Any strategies for minimizing side effects of IMRT Radiation or making therapy more effective?

[Scout4answers]

Starting IMRT radiation in 2 weeks.

VMAT 20 sessions

[Brysonal]

I finished my 20 yesterday. I’ve had a couple of days when I needed to run for the loo and gone through more toilet roll than usual but it’s not been too bad. I have found a banana and Skyr yoghurt for breakfast and a rice and protein dinner has helped me!

I was on Degarelix throughout of course with ADT meant to help its effectiveness.

Overall it’s not been a problem and I’ve worked and lived life throughout the 20 sessions.

Good luck!

[Scout4answers in reply to Brysonal]

Happy to hear of your good response to radiation. I stocked up on TP at Costco last week.

[Mischa1111111 in reply to Scout4answers]

Same here!!!😀

[Hidden in reply to Brysonal]

Oh yah! 👏🏼👏🏼👏🏼💪

[rogerandme]

Had 20 ebrt to debulk prostate in September 2021. Only complaint was trouble urinating which RO said was do to inflammation. Flomax and advil helped... some discomfort in rectum but not to bad...9 months later feel great no bowel problems and flomax keeps it flowing...feeling great.

[treedown]

Be careful what you eat, avoid foods that cause gas. I changed my diet because most of what I eat regularly causes gas. I had a routine to arrive early and get into a relaxed state and refill my bladder. It was uneventful in every way. My radiation was more than whole pelvic, it extended up to the aortic bifurcation. They gave me Zofran for nausea which I didn't like and was able to stop when it became evident I did not need it at about 24th. Others there at the same time clearly had it harder based on the looks on their faces on exiting. Hopefully yours is as uneventful as mine.

[Tall_Allen]

Yes, exercise heavily! Oxygenated cancer cells are more easily killed by radiation and healthy cells are better protected. Exercise also prevents fatigue. I hit the gym for 2 hours every day during RT.

[Scout4answers]

Thanks smurtawFor Tons of info !

Exercise statins and melatonin high on my list will wade through the rest do some actionable ideas

[Mischa1111111]

I am doing ADT concurrently with my IMRT treatment . Im only 10 treatments in and have slight burning when urinated and i am unussually constipated since treatment and change of diet began . No gassy foods/ beverages , no fried foods or sugars I started excercising 2 weeks before treatment

[Mischa1111111]

I think you covered it all!!! Hadn't a clue about the statins till now. Thanks!

[Mischa1111111]

I've been doing 45m + cycling back and forth from the treatment center. Thanks for the tip!

[Aodh]

As many have said, exercise daily. Become well hydrated before and during the radiation treatment. If you can, sip at least 1 litre of water each day prior to treatment and another 1 litre throughout the day afterwards. I say sip, as that way you’ll achieve good hydration i.e. the water will remain inside you; gulping it down or drinking briskly won’t hydrate you, you’ll just pee it out just as quick.

Also having a full bladder helps ensure that the prostate is positioned properly so as to receive the maximum hit from the radiation.

My radiation oncologist team were insistent upon this and ran a CT scan just prior to giving the radiation daily to ensure compliance and appropriate positioning. Apart from hating that I had to sip / drink so much each day, I did benefit; I felt more awake and alert and better within myself, so I continue to try to keep myself well hydrated. It’s still hard to consume 2 litres of liquid a day as I was astonishingly dehydrated for years if not decades!!

I found the daily round trip to the hospital, 2 hours drive each way very tiring; if you can get help with this aspect it will help your mental health enormously.

Make sure that you carry good reading material so that you don’t get bored waiting, Linacs breakdown often causing delays sometimes of an hour or more. Bring something to eat on the way home, it’ll cheer you up.

I did have some minor urinary urgency issues from week 6 onwards, but the oncologist nurse suggested that I take 2 Solpadeine at night, which I did for a few weeks, and the issues stopped by day 3.

I was on both Zoladex and Casodex before during and after radiation. Apart from reducing the target size, ADT makes cancer cells more sensitised to radiation. The doc said that, I’ve no way of proving it or otherwise! The ADT blockade took my PSA down from 87 to 0.51 prior to starting radiation. Since completing radiation including pelvic lymph nodes in’20 my PSA fell to undetectable <=0.08 and has remained there ever since.

I wish you the best for your treatment.

Hugh

[Concerned-wife]

Other than temporary urinary urgency, my husband had no side effects. We did walk each day. It was the bowel and bladder prep that was a bit tricky. The guys gave you some tips. He struggled with constipation during this, not urgency, probably because eliminating gaseous food.

