I am new to the forum, and I expect to begin Radiation Therapy in March or April after two months of ADT. Among the many disturbing aspects of the treatment are the side effects of RT.
Can anyone direct me to info on the risk of RT damaging the colon, bladder or rectum and then requiring even more disturbing procedures to fix the damage?
Also, will RT increase the incontinence that resulted from the 2007 prostatectomy?
Did you have a PSMA PET/CT before settling for sRT?
I will have the PCMA-PET in early Feb.
Good news…maybe. The PET PCMA found no detectable localized or distant cells. Maybe those bad boys vanished, or too few are at the party for the PET scan to light up. Perhaps more cancer will grow and become detectable over time. Since my PSA continues to rise.. about 0.4…ADT and RT seem reasonable for treatment.
Definitely good news!
Your upcoming sRT has now ~15% increased chances for a 3 yr. Freedom From Progression (FFP).
...."Overall, FFP was achieved in 64.5% (120/186) of those who received sRT, 81% (81/100) with negative results or fossa-confined findings versus 45% (39/86) with extrafossa disease (P < 0.0001). On logistic regression, PSMA PET was more independently predictive of FFP than established clinical predictors, including PSA, T stage, surgical margin status, or Gleason score (P < 0.002). Thirty-two percent of men with a negative PSMA PET result did not receive treatment. Of these, 66% (19/29) progressed, with a mean rise in PSA of 1.59 ng/mL over the 3 y. "...
pubmed.ncbi.nlm.nih.gov/316...
There is also a study from Italy, that I can't find it now, leading to similar conclusions. If memory serves, in this study negative results were a class of their own (in the quoted one negative plus local findings were combined) and the number was a bit higher, off the top of my head, ~20% .
Would this be salvage radiation to the prostate or something else?
I can’t direct you to info but for me, after IMRT to my prostate, 28 sessions, and 28 sessions of IMRT to my para-aortic lymph node string I developed great difficulty in passing stool and need to use prunes and Metamucil to fix the problem. I also developed itchy rashes on my back and torso. Can’t say for certain it’s from the radiation but that would be my guess. Not things I can’t live with.
Late-term rectal injury is very rare. Bowel injury is only a concern if you are having whole pelvic radiation. It is usually not a problem.
If you are already suffering from incontinence, it may get worse. Not much choice but to deal with it if it happens.
You always give great answers and right to the point. Thanks
Thanks for your insight. I'll get a PCMA-PET Feb. 7 and that may show the extent of the RT I will need.
Everybody's body is different and you'll have to find out what yours does the hard way. I am 2 years from the start of my 44 treatments and so far all is good.
Welcome teaker! Please don’t predict this on yourself. Unless you already have some issues? With the colon . I did 8 weeks imrt over six years ago. I had tubes into my kidneys and complications that you don’t have. I had fatigue and all of the other common side effects. The best side effect for me is life itself. This worked for me.I hope that It will work well for you. You’ll get proper info here. Good luck ! Scott 🏜
Your colon will likely be fine. Any incontinence will probably either remain the same or worsen. A number of good options for that though.
Thanks for your reply. Incontinence is annoying, but manageable. I see both slings or artificial sphincters are often recommended.
Had Pelvic Radiation 2 years ago Keep colon empty as possible You will get through it Stay as active as possible and stay as positive as you can you will get through! It is not that bad at all
Exact sharp cut! Dont go in with a t-bone and baked potato aboard. I fasted two treatments day per imrt week .
You can't directly control the possibilities. With modern technology, the odds are in your favor of not having extremely negative side effects. Maintain a consistent routine with your bowels, fluid intake and diet during the entire treatment. Try to find a state of mind to control anxiety. The sessions are painless and quick. The medical staff is considerate and professional. Get to know them as individuals. They will be part of your family for a couple of months. As much as I hated it, I gave up all caffeine and it truly helped reduce frequency and bladder discomfort.
I had SBRT (CyberKnife) treatment six months ago. Five fractions over 10 days. Like 6357axbz reported above, I developed constipation after the treatment. But I attributed that to the low-fiber diet my RO put me on in advance of the treatment. Once I resumed a normal diet plus prunes, the constipation gradually went away. But I, too, experienced difficulty passing stools.
Request spacroar gel inserted to protect rectal issues
Thanks for tip.
I'm reading the thread 4 days late but saw this comment. My husband had a simple prostatectomy (not radical, as I suspect you probably had) in 2014 because 11 years of TRUS biopsies had been negative. Three years later, PSA gradually rising, we knew he needed ADT and RT. I began turning over every stone to get SpaceOar for him. The manufacturer's customer relations employee told me that there are radiologists who will use SpaceOar on post-prostatectomy patients, but she would not so much as give me hints on where to search. In the end, I could find none no matter how many calls I made. We finally ended up consulting two NCCN radiologists who strongly advised against the use of SpaceOar after the prostate has been removed. Their reasoning was that 1) the prostate holds SpaceOar in place during RT and is not "available" to perform that function after prostatectomy; and 2) the SpaceOar gel is meant to dissolve. If there are PCa cells in the gel as it dissolves, off they go into the body. They both had another reason, but in the interests of not creating conflict with those who have used it successfully, I'll not state it. In the 8 years since my husband had his simple, I have not seen one case where SpaceOar was used at salvage RT. If this statement is wrong, I will hear about it. Both radiologists' reasons and reasonings were identical.
There is another SE that can happen (it is rare). With ADT and radiation you can have the SE of shrinkage.
I had srt last year, 70 gray, 35 treatments with no issues. I had to have my bladder full and colon empty. The technicians will let you know if your bladder isn't full enough.
Had RP in 2015, 31 external beam radiation treatments 2015 and two yrs ADT. The radiation targeted pelvic region as the cancer had breached my prostate capsule. I had a bit of a rough go with it as it landed me in the hospital for 10 days with a badly beaten up small intestine. I was litterly ‘crapping’ myself into oblivion and ate jello for 10 days…..red, green and yellow! What made this even more interesting is that my oncologist said that he’d never seen such a reaction and therefore thought I had some underlying problem such as Crohn’s disease that the radiation unleashed. Gastroenterologist said no Crohns, etc!! I asked the oncologist if the physicists who do most of the calculations could have miscalculated. As expected, onco said, ‘no way’. Anyway, a year later I was peeing full on blood that required my bladder to have a fulguration (cauterization) of a damaged spot. Also had some minor rectal bleeding. Years on…all is good but the initial year plus wasn’t so great. We are all different so don’t take my journey as a some sort of common event. I am however left with the really unanswered question, “was there a miscalculation made” that caused my radiation problems? We will never know. In any event, I have just started ADT again as my PSA is rising rapidly.
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