side FX Radiation post and after

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flippin out
Regular Member


Date Joined Mar 2006
Total Posts : 137
   Posted 10/29/2007 2:40 PM (GMT -7)   
After little o r no side FXs wth Davinci
what can one expect with Radiation ! weather Proton or Tomo ?
 
 
 
 
Davinci 4/06 minor side FXs  none to realy speak of :one positive margin
17month PSA .1 18 Month PSA .2
   Radiation advised sad

Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8122
   Posted 10/30/2007 10:53 AM (GMT -7)   
It's an easier ride than the surgery. And surgery for me wasn't bad, either. My last treatment was Aug 3. I am only 2 and a half months out and just 8 months post Davinci. While I am mentioning it I am into HT for nearly 6 months. I am actually doing well at this point. I did something religously after my daily treatment. Walked about 3-4 miles. Then walked alot at work too. I think I would subscribe to the notion that the best way to avoid side effects, is walking. After davinci I walked 1 mile. two miles, 3 miles, within 2 weeks of treatment. I also stepped it up to 6 miles and a couple 11 mile walks. I used Zion National Park and Southern Utah as my motivation but I was doing some very strenuous hikes within 2 months. That territory is a site to behold...God's country as I call it. Don't sweat the radiation. Just try to get your excercise regimin to a healthy pace. I took the second slot of the day. I was in and out of the clinic by 8:00am. My job was flexible enough to allow me the time it took to get through this, so I walked after treatment everyday but was able to be at my desk by 9:00am. Then I would go to my customer sites (Las Vegas resorts) and each site would add almost 2 miles in walking just in and out of their offices.
 
Tony


Age 45 (44 when Dx)
Pre-op PSA was 19.8
Surgery on Feb 16, 2007
Post-Op Pathology was poor: Gleason 4+3=7, 4 positive margins, Stage pT3b (Stage III)
HT began in May, '07 with Lupron and Casodex 50mg
IMRT radiation for 38 Treatments ending August 3, '07
 
My PSA did drop out after surgery to undetectable.  It has not returned and I will continue HT until January '08.
 
My Life is supported very well by family and friends like you all.
 
STAY POSITIVE!


sterd82
Regular Member


Date Joined Sep 2006
Total Posts : 187
   Posted 10/31/2007 6:58 AM (GMT -7)   

I did 36 sessions of IMRT along with 6 months of HT....   about half way thru the RT session, I noticed I got tired at night.   Tony is right, exercise will help this A LOT.....I think my experience was fairly typical:

Toward the end of my treatment, I had some urinary discomfort, and some rectal issues (discomfort, minnor bleeding) -- all very treatable.  I also had some bowel irritation.

Eight months later, I have had some ongoing issues with stress incontinence --- that kind of comes and goes --- I play jazz gigs on the weekends and lug a fairly heavy keyboard around --- that lifting seems to set things off.  Keigels help get things back on track.

Hormone Theapy is often recommened along with RT --- I had two Zoladex shots at three month intervals.   about 5 weeks into it, I started experiencing hot flashes, and had a complete loss of libido.   Eight months later, my hot flashes have settled down (but not disappeared), but my libido remains low.  My doc told me it can take several months for the testosterone to start kicking in.....HOPE this helps---good luck!

 


Sterd82
Age 47
Open Radical Prostatectomy 6/9/2006
Pathological Stage T3a, Positive Surgical Margin
Gleason 3+4
PSA rose to .24 in November of 2006
6 month hormone therapy initiated December 1. 2006
36 sessions of IMRT Ended Feb 1, 2007
PSA as of May 25, 2007 undetectable
Next PSA November, 2007


Dutch
Regular Member


Date Joined Feb 2007
Total Posts : 400
   Posted 10/31/2007 12:24 PM (GMT -7)   

Mjr:

While taking the proton treatments you should not have any problems - a few have side effects of tiredness towards the end.  They want you to exercise as much as possible - at Loma Linda they give you free access to a great gym on campus.  After treatment one of the minor side effects could be some rectal bleeding - happens in about 25%.  All in all it is a very easy tolerated treatment.

Dutch


Diagnosed Feb 2001  (Age 65)  Currently 72
PSA 4.8      Gleason 3+3=6      Stage   T2b
Completed Proton Therapy @ Loma Linda - Aug 2001 - No side effects.
6yr PSA - 0.19
Our responsibility now is to educate men about Pca, PSA and the importance of early detection. 
 