[London441]

Don’t move! 😀

But seriously, everything has been covered by these fine gentlemen.

Don’t slow down. Nothing about IMRT that should cause you to need to. If you’ve seen any of my posts or replies most of it is exercise-centric. Nothing is more important, and not much is as important.

Full bladder/empty bowel was the mantra they gave me, I suppose that hasn’t changed. Timing of the hydration is everything. If you start early you won’t have to play catch up when you get there.

They also pitched a low fiber diet, but it was a list of things I don’t eat, and it only made me constipated. Compromise was reached when they said just please leave out the kale lol.

You’ll be fine, your attitude is on the far side of positive 👊

[mjtct61]

Im on 2nd week of IMRT and I have slow urination problem. On Flomax but hoping there is other options. The nurse had no suggestions other than adding some Advil. I dont have any pain just slow flow and it is annoying when using public restrooms.

[Hidden in reply to mjtct61]

No pain is great!

Hang in there guy! It takes toll on us. But hopefully It will knock out the pc! I’m pulling for you bro! I was born in 61 and I’m 61 now!

[Hidden]

In 2003 with 25 sessions of IMRT, I did not fast. Tried to keep the bowel normal so that it would not move to much. As far as urination, as Brachytherapy and IMRT, I take two a day of Flomax since. Do not underestimate the value of site baths. Relax and pee away in the tub. It won’t hurt you. Tip from an ROs RN and confirmation by my WWII RN mother.... Becsure and discuss this with your RO.

GD

[Teufelshunde]

Lot of good advice above. Coming up on my one-year anniversary of sRT with Dr Liauw. I used statin, nanocurrium, and other radiosensitizers. ALso high dose melatonin, and melatonin cream in the pelvic area. The cream was 400mg per 5 pumps. And no, were no issues from taking melatonin during the day. My biggest advice is a bland diet LOW in fiber. I was on a plant based high fiber and after a week, stuff coming out big time. Went to max 10g fiber per day. Again, the white death diet. Keep liquid Imodium AD with you at all times. Life saver on my hour drive each way every day.

[Scout4answers]

other radiosensitizers. ALso high dose melatonin,

Could you please elaborate on other radiosensitizers.

How high a dose melatonin, currently I am taking 20mg nightly and stools are loose.

melatonin cream in the pelvic area. The cream was 400mg per 5 pumps.

interesting

brand name??

looking on Amazon they have 5% and 6% creams but no pumps

liquid Imodium AD

thanks ordered it, just in case

Dr. gave no direction for diet so far and I assume they did not rec. sensitizers or Melatonin cream.

[BruceSF]

I’ve been taking Prazosin for 4 years since my radiation therapy, it is a drug that helps urinary flow (same family - alpha blocker - as Flomax) and lowers blood pressure and still have an undetectable PSA based on this article : nature.com/articles/s41598-...

It seems to be effective at lowering recurrence rates in a retrospective study in Australia.

[Scout4answers in reply to BruceSF]

Bruce this is amazing! first time I have heard of this.

I started a new thread to alert others to this.

Great find and proof is in your own experience.

I just sent a message to my Urologist to talk about switching

Thanks

[BruceSF in reply to Scout4answers]

I hope it can help you. Currently I take a flomax every morning and 2 mg of prazosin at night since had some flow problems a year ago with just prazosin.

[Scout4answers in reply to BruceSF]

How did you find this study?

[BruceSF in reply to Scout4answers]

Actually, Tall Allen brought it up back in 2018, it was reported in a small poster at a meeting about incontinence therapies. I managed to contact one of the authors and I alerted them to the publication of a paper on dukoral in Nature communications, and they later able to get their paper published there. The author told me that they had encountered trouble getting the paper published because the results looked 'too good to be true.' Anyway, they have embarked on a prospective trial which should finally get the attention of the academics when it reports in a few years.

[Scout4answers in reply to BruceSF]

Do you have any more details on their new study?

[Hidden]

Dam Scout! Even then , you looked like you know something! Nice stroller! YouTube video was shown to me by my nat dr. It’s called fast and live. I had two 500 calorie days per every five days of treatment. The theory is that the bad cells are weakened by the fast and more readily eliminated!! In 8 weeks of imrt I went from 233 down to 165 … my PSA and pc never came back. Of course I did a lot of other crazy stuff to boot at that time. If you can work out during treatments they say it’s best? You’ve got this. Save your ