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Advanced Prostate Cancer
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Salvage Radiation Therapy Question

I am in process of 39 radiation treatments following biochemical recurrence after prostatectomy. Had 24th treatment yesterday. Just had 25th today. Was told that my last 15 treatments would be “more concentrated.” Machine rotated only 2 times instead of 3. I attempted to research on Internet, but found no definitive explanation for this type of treatment plan. So, I’m reaching out to this extremely knowledgeable Group to help me understand. Thank you all very much in advance! Joe

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I just had my 40th yesterday...and, the last 15 were focused on the fossa, rather than the entire pelvis... this seems perfectly standard. And, the concentration actually left me with more energy, less fatigue.

Good luck to you and I.

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Good to know of side effects improvement! What where is “fossa”, exactly? Thank you very much for your reply! Joe

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This is sort of a misapplied term... fossa means "hole"; there isn't actually a hole, but space where the prostate used to reside. If the techs aren't too busy - and, they usually are - they can show you the "plan" the RO, physicist, and dosimetrist devised, displaying it on a screen. Mine did this for me after the plan was created.

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Thank you very much!

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spinosa,

Great to hear you are finishing up your 40th. I start number 1 on Monday. How were your side effects? I know everyone is different, but interested in your take

Thanks

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Not as severe as others I was going through with -still, some urgency to defecate at times, and this was a couple to three times a day. Diarrhea only a few times -others had it constantly -your RO can prescribe meds...also, some frequency with urinating. My doc told me I'd feel burning with both urination and defecation - but, I didn't with either. I was fatigued - each evening, I'd have to rest before dinner...Saturdays, I felt wiped out...

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Got it, yup, that is what my RO said. Hoping the side effects are on the lighter side.

Also, hope you bounce back quickly.

Thanks

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I joked with the techs a few times that I felt as if I were in the placebo group - you feel nothing while the armature makes its revolutions...but, later... oh! The techs advised me to stay hydrated...rectum empty, bladder "comfortable full."

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Should be interesting. I have my marching orders for liquid and other recommendations

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yeah, good - it's a trip - wish I hadn't needed it, but... much learning - and, so many people I met, waiting, were so terribly worse off then I...very sad we can't do better with this disease. I'm writing a short book about the (rather Biblical) 40 days.

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I hear you. Good luck with your treatment, best of luck

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I've had 39 treatments (8 weeks, 5 days a week minus 1 day). I did NOT have any side effects during the actual "FRYING". However years later it was discovered that my left urinary tract has become scarred/constricted and required many "in and out stents" for my kidney and urine. BTW the in and out of the stents were "a walk in the park". No Pain or discomfort. Rad was done at Memorial Sloan Kitterring cancer center in NYC in 2005. After not having a stent in my tract for a few years my Urologist went in to see what's happening this past Wednesday. This procedure was done based upon routine CT scans and a scheduled Ultrasound prescribed by my Urologist. So in went a stent (he also added one in my right side for a kidney stone in my right Kidney).

Just be wary of the damage that Rad can do (even if it's silent).

Good Luck and Good Health.

j-o-h-n Wednesday 03/14/2018 3:06 PM EDT

P.S. One plus is that my naive blow up doll can feel the left stent while we're dancing.

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Thank you very much for the heads up! I’m sure that your dance partner just thinks that you are very happy to see her!

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My dosimetrist explained the radiation plan to me with a graphic of my body before RT commenced. You should ask your dosimetrist!

Bob

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Thank you!

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Did y’all take 4-6 months of ADT while having SRT? Were pelvic lymph nodes radiated also.

Thanks.

David.

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Yes to both, David. Started hormone therapy 6 weeks before radiation, maintained during the 8 weeks of radiation and continued 6 months after radiation. First 25 radiation treatments covered prostate bed as well as pelvic lymph node areas. Last 15 concentrated on prostate bed.

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I went to RO at MD Anderson and RO at Medical College in GA. They both recommended 35 sessions along with 4-6 months ADT. ADT 1-2 months prior to radiation. Where did you get yours done?

Thanks

David

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My surgeon and oncologist is at Houston Methodist. Since I live in Austin, I asked for a local referral for radiation treatments. So I had treatments locally at Texas Oncology. A friend of mine who lives in Denton chose MD Anderson for his radiation treatments.

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I had my surgery at Mayo in Rochester. The RO here is very sharp and was part of study presented at Astro Conference in Oct. 2018 San Antonio. Much more convient here than going to Houston. Just wanted to make sure they were in agreement. Doing lymph nodes does have increased risks. Have have you had any problems with radiation. I took my first 3 month Lupron shot Friday. So far not too bad. No sweats yet. But early.

Thanks

David

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My doc subscribed Bicalutamide (casodex) instead of Lupron (best for me). My radiation side effects included fatigue (naps are good!) and diarrhea (had to hurry home several times after treatment).

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Oh, after radiation treatments, my annual check up by my primary care physician revealed anemia (via blood test).

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