 
 


sterd82
Regular Member


Date Joined Sep 2006
Total Posts : 187
   Posted 10/31/2007 8:50 PM (GMT -7)   
Tony hit on an important point on a different thread on the difference between proton and IMRT radiation in treatment for PC.  I live in Indiana, and we have a proton facility at IU --- about 3 hours from me --- this was a viable option in that my work would not have suffered had I had the therapy there....  I think if I were using radiation as my PRIMARY therapy, I'd look seriously at proton, but for adjuvant or salvage therapy, I opted for IMRT for cost and convenience.  Plus, I wasn't too worried about side effects....I have no idea if proton offers a better chance to retain potencey in a salvage therapy environment (I had non-nerve sparing surgery due to tumor volume, so potency was already off the table)....  My conclusion was that IMRT in a salvage/adjuvant setting was so much easier, and really didn't prove to be very nasty.
Sterd82
Age 47
Open Radical Prostatectomy 6/9/2006
Pathological Stage T3a, Positive Surgical Margin
Gleason 3+4
PSA rose to .24 in November of 2006
6 month hormone therapy initiated December 1. 2006
36 sessions of IMRT Ended Feb 1, 2007
PSA as of May 25, 2007 undetectable
Next PSA November, 2007


Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8122
   Posted 10/31/2007 9:20 PM (GMT -7)   
mjr, This is the post sterd is referring to.

You should be searching for the differences between Protons and Photons. Protons are very expensive to create and it is done so through a proton accelerator. The object using protons is that the energy is released inside the body using a process called ionization. When the protons are being delivered they actually penetrate your skin and facia tissue before the radiation is released. Proton treatment centers boast that there are less side effects and they can deliver a higher gray than external beam photons. Proton technology is about 17 years old in the medical field and is very effective at treating certain cancers, including prostate cancer. But, things have changed in 17 years and the newer technologies in radiation are 3D Tomo IMRT and IGRT. This does not mean they are better but they are equally as effective at a much lower cost and can now deliver the same gray without damaging healthy tissue. 3D Tomo is a newer device that includes a CT scan during treatment and allows the technician to physically point the delivery of the photons realtime. What makes this technology better is that the human body and its internal organs shift. Your bladder, prostate, and rectum for instance might be in adifferent shape from one day to the next. Thus your body changes but the radiation does not change in conventional treatment. With 3D Tomo you can physically see the target and better point the gun so to speak. This image guiding technology is the wave of the future and will allow better tools to deliver radiation. Both methods are equally effective at treating cancer. I was surgically treated at City of Hope and it is a world class cancer center. In my case there was no way that radiation would have been an effective choice as a primary treatment. Radiation for me was a decision that came after surgey. And I may have decided to use protons but for the fact it was highly inconvenient. I would have had to taken a break from work and stayed in southern California for nearly two months. 3D Tomography is readily available at far more centers and allowed me to keep working.

Tomo:
http://www.tomotherapy.com/patient/process/

Proton:
http://www.proton-therapy.org/howit.htm
Age 45 (44 when Dx)
Pre-op PSA was 19.8
Surgery on Feb 16, 2007
Post-Op Pathology was poor: Gleason 4+3=7, 4 positive margins, Stage pT3b (Stage III)
HT began in May, '07 with Lupron and Casodex 50mg
IMRT radiation for 38 Treatments ending August 3, '07
 
My PSA did drop out after surgery to undetectable.  It has not returned and I will continue HT until January '08.
 
My Life is supported very well by family and friends like you all.
 
STAY POSITIVE!


jwb187
Regular Member


Date Joined Apr 2007
Total Posts : 101
   Posted 11/1/2007 4:14 AM (GMT -7)   
Mjr,

