depressing.
 
There are lots of pages about diarrhea and loss of appetite.
 
Did many/any of you have that problem?
 
I guess I will start to use the Prep. H wipes before problems start.
 
I wish we would get going already with this SRT. These delays have been annoying and certainly not good. Unless I get a call Monday, it looks like I don't start until the following week.
 
Mel

duke68
Regular Member


Date Joined Mar 2007
Total Posts : 243
   Posted 3/19/2011 2:11 PM (GMT -6)   
Hi Mel

I had 35 treatments to prostate and lymph nodes.

Only thing I can remember was to drink more water.
I had a mild reddening in the area. Loss of hair, that came back.
Very mild diarrhea. I had fatigue, but I was on adt2.

Overall no problems just time consuming.

Best Wishes
Gerry
age 68 diag. oct 2006 G8 T2b psa 11.7
4 of 8 cores 20% 30% 60% 100%
rrp dec 2006 G9 4+5 m+ sv+ ece after 6 weeks psa 0.6 second opinion Dana-Farber pT3b 4+4 + T5 = G9
Rt 35 sessions to lymph nodes and prostrate 4-2007
3/2007 cab 6 months lupron + casodex.
psa <0.1 from june 2007 to march 2010
psa 6/10 0.3 9/10 0.6 12/10 2.5 :(

Dana- Farber Phase 2 trial Avastin Lupron and casodex

mr bill
Veteran Member


Date Joined Sep 2010
Total Posts : 688
   Posted 3/19/2011 4:22 PM (GMT -6)   
Mel,
Doing the RT now. Everyone pretty well covered the side effects. The only thing I can add is weight loss. I found it helpful to weigh in every morning at the same time. Usually just after shower. Onc. said if I experience rectal irritation to use wipes, just make sure they have no alcohol in them. He also told me to watch the roughage and the corn, and the peanuts, and the apples, and the antoixidants, etc., etc., etc. I really am getting tired of salmon, spinach, with unsweetened ice for desert. Think I may change my screen name to Mr. Yuk.

Mr. Bill
Age 66
BPH since 1996. at least three negative biopsies Erie. Uro did not Rx finasteride
2007 acute urine retention photovaporize Clev. Clinic Rx finasteride
8-9-10 PSA rose to 10.14 with finasteride positive biopsy gleason 9, cat & bone scan negative
9-8-10 RP at Cleveland. Biopsy 9 nodes 2 positive,
seminal & vas deferens +
RT started 2-17-11
PSA 3 wk .06, 6 wk <.03, 12wk 0.0

fulltlt
Regular Member


Date Joined Nov 2010
Total Posts : 264
   Posted 3/19/2011 4:25 PM (GMT -6)   
I started to have loose bowels shortly after my IMRT treatments started. Now I think I will never need to take a laxative for the rest of my life. They do want you to drink a lot of water especially right before the treatment. I asked the nurse to make sure the bathroom door next to the treatment room was unlocked at all times for when I was finished. There were a few times I could hardly wait to make it to the bathroom after the treatment was over. Other than that it was a pretty easy process.
age 57 2/2010
PSA Feb 8.2
biopsy 2/2010 - 2 of 8 left & 2 of 8 right positive, Gleason 3+4=7
attended support group - advised to get a second opinion
second opinion on pathology from Johns Hopkins 4+4=8
PSA 15 4/2010
5 weeks IMRT 4/2010-6/2010 at Copley Hospital in Aurora, IL
91 palladium 103 seeds 7/2010 at Chicago Prostate Center, Westmont, IL
PSA Oct 3.97, Dec 2.78, 3/9/11 2.42

Skate
Regular Member


Date Joined Oct 2010
Total Posts : 424
   Posted 3/19/2011 4:37 PM (GMT -6)   

