Need advice for organ damage control ... - Advanced Prostate...

Advanced Prostate Cancer
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Need advice for organ damage control during RT

Karmaji
Karmaji

Dear Friends....I am on Firmagon since 2 months.

.(aged 79.. GL 8 T3B...small oligo metastases on 2 points in pelvis... not seen in Bone scan but seen in Choline and MRI.....° no pain anywhere)

will be starting RT in 2 weeks.

I seek some advice on Diet choice and other precautions to take during IMRT.....

Do not know yet if I will have 20 or 40 sessions... around 2 GY

10 Replies
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No dietary changes are needed for pelvic metastases.

It is best done in a single session:

pcnrv.blogspot.com/2019/08/...

Karmaji
Karmaji in reply to Tall_Allen

Thanks Tall Allen....caring as ever

In my case... prostate is there...

GL8 plus 2 spots in Pubic iliac wing...

So RO will do anatomic verification....

If favorable

60GY prostate/3Gy 48 boost vesicule seminal plus 2 lesions of Ilio

==========================

If unfavorable....(do not know what is means....as we have MRI and Choline Pet..RO has not seen the MRI)

46Gy/2GY Vesicule seminal Right

64/2GY vesicule left

46/2Gy on secondary bone spots

76/2GY on prostate...

==========

So lot of fireworks......

Any remarks will be of great use....

A bit lost in this jungle of IMRT...

Mr RO is very accessible...

Tall_Allen
Tall_Allen in reply to Karmaji

He is saying that the dosimetry will depend on your anatomy and the location of the bigger lesions on the MRI, which is appropriate. Exercise a lot.

Karmaji
Karmaji in reply to Tall_Allen

No problem exercise... 61 Kg BMI 19...lot of trekking....

No other health problem...

Right now no symptom due to prostate cancer except on scans....

Strange is this disease...

GL 8 T3B Oligo metastsases....

With Firmagon... no symptom...some hot flashes ;;very pleasant feels like sauna....

My URO says your mind is telling me all that....

Afraid for organ damage....that is where Tall Allen comes in....

Does MRI give more information of anatomy for dosimetry

RO have not seen it yet....

he knows locations of mini lesions thru Choline

I am followed by Prof Olivier Cussenot.. a top prostate Oncologist of Paris....He listens does not talk much....works on Prostate Genome... PROGENE project....

PC is there but seems like a strange renter....I am feeding him but why he wants to kill the feeder to suicide him or her self ...or the feeder....

Seems like a strange way of me suiciding.....

Tall_Allen
Tall_Allen in reply to Karmaji

They used to fuse a CT and an MRI, but CTs have improved so much that some are just using CTs alone for contouring.

Karmaji
Karmaji in reply to Tall_Allen

That is what RO SAYS...

For metastases spots he say he will superimpose Choline Pet scan image to hit the lesion.....

Thanks for your caring....a human heritage

There are some good threads on IMRT prep:

healthunlocked.com/prostate...

I finished IMRT in August, the challenge was showing up with a full bladder and empty colon. My sessions were midday, and I had to start drinking water about 2 hours before the appointment. Also it helped to mix in some electrolytes to increase the kidneys filtration rate. The uncomfortable part was getting in the car with a full bladder and driving 20 minutes to the tx center. On cleaning the colon, I found that eating a cup of beans every day after treatment, which helped soften my stools, and allowed me to have regular BM's. On diet, they should tell you to stop antioxidant supplements like Vit C/E during treatment which may actually protect cancer cells from radiation. But do eat your normal diet with lots of greens to protect normal cells. One supplement I did take was Berberine after I read a study supporting it making cancer more sensitive to radiation:

diagnosticpathology.biomedc...

Hidden
Hidden

I am afraid I go against the grain when it comes to aggressive radiation in the pelvic area without very very very good reason. The usual reason is to "get it all!" which is a lie based on old concepts - it is already Stage IV in hundreds of places, but too small to show up in scans. Using that flawed logic, you need to blast the whole body.

In the usual progression of events, these cancer nodes in the pelvic area will repair themselves over a period of months and become scar tissue. So ask the questions: Why are we doing this? (Money?) What will happen if we skip this step? (Probably nothing bad when you look back a year later!)

Radiation does have permanent and serious side effects which only show up a year or two later - bladder and bowel problems, and later secondary cancers from the radiation.

For those who insist on getting blasted, using Sodium Ascorbate IV immediately after the radiation "hits them when they are down" and greatly increases the kill from each treatment and also reduces short term side effects. Which means you can cut the number of treatments by up to 70% (and/or reduce the radiation dose each time) to get the same net effect, which means you are far less damaged afterwards.

If your guy puts up a fight, perhaps time to look around for a practice with a more integrated approach. Seems like you need to do some more homework as well to make a more informed decisions. Good luck on your journey!

Very interesting

But I did not understand

RO wants to irradiate prostate...

He will do scan and identify

Anatomy...of prostate...

Then propose Protocol

.....

So please let me know how to handle it...

My oncologist uro and Ro

Are agreeing...to it....

Thanks

A couple of thoughts. You want to have your internals in the same condition at every treatment. Full bladder, empty bowel.

Full bladder: Stop drinking all fluids about 2 hours before your appointment. You can experiment with the amount and timing, but I found that drinking about 14 ounces of water 40 minutes before the appointment was just right. It took me a couple of weeks to fine-tune that timing and amount. If you have some time, you can find your own optimum. The only time it was a problem was if something unusually delayed the treatment!

Empty bowel: That includes "gas". During the week of treatments, I avoided all foods that are "gassy" (salads, beans, etc.), no carbonated beverages at all. Also, since radiation irritated the urethra, I quit coffee too. Again, with some effort you maybe able to train your "system" to eliminate when you need to. Go earlier, delay an hour or two, but over the course of 2-3 weeks you may find you can time yourself to be empty before the treatment time.

These are fairly important efforts. You want your system in the same condition each time so they can accurately design and deliver the treatment field.

Good luck!

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