SBRT...Urination...Flomax

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three 5's and a jack
Veteran Member


Date Joined Jul 2017
Total Posts : 519
   Posted 12/27/2017 8:29 PM (GMT -6)   
5-6 days out from completion of SBRT. I have been taking .4mg flomax since 4th day of treatment with Aleve for the pain upon starting the flow. Those two drugs really seemed to help with pain and flow but..........it seems that the last day or two the flow is slowing, even more, and the pain is SLIGHTLY increased. Understand that if this is what I had for the rest of my life I would still be very pleased if the PCa were gone. So...........................just looking for some personal stories about these issues.

Thanks all

May all beings be well and always free from animosity.

Roger
Looking for the 4th 5
69yo weight 7/1-283# on 12/18 220#
PSA 6.01 6/17 & 6.07 on 10/11/17 and 5.56 on 11/17/17
BX 8/04/17 DX 8/11/17 5/16 cores positive all on left
L mid/base 4/6 4+3=7 25%
L apex 1/2 3+4=7 30%
Sec opinion from UofW same GS7 but called overall 3+4=7
Markers and scans completed Dec 7/8 Completed SBRT Dec 22 3625 cGY in 5 fractions at Swedish in Seattle Dr. Robert Meier

Jerry_Delaware
Regular Member


Date Joined Jul 2011
Total Posts : 218
   Posted 12/27/2017 8:37 PM (GMT -6)   
I had the same issues after my proton treatment and was given double the standard dose of Flomax. After about a month, I was pretty much pain free and flowing well. I continued to take the standard dosage of Flomax for the next year, then quit entirely and have had no issues since. Good Luck!

...Jerry
PCa History: VIEW IMAGE

three 5's and a jack
Veteran Member


Date Joined Jul 2017
Total Posts : 519
   Posted 12/27/2017 8:41 PM (GMT -6)   
Hey Jerry......you said "Standard" dose???????.4mg?????
Looking for the 4th 5
69yo weight 7/1-283# on 12/18 220#
PSA 6.01 6/17 & 6.07 on 10/11/17 and 5.56 on 11/17/17
BX 8/04/17 DX 8/11/17 5/16 cores positive all on left
L mid/base 4/6 4+3=7 25%
L apex 1/2 3+4=7 30%
Sec opinion from UofW same GS7 but called overall 3+4=7
Markers and scans completed Dec 7/8 Completed SBRT Dec 22 3625 cGY in 5 fractions at Swedish in Seattle Dr. Robert Meier

BUSMAN
Regular Member


Date Joined Mar 2017
Total Posts : 74
   Posted 12/27/2017 8:57 PM (GMT -6)   
Hi three 5's,

I am currently undergoing SBRT treatment as you know since you responded to my recent questions and thanks. After my second treatment I started having weak urination and urgency/frequency with pain in the urethra also. I had already started taking 0.4 mg per day of FLOWMAX even prior to my first treament per the RO recommendation.

After my third SBRT treatment yesterday (Tuesday) I met with the RO and he recommended doubling the dose rate to taking 2 - 0.4 mg tablets per day at the same time so I did. This seems to have helped increase the flow and reduce urgency/frequency. I also started taking Aleve today. The other thing the RO recommended to reduce urination pain is Pyridium (can buy over the counter as AZO compound) which I have not tried yet.

I hope your pain and urination symptoms improve soon and stay warm!
DOB, 12/1955
PSA, Date
0.5, 2003; 0.95, 2006; 1.6, 2008; 6.6, 11/2016; 6.7, 12/2016 (free PSA = 11%); 5.6, 7/2017;
6.2, 10/2017
Pca3 = 116 (< 25 normal)
DRE = suspicious ( 11/2016 ) ; Prostate Size = 63 cc.
3TMRI , 3/2017 ; 2 Lesions are PIRADS=4 ; Prostate volume 63.4 ml
BIOPSY 4/20/2017;7 of 14 cores positive 15-70% adenocarcinoma Gleason(3+3)=6;Perineural
Invasion in 1. Dr. Epstein confirmed.

three 5's and a jack
Veteran Member


Date Joined Jul 2017
Total Posts : 519
   Posted 12/27/2017 9:04 PM (GMT -6)   
Thx Busman I hope you do as well as I have been doing.