I just finished 35 IMRT treatments with the Novalis shaped beam. I like Tony walked daily during my treatments (3 miles) and I had no physical problems with the treatments. I felt briefly like I was a little tired in the evenings, however that went away after a couple of days. I was sort of expecting maybe a little nausea and especially fatigue but thankfully none of that. I like Tony have locally advanced disease that has escaped the prostate capsule. Mine had invaded one seminal vesicle and I had a positive surgical margin. My Oncologist strongly suggested radiation therapy after my recovery from surgery and I also am on Androgen therapy and have been taking Lupron since June. Fortunately I have not had many side effects with that either. I hope that you come along as well as I have.....good luck. Jwb.
age: 61
PSA 4.57 - Positive DRE
Biopsy 3-19-07 - Gleason 4+4=8
Negative bone scan 3-20-07
DaVinci 4-24-07
Catheter out 5-01-07
post op pathology:
positive margin left side of prostate
left seminal vesicle involved (both removed)
No lymph node involvement
New gleason score 9
T3B....radiation consult on 5-9-07.
June 5, 2007 1st psa post surgery 0.62
June 27, 2007 second psa post surgery 0.59
June 27, 2007 started Lupron injection (24 mos)
September 6, 2007 scheduled to be marked and prepped for radiation therapy.
Start IMRT therapy on September 13, 2007.
September 26,2007 psa test .08
Finished IMRT therapy October 31!!!
Finished 35 IMRT treatments 10-31-07


mgl
Regular Member


Date Joined Feb 2007
Total Posts : 122
   Posted 11/1/2007 4:22 PM (GMT -7)   

I just completed 37 IMRT treatments (radiation) last friday

I had DaVinci surgery last april,

The only side effect I had from radiation was  a irritated rear end some days

other than that I felt fine and did everything I did before radiation


50 years old
gleason 3+4=7 psa5.8 clinical stageT3a
Da vinci surgery April10 2007 Mayo clinic Rochester, Mn.
extraprostatic extension Gleason -same
pelvic lymph nodes -negative
Catheter out April 19
37 treatments IMRT ended 10/26/07


flippin out
Regular Member


Date Joined Mar 2006
Total Posts : 137
   Posted 11/5/2007 12:19 PM (GMT -7)   

thank 'YUs all around.

   I have a decision to make. My situation is that I have the choice to have the Proton Or whatever they may decide At Loma Linda or the Helical Tomo therapy at the City of Hope Insurance Covers Loma , Covers only the Hospital portion at the City of Hope. Cost not being the main factor travel not much difference I was lead to believe Proton is the less exact method in comparison as with Tomo they are constantly monitoring any movements, If I understand it right

 

 
 
 
 
 
Age 56
open Radical Prostatectomy 4/25/2006
Pathological Stage T3a, Positive Surgical Margin
Gleason 3+3 or 3+4 or 4+4 depends on who ya talk to ?
PSA rose to .1 in September 07 4weeks later .2
 

Dutch
Regular Member


Date Joined Feb 2007
Total Posts : 400
   Posted 11/5/2007 3:36 PM (GMT -7)   

Mjr:

Both Proton and Tomo scan before treatment is administered.  You said Tomo is "constantly" scanning - does this mean that as the machine is spinning and couch is moving you are being scanned constantly?  The difference between Proton and Photon (Tomo) is that Proton radiation stops at the area to be treated and Photon continues on thru the body (has exit radiation).

Best wishes on the choice best for YOU.

http://www.proton-therapy.org/documents/!Proton%20vs.%20IMRT%20PAACT%2003-07.pdf

 

Dutch 

 


Diagnosed Feb 2001  (Age 65)  Currently 72
PSA 4.8      Gleason 3+3=6      Stage   T2b
Completed Proton Therapy @ Loma Linda - Aug 2001 - No side effects.
6yr PSA - 0.19
Our responsibility now is to educate men about Pca, PSA and the importance of early detection. 
 
 
 


Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8122
   Posted 11/5/2007 9:37 PM (GMT -7)   
When we refer to constantly scanning it's more of an aim before you shoot. Both IMRT and proton treatment go through MRI and CT scan and a cast created before treatment. And then we get our tatoos. Those dots that line us up before the treatment begins. And of course before each and every treatment the laser lights are aligned to the dots and the technician goes behind the led walls and hits the fire button. Imagine that you move before the button is pushed. Is it possible that your rectum or something else gets the photons or protons? Of course it is. Thus the 25% side effects even with protons. But also add the physiological part. The day your are casted in the begining and the dots placed, might not be the same physiologically as you gain weight or lose it, or even that I have had more dinners last week than the week before. The point is that our bodies our constantly changing inside and out. Using the old IMRT with seven positioning angles, protons are probably better for less side effects. With IGRT and Tomo, the crosshairs of the radiation are pin pointed internally in front of each treatment from the images of the organs as you lie on the table. This science is impressive. There is entry and exit points, but there are up to 53 points that are very carefully mapped to hit the disease and the tissues around, and miss the organs that don't tolerate it well. Which is better Protons or IGRT/Tomo, probably none. When protons came out EBRT was the competition and no way. protons before EBRT. IMRT closed the gap and is very tolerable at a hundreth of the cost of the equipment. Tomo and IGRT are the latest technology along with cyberknife. But IGRT and Tomo are making the experience better for patients if for nothing else equally fighting cancer as protons, and available at perhaps 80 places as opposed to 5 places in the country. I am wondering when the or if the proton systems can be improved with this technology. My friend went to Loma Linda and he has the tatoos, they basically lined him up and fired at him. If protons or tomo were available at the same center and they say "get in"...I'd feel just as safe either way. But then I had the seven angle IMRT and have no side effects.  And whats more...Why would I want to go down to sunny southern California and stay at my sisters beach house in Laguna a couple months while all those bikinis were going by just so I could have protons hitting my prostate?  I rest my case!  It's torture!  I stayed here in 115 degree Las Vegas getting hit by IMRT while on HT.  :-)