Hi Mel.  I had 36 treatments,  Monday to Friday and met with my radiation oncologist one day each week,  usually within an hour of a treatment.  There was always a nurse at the station who was there to assist with any questions or concerns.  I used wet wipes ( advised to use alcohol free and lanolin free as there will be no irritation from them).  Yes use them from the start. I used them for a while after my treatment as well. I had no burning whatsoever.  Maybe some urinary frequency (perhaps because of all the water I was drinking). I also switched to decaff rather than giving up coffee altogether, no alcohol is also a good recommendation. BM's became very loose and you will definitely want to avoid a lot of fibre. How about a protein shake daily with fresh/frozen fruit? Any gym or health food store carries the zero sugar etc. During treatment I actually could taste a metal flavour at times and my appetite for certain foods changed, some to this day. The only other side effect I felt personally was about two/three weeks in,  all of a sudden I would feel that I hit a wall and so I settled in for  a good nap whenever that happened.  I worked mornings only and travelled 70 km to the  centre in the afternoon.  I drove myself daily except for the weekly visit with my rad. onco, my wife came with me. Four ears are better than two.  My weight and blood pressure were checked weekly for consitency and monitoring. Other than that, no other implication from RT for me personally.  The team at the centre was great, always on time for appointments with very little waiting. If I ever had to re-schedule a time on a specific day (only happened once) they were more than accommodating. Hope everyone makes your experience as pleasant as it can be, "In keeping with the situation" (Dickens).

Jack


Age 59 at Dx / 63 now
01/08 PSA 4.17 DRE showed node
03/08 RP - pT3a 10% ca , 2 of 12 / 3+4
Nerve Sparing, Margins clear, no SV invasion
Continent 3 weeks post surgery / ED
06/08 until 08/09 PSA 0.01
08/09 PSA .14
09/09 SRT / 36 treatments
01/10 PSA .13
08/11/10 PSA 3.44 / T = 25.0 nmol/L
30/11/10 Zoladex ADT
24/02/11 PSA <.04 / T = 1.0 nmol/L

compiler
Veteran Member


Date Joined Nov 2009
Total Posts : 7205
   Posted 3/19/2011 5:29 PM (GMT -6)   
Mr. Bill:
 
I asked you a question-- check your email.
 
Fortunately, I like salmon but don't get to eat it too much. I like to grill and the weather is starting to cooperate. We grilled it last night!
 
Mel

Casey59
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Date Joined Sep 2009
Total Posts : 3172
   Posted 3/19/2011 5:52 PM (GMT -6)   
compiler said...
For example, what is a high protein diet? I mean, steak and eggs are high protein (am I correct?) but that doesn't seem to be advisable...
 
You're right, it certainly wouldn't be adviseable for anyone on SRT or not on SRT.
 
Some people confuse the notion that protein=red meat, but this is certainly not the case.
 
Here's a good example for comparison:
 
Picture a serving sized porterhouse, and a serving sized pacific wild salmon...both about 6 oz.  They both have about the same protein (38g vs. 34g), but the steak has 44g of fat (16 saturated fat) while the salmon has only 18g of fat (only 4g saturated).
 
The way they described it in THIS Harvard School of Public Health resource is that the protein is "packaged" differently in the salmon vs. the steak.  Fish and poultry are the best choices for proteins.

Julietinthewoods
Regular Member


Date Joined Sep 2010
Total Posts : 309
   Posted 3/19/2011 5:53 PM (GMT -6)   
Mel, did they give you a specific diet to follow? My husband had IMRT as a primary treatment, and it should bring the same basic issues as SRT. He had no loss of appetite, no bowel changes and no bladder symptoms. If it hadn't been for the burn he got across his rear end at the very end of treatment, we'd have thought the machine wasn't loaded.

They thought he did as well as he did because he followed the low-residue diet religiously. It was outlined in the packet he received before treatment began, and included detailed lists of foods to avoid and foods to consume. He also took Citracel beginning a few days before treatment. That was to keep his bowels regular and prevent constipation. The low residue diet kept his bowels from becoming too loose. They mentioned that the guys who ignored the diet were the most likely to experience diarrhea.

Carter hated the diet and missed his salsa and crunchy peanut butter (not together ;)), but it was well worth it. We ordinarily eat no white flour or white rice or white pasta. He had to give up whole wheat everything for the nine week period, and go back to white products. I don't want to know what that did to his triglycerides, but he had no choice.

Ask your doctor for specific dietary suggestions. Another option might be to start out with your regular diet, but make the switch quickly if you start experiencing bowel issues.

It will all be over with before you know it!