Roger
Looking for the 4th 5
69yo weight 7/1-283# on 12/18 220#
PSA 6.01 6/17 & 6.07 on 10/11/17 and 5.56 on 11/17/17
BX 8/04/17 DX 8/11/17 5/16 cores positive all on left
L mid/base 4/6 4+3=7 25%
L apex 1/2 3+4=7 30%
Sec opinion from UofW same GS7 but called overall 3+4=7
Markers and scans completed Dec 7/8 Completed SBRT Dec 22 3625 cGY in 5 fractions at Swedish in Seattle Dr. Robert Meier

Jerry_Delaware
Regular Member


Date Joined Jul 2011
Total Posts : 218
   Posted 12/28/2017 6:40 AM (GMT -6)   
three 5's and a jack said...
Hey Jerry......you said "Standard" dose???????.4mg?????


I'm pretty sure I was given .4mg twice per day but this was almost 8 years ago and my memory is fading. [grin].

...Jerry
PCa History: VIEW IMAGE

Tall Allen
Elite Member


Date Joined Jul 2012
Total Posts : 10645
   Posted 12/28/2017 2:57 PM (GMT -6)   
If I remember correctly, those symptoms peaked at about 10 days post-SBRT but were all gone within about 2 weeks after that. I did have a recurrence of those symptoms a year later that lasted longer. That was when I discovered Rapaflo. (I sound like a TV ad).

BTW - if Dr Meier isn't already having you fill it in, I think it's a good idea for patients to track their own progress using EPIC-26:

/medicine.umich.edu/sites/default/files/content/downloads/EPIC-SF-6.2002_0.pdf
/medicine.umich.edu/sites/default/files/content/downloads/Scoring Instructions for the EPIC 26.pdf

Post Edited (Tall Allen) : 12/28/2017 7:46:22 PM (GMT-7)


three 5's and a jack
Veteran Member


Date Joined Jul 2017
Total Posts : 519
   Posted 12/28/2017 6:40 PM (GMT -6)   
THX TA. Yes have a stack of p'work they sent me home with. I will be followed for at least 8 years. Quarterly to start and then back off to bi-annual and then the last 5 years to yearly.

The SBRT was such a non event and my SE's are so mild it is hard for me to understand how the other treatments get anyone to sign up when the recurrence rates are so similar. Thanks for helping me find this TX and the great facility and Doctor.

May all beings be well.

Roger
Looking for the 4th 5
69yo weight 7/1-283# on 12/18 220#
PSA 6.01 6/17 & 6.07 on 10/11/17 and 5.56 on 11/17/17
BX 8/04/17 DX 8/11/17 5/16 cores positive all on left
L mid/base 4/6 4+3=7 25%
L apex 1/2 3+4=7 30%
Sec opinion from UofW same GS7 but called overall 3+4=7
Markers and scans completed Dec 7/8 Completed SBRT Dec 22 3625 cGY in 5 fractions at Swedish in Seattle Dr. Robert Meier

19tarpon47
Regular Member


Date Joined Feb 2017
Total Posts : 185
   Posted 12/28/2017 9:13 PM (GMT -6)   
Hey TA.....I tried to look at the three links you posted (U of M) above and the first one which is the Epic-26 form works, but the last two do not. UM has a note that some of the sites that were previously available have moved but I wouldn't know which of the sites might be the correct one, if any. I particularly would like the scoring info, although I guess that is probably available through Google. I'll check but thought you would want to know about the links. As always, your contributions are invaluable to us all. Thanks.
Dx Age 69 Jan 2017
Prostate at biopsy 27.3 g
BX, core needle biopsy, 3 of 12 cores positive G 3+4=7, L3 left apex 60%, L5 left lateral mid 50%, L6 left lateral apex 30%, and R3 right apex: Focal high-grade prostatic intraepithelial neoplasia
PSA: 01/17.....7.3
Completed SBRT Wednesday, July 26, 2017 at Cyberknife Center of Tampa with Dr. Debra Freeman
PSA: 10/17.....2.5

Tall Allen
Elite Member


Date Joined Jul 2012
Total Posts : 10645
   Posted 12/28/2017 9:50 PM (GMT -6)   
The problem was not the URL, it's the extra code this website added when you clicked on the link. I replaced some of the code. It hope it will work now.
Allen - not an MD
•PSA=7.3, prostate volume=55cc, 8/17 cores G6 5-35% involvement
SBRT 9 yr onc. resultsSBRT 7 yr QOL results
•treated 10/2010 at age 57 at UCLA,PSA now: 0.1,no lasting urinary, rectal or sexual SEs
my PC blog

