Vmat rapid arc radiotherapy

[Brysonal]

Has anyone got any experience of this? Scans at chemo 1 showed ongoing faint prostatic activity after 3 x Lu-177 and whilst on Degarelix

My primary treatment to the prostate was HIFU so apart from early Lu-177 I have had no radiotherapy to the prostate.

My London RO also has me lined up for radiotherapy to the prostate but said ERBT

20 fractions of VMAT rapid arc being suggested by Finland so would need to get a flat for a month ( commuted so far)

2nd of 3 Docetaxel bombs today.

Finland suggesting HDR Brachytherapy after the 20 fractions so guess that would be all radiotherapy options thrown at it!

Anyone has experience of Vmat rapid arc radiotherapy?

[Nusch]

I‘m doing VMAT currently, two more to go out of a total of 25. I have limited side effects such as fatigue (exercising helps) and digestion (carefully select what and when to eat). I support the therapy with selen, melatonin and Omnibiotic Stress Repair.

[john_in_pa]

I had 23 fractions of VMAT at Fox Chase Cancer Center in Philadelphia, PA. My only side effect was urinary burning sensation towards the end of treatment. Otherwise no other side effects. I worked full-time during treatment and exercised every day. My VMAT was followed up with a HDR-Brachytherapy boost. No side effects from Brachytherapy either other than the urinary burning.

[Nusch in reply to john_in_pa]

I was told to drink a lot of water after each session in order to minimize urinary problems. For me it worked.

[Brysonal]

Thanks both. I am also being recommended a HDR 'brachy boost' after. Need to read up on that one too!

[Tall_Allen]

I had it. It's very popular in the US.

[Brysonal]

Ah..I think only a couple of machines in the UK. I will speak to my London RO for an opinion. She took stampede trial scans and said I could benefit from radiation to the prostate but she was saying ERBT and first mention of a brachy boost but it made sense during the consultation to my none medical brain. Again I think its off plan other than the stampede trial data but not too far off plan!

[NickJoy in reply to Brysonal]

Hi, my husband had 20 sessions plus HDRB x 2 at Docrates from Dec 2021 to Jan 2022 plus SBRT to three lesions. I think they really go for it on the radiotherapy front. He was pretty tired during it all but he was also taking Xtandi at the same time so it is hard to tell which did what. It was tough to be in Helsinki for that long over the Christmas period and very, very cold!!! In retrospect we could probably have had the 20 sessions of radiotherapy completed in the UK but I am not sure if they will radiate to the same extent if you see what I mean. I don't think the UK would ordinarily follow on with the HDB bit but I'm not sure. I think that Docrates are fine about you using them for only one bit of the treatment plan. As you know, Helsinki is a lovely city, accommodation was good and the treatment was made as easy as possible. They even offer you a cognac and the brachy! Dr Kononen is the MO we were allocated and I think that he is really great. My husband had and still has urinary problems from the procedure but these have eased off to a degree. I hope this helps. Best of luck, Nicola.

[Brysonal]

Can I also ask the impact of this radiotherapy/ brachy on erectile function . Currently I am still functional in this respect (easier with tablets but natural also possible even on Degarelix). Would it be game over in this respect?

[ulfhbg in reply to Brysonal]

Hi Brysonal !

Ulf from Sweden and new to this forum but find it extremly good and the members sharing is fantastic and you learn a lot.

I see that you where functional sexually even when going on Firmagon. I’m also one of the lucky ones. My question is more, did you succéed in keeping up your sexual function or did it decrease over time and did you find any good ’rehab methods’ to knep up function and if so what.

A very personel topic but hopefully you can share some insights from personel experiences.

Best regards Ulf

[Aodh]

Volumetric-Modulated Arc Therapy (VMAT) is a newer form of IMRT that delivers external beam radiotherapy through a continually rotating radiation source that encircles the patient.

It makes changes in the speed of rotation, the shape of the radiation field and the strength of radiation. This results in the faster delivery of precisely targeted radiation doses.

These RapidArc linear accelerators were the machines used in my treatment in Dublin in 2020. I can’t believe that you would need to go to Finland to access treatment. I had to have a more conventional approach to the delivery of my treatment i.e. 39 sessions instead of 20 as I was having treatment to my pelvic lymph nodes as well as my prostate.

I was treated at St. Luke’s Radiation Oncology Centre, Beaumont hospital in Dublin. They had 4 RapidArc linear accelerators in constant use all day every weekday.

There’s bound to be the same equipment available in the U.K. I believe that there is a reciprocal agreement between the NHS in the U.K. and the HSE in Ireland if you need to avail of it. A lot of planning went into my treatment (behind the scenes) including the usual CT scans with contrast and MRIs etc. but it took about a fortnight and then was scheduled for daily (Mon through Fri) sessions.

I had to have an empty bowel and full bladder before getting on the machine and they checked regularly that I was ready using the inbuilt CT scanner on the linac.

The worst aspect was the daily driving for 8 weeks, I found that very tiring.

Cancer treatment is free in Ireland.

I hope that helps.

Hugh

RapidArc linear accelerator

[j-o-h-n]

RapidArc linear accelerator

Runs on 3 B sized Duracell batteries.

Good Luck, Good Health and Good Humor.

j-o-h-n Tuesday 03/29/2022 7:37 PM DST