Juliet

Fairwind
Veteran Member


Date Joined Jul 2010
Total Posts : 3747
   Posted 3/19/2011 7:39 PM (GMT -6)   
Mel, you worry too much..Just drink that pint (or quart) of water before your treatment, have a BM if you can and just do it.....If any of these side-effects actually happen, they come on slowly and you can change things to mitigate them..My favorite high-protein, high-energy diet ?? Pizza & Beer!!! turn

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 3/19/2011 7:55 PM (GMT -6)   
Mel, I did want to add the following:

Despite my nature of experiencing all known side effects, I only had nausea on a couple of treatments, seems like it was during the first 2 weeks.

And despite the damage to my bladder, didnt have much with loose bowels at all. More than a year after my SRT ended, I know experience what I call Bowel Urgency, and boy, if I even have the slightest urge for a number two, I best be scoping out the nearest white throne.

Some radiation side effects due come long after the treatments end. The fatigue, for most men, fortunately, is short term, and for others, like me, become chronic. I do believe that since I have been through major radiation twice, it compounded the fatigue issue.

I dont blame you wanting to start and get it going at this point, I remember feeling that way too.

David
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 2/11 1.24
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 9/10,

hb2006
Regular Member


Date Joined Nov 2008
Total Posts : 299
   Posted 3/19/2011 9:16 PM (GMT -6)   
Mel
 
My last RT session is on March 21, of 39 sessions. I had no side effects at all. No burning, no getting up at night, etc. I'm on the Varian Rapidarc equipment.
 
I was told to not drink regular coffee so I cut that out during the week and had it only on Friday after my session and over the weekend. Regular coffee irritates your bladder with the RT.
 
I also didn't change my diet at all, had the same food that I always did. One different result was that I have had an anal fissure that would bleed off and on, it has completely stopped bleeding since I started the RT. I was using the Prep H wipes, so maybe that's what cured it.
 
I also experienced that "hitting the wall" tired feeling but I relate that more to less caffeine that anything else. I continued to drink 2 glasses of wine or a couple of beers every day. And lots of water....
 
The oncologist did say that men doing the RT in place of surgery, do seem to experience more side effects. Especially in getting up alot at night. Their bladders are irritated more somehow.
 
I think you will do well.
Age 60, PSA 2007 4.1, PSA 2008 10.0
Diagnosed April 2008, Biopsy: 6 of 12 cores positive, Gleason 4 + 5 = 9
CT and Bone Scan negative, Open surgery at Shawnee Mission Medical Center May 21, 2008
Right side nerves spared, Radical prostatectomy and lymph node dissection
Cather removed on June 3rd, totally dry on July 9th, pT2c, lymph nodes negative
PSA Sept 28, 2008 0.00, PSA Jan 22, 2009 0.00, PSA June 29, 2009 0.00
PSA Sept 2009 0.00, PSA Dec 21, 2009 0.02, PSA March 29, 2010 0.03
ED Status- Currently using Trimix, Levitra daily for increased blood flow.
Noctural Erections have completely returned on a nightly basis, same hardness as before.
Stopped the injections except for "Fun" weekends. Really don't need them anymore.

Im_Patient
Veteran Member


Date Joined Aug 2009
Total Posts : 665
   Posted 3/19/2011 9:27 PM (GMT -6)   
Mel, I have had colitis for nearly 20 years (lots of time before I went through SRT). My doc said that based on my history, I would know better than most how to treat my bowels through the SRT. Metamucil once a day. John T is right - it helps make you more regular in either case. What has worked for me for a long time is to take 2 showers a day - the one at night was just to wash up the affected area (wish I had a one of those european things for washing up down there). I was afraid that the SRT would flair up the colitis but it didn't. Drink lots of fluids to help the body recover from the damage. Exercise as much as you are able. Although many do, I did not have significant urinary effects through the treatments. I hope things go well for you. Don't be convinced they won't - stay positive. Although I had a lot of fatigue, some don't.
Take care
Jeff
Gleason,3+4;PSA 7.9,Nerve-sparing RRP,03/2008(Age 48 then),pT2c, 60g, neg margins; perineural & lymphatic invasion;3 lymph nodes removed,clear; seminal vesicle invasion:absent;Gleason 4 was 5-10%; PSA <0.1 until Oct 09:0.1; retest <0.1; scans clear;monthly results from Jan 2010:0.2,.2,.17,.17,.24,.31,.29,.41, IGRT SRT started 8/4/2010, PSA@5 weeks in: .17,after:.12,.10
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