19tarpon47
Regular Member


Date Joined Feb 2017
Total Posts : 185
   Posted 12/28/2017 10:07 PM (GMT -6)   
Thank you. It is fine now and I just printed it all.
Dx Age 69 Jan 2017
Prostate at biopsy 27.3 g
BX, core needle biopsy, 3 of 12 cores positive G 3+4=7, L3 left apex 60%, L5 left lateral mid 50%, L6 left lateral apex 30%, and R3 right apex: Focal high-grade prostatic intraepithelial neoplasia
PSA: 01/17.....7.3
Completed SBRT Wednesday, July 26, 2017 at Cyberknife Center of Tampa with Dr. Debra Freeman
PSA: 10/17.....2.5

Paxton
Veteran Member


Date Joined Aug 2016
Total Posts : 1105
   Posted 1/1/2018 1:25 PM (GMT -6)   
three 5's and a jack said...
The SBRT was such a non event and my SE's are so mild it is hard for me to understand how the other treatments get anyone to sign up when the recurrence rates are so similar.
Roger


When I asked my RO, given the efficacy and reduced side effects of SBRT, why would anyone NOT choose it if they were going the radiation route, she said that she didn't know, either.

I'm now just over a year out from completion of my SBRT, and have had a few bouts of reduced urinary flow and minor urinary discomfort. They have only lasted a couple of days at a time, and have resolved with only ibuprofen for pain. I haven't taken FlowMax since about week 5 after treatment.

Hang in there. You're doing just fine.
Age 68 at Dx
PSA history: 2000-2012 0.9-1.2; 06/2012 started T replacement
2013-2015 3.0-3.3 (new normal); 11/2015 4.6; 05/2016 5.7
Biopsy: 12-core biopsy 07/2016; 3 cores G3+3, 5% or less; 1 core 3+4, 15%; 1 core HGPIN; 2% of gland involved. Summary G3+4.
CyberKnife SBRT with Dr. Hirsch; start 11/15/16, finish 11/23

three 5's and a jack
Veteran Member


Date Joined Jul 2017
Total Posts : 519
   Posted 1/1/2018 3:43 PM (GMT -6)   
Well Paxton I will say this: If what I am experiencing as SE's are what I can expect for a few more weeks and then even half a dozen times off and on into the future......................... I am a HAPPY HAPPY HAPPY man. Now let's just couple that with a descending PSA and I will be absolutely ecstatic.
Looking for the 4th 5
69yo weight 7/1-283# on 12/18 220#
PSA 6.01 6/17 & 6.07 on 10/11/17 and 5.56 on 11/17/17
BX 8/04/17 DX 8/11/17 5/16 cores positive all on left
L mid/base 4/6 4+3=7 25%
L apex 1/2 3+4=7 30%
Sec opinion from UofW same GS7 but called overall 3+4=7
Markers and scans completed Dec 7/8 Completed SBRT Dec 22 3625 cGY in 5 fractions at Swedish in Seattle Dr. Robert Meier

Paxton
Veteran Member


Date Joined Aug 2016
Total Posts : 1105
   Posted 1/2/2018 9:00 AM (GMT -6)   
three 5's and a jack said...
Well Paxton I will say this: If what I am experiencing as SE's are what I can expect for a few more weeks and then even half a dozen times off and on into the future......................... I am a HAPPY HAPPY HAPPY man. Now let's just couple that with a descending PSA and I will be absolutely ecstatic.


That's pretty much what I bet you WILL experience. Makes for a Happy New Year!
Age 68 at Dx
PSA history: 2000-2012 0.9-1.2; 06/2012 started T replacement
2013-2015 3.0-3.3 (new normal); 11/2015 4.6; 05/2016 5.7
Biopsy: 12-core biopsy 07/2016; 3 cores G3+3, 5% or less; 1 core 3+4, 15%; 1 core HGPIN; 2% of gland involved. Summary G3+4.
CyberKnife SBRT with Dr. Hirsch; start 11/15/16, finish 11/23

Terry's Cellar
Regular Member


Date Joined Mar 2017
Total Posts : 77
   Posted 1/2/2018 6:13 PM (GMT -6)   
I think a lot of men don’t investigate radiation including SBRT as an option simply because they don’t do their homework, don’t understand RT/SBRT and only speak with their Urologist/surgeon. I credit this forum with providing sound information on all the treatment options. The decision you make on treatment can have a profound impact on the quality of your life post treatment.