Tony


Age 45 (44 when Dx)
Pre-op PSA was 19.8
Surgery on Feb 16, 2007
Post-Op Pathology was poor: Gleason 4+3=7, 4 positive margins, Stage pT3b (Stage III)
HT began in May, '07 with Lupron and Casodex 50mg
IMRT radiation for 38 Treatments ending August 3, '07
 
My PSA did drop out after surgery to undetectable.  It has not returned and I will continue HT until January '08.
 
My Life is supported very well by family and friends like you all.
 
STAY POSITIVE!

Post Edited (TC-LasVegas) : 11/5/2007 9:46:03 PM (GMT-7)


Cedar Chopper
Regular Member


Date Joined Mar 2007
Total Posts : 432
   Posted 11/6/2007 4:59 AM (GMT -7)   
Dutch & Tony & PCDAVE and/or any Radiation Techs and Imaging Techs,

I'm unclear about the term "TOMO?"

I thought 
  -Positron Emission Tomography (P.E.T. - pioneered in neurology reseacrh) was just an imaging technology
                  -developed shortly before:

   -Nuclear Magnetic Resonance Imaging (MRI - The "N" of NMRI was quickly dropped as misleading as it is not "nuclear" radioactive but rather exciting atoms with magnetic waves and the computer enhanced imaging of their predictable reaction with a modulated low power FM radio wave broadcast.)   
                   - and I assumed:

   -CAT (Computer Assisted ?Tomography???) scans use x-rays.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
This is to ask, if TOMO is a description of the imaging process, 
   *What type of radiation is used in this process? 

My physics classes were long ago!  I know Proton Beams radiate non-radioactive-decaying protons.  (I think maybe Proton Beam technology is more similar to HIFU than is discussed.)
   *What is emitted in the X-ray of the CAT scan?
   *What is emitted in the radiation of the IMRT?
   *What is emitted in "TOMO?"

Thanks to all of you for keeping up with this rapidly changing topic  - and sharing.

CCedar
ICTHUS!



2 Years of PSA between 4 and 5.5  + Biopsy 23DEC06 
Only 5 percent cancer in one of 8 samples.  +  Gleeson 3+3=6
Radical Prostatectomy 16FEB07 at age 54.
1+" tumor - touching inside edge of gland.  + Confined:)
Pad Free @ 14 weeks.  Six Month PSA <.003  :)
At 6 months, ED treated with Pump Exercises & 50mg Viagra Daily
Texas Hill Country FRESH Produce Department Manager
Have you had your 5 colors today?

Post Edited (Cedar Chopper) : 11/6/2007 5:03:35 AM (GMT-7)


Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8122
   Posted 11/6/2007 10:28 AM (GMT -7)   
Hi Cedar,
The link below thourly describes the Tomotherapy system. It was first released for use in prostate cancer in 2005.

http://www.cityofhope.org/radonc/helicaltomotherapy
http://www.cityofhope.org/Media/ReleasesMedSci/TomotherapyRadiationTreatment10-29-04.htm

Tony
Age 45 (44 when Dx)
Pre-op PSA was 19.8
Surgery on Feb 16, 2007
Post-Op Pathology was poor: Gleason 4+3=7, 4 positive margins, Stage pT3b (Stage III)
HT began in May, '07 with Lupron and Casodex 50mg
IMRT radiation for 38 Treatments ending August 3, '07
 
My PSA did drop out after surgery to undetectable.  It has not returned and I will continue HT until January '08.
 
My Life is supported very well by family and friends like you all.
 
STAY POSITIVE!

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