Yesterday, we went to our urologist/surgeon to review the PSA and PET scan results.
PET scan - clear
PSA @6weeks - 0.17
Urologist has asked about
incontinence progress and said that PSA was not what he has expected to be at 6 weeks (though it has decreased), we should go and visit the radiation oncologist and arranged for ART.
So we went to visit the RO today and have an informative session with him.
He said my husband will have 39 sessions, each with 1.8Gy
He wanted to start the ART on either 3Sep or 10Sep, depending on how soon the preparation work can be completed.
We have asked quite a number of questions and he could answer all of them.
Which part of the area will receive the radiation ?
the prostate bed, including the bottom of the bladder. No need to radiate the whole bladder as it is not the feature of PC to spread to the other parts of the bladder.
the water consumption during the radiation period ?
My husband needs to drink 1.5-2L a day, he needs to have full bladder during radiation. The reason is that the RO wants the urine to help to flush the urethra and bladder after the radiation. The more urine flushing the bladder and urethra during the radiation period the better, as it is impossible for the doctor to flush the bladder after every radiation session. Therefore, the urine will do the flushing job. He will teach my husband how much and when to drink the water.
Since my husband is dry most of the day, it should be fine to start now. He does not want to wait till 100% dry as he wants to kill the PC cells while they are weak. Incontinence will either stay the same or worsen after ART.
Should stay at what my husband is now as he is not going to radiate the nerves.
What are the side effects ?
Increase bathroom trips as the scars on the bladder (after radiation) will shrink the capacity of the bladder. Will start to have fatigue at Week 4 of ART. All SEs should go away 1 month after ART has completed.
Any medicine during ART ?
No need. But need to talk to Chinese medicine doctor to ask him not to use herbs that will increase bowel movement as it will impact ART. Other supplements are fine to use.
Any change in diet required ?
No, as PC is caused by your old diet, so not much help to change diet now though a healthy diet is always good.
Can therapy proceed if not feeling well ?
As long as there is no fever, can go ahead with ART. The reason is that the increase in body temperature will increase the effect/power of radiation and have detrimental effect. The nurse at the centre will make sure that one is not having a fever before starting the therapy.
sneezing or coughing during the therapy ?
No problem, the technician will stop the machine. Even if one sneezes during the session, it will not do much harm.
We will have another PSA blood test before the actual radiation start in order to get a before radiation baseline. Hope that it will be a 0.
hubby (age 52) dx May2012 PSA 5.4 GS 7 (3+4), 1 positive in 16 core,T1b
RP on 6Jul2012, MRI clear
Upgraded to GS 9 (5+4), pT3b
3-week post-ops PSA: 0.24, @6weeks:0.17
12Aug12 - first natural erection