The burning on urinating during and following treatment was very minor for me and lasted only about ten days. Possibly my good results were due to having good urinary function prior to treatment? I had zero bowel issues during or following treatment...not even a wet fart. Erections and sexual function are great. My wife says she doesn’t miss the wet spot either. So glad I found and elected this treatment.
Rising PSA
11/12 1.98
11/13 1.95
9/15 3.28
10/16 5.94
1/17 3.0
TRUS 1/17
Bx: Three of twelve cores adenocarcinoma Gleason 6 (3+3)
all on left side and <5%, no pni
DOB 7/21/47 good health.
Age 69 @ Dx
Family history uncles both sides.
Treated with SBRT by Dr. Tendulcar @
Cleveland Clinic 6/23/17
PSA 3 months post treatment 1.1
Reduced ejaculate is only side effect. Everything works.

three 5's and a jack
Veteran Member


Date Joined Jul 2017
Total Posts : 519
   Posted 1/2/2018 10:32 PM (GMT -6)   
TC: I was having some minor urinary issues with low pressure before TX. That issue has increased and I also am having some pain, very minor but bothersome, and frequent urination during the day and once at night. My Uro increased the flomax from .4 to 2X .4 daily and gave me something for the pain/burning, it is a yellow dye. Just started today so don't know yet.
Looking for the 4th 5
69yo weight 7/1-283# on 12/18 220#
PSA 6.01 6/17 & 6.07 on 10/11/17 and 5.56 on 11/17/17
BX 8/04/17 DX 8/11/17 5/16 cores positive all on left
L mid/base 4/6 4+3=7 25%
L apex 1/2 3+4=7 30%
Sec opinion from UofW same GS7 but called overall 3+4=7
Markers and scans completed Dec 7/8 Completed SBRT Dec 22 3625 cGY in 5 fractions at Swedish in Seattle Dr. Robert Meier

Terry's Cellar
Regular Member


Date Joined Mar 2017
Total Posts : 77
   Posted 1/3/2018 12:19 PM (GMT -6)   
5's
Although my Dr. wrote a script for Flowmax my symptoms were mild enough that I chose not to take it. Prior to treatment the only urinary issue was some mild urgency that remains the same post treatment. I keep looking for any changes at all; but, so far nothing post treatment. For most low and intermediate risk guys with reasonable urinary function I see little value in 7 weeks of IMRT or LDBT. Surgery remains an option for those guys with lower urinary issues or those that just have to know the full extent of their disease. For me I was comfortable with the Partin Tables assessment that my cancer was local.

When I weighed the side effect risks of SBRT verses surgery it was a no brainer. I totally accept others who may weigh it differently especially if they have researched their options.

I hope your symptoms clear up quickly. Best of luck on future PSA's.
Rising PSA
11/12 1.98
11/13 1.95
9/15 3.28
10/16 5.94
1/17 3.0
TRUS 1/17
Bx: Three of twelve cores adenocarcinoma Gleason 6 (3+3)
all on left side and <5%, no pni
DOB 7/21/47 good health.
Age 69 @ Dx
Family history uncles both sides.
Treated with SBRT by Dr. Tendulcar @
Cleveland Clinic 6/23/17
PSA 3 months post treatment 1.1
Reduced ejaculate is only side effect. Everything works.

Tall Allen
Elite Member


Date Joined Jul 2012
Total Posts : 10645
   Posted 1/3/2018 1:25 PM (GMT -6)   
If the flomax doesn't work for you, try Rapaflo - it worked much better for me. There are half a dozen alpha blockers you can try - everyone reacts differently. Urologists usually get samples from the drug companies. Pyridium, the yellow dye, stains everything permanently. Don't wear with white underwear and sit down to pee.
Allen - not an MD
•PSA=7.3, prostate volume=55cc, 8/17 cores G6 5-35% involvement
SBRT 9 yr onc. resultsSBRT 7 yr QOL results
•treated 10/2010 at age 57 at UCLA,PSA now: 0.1,no lasting urinary, rectal or sexual SEs
my PC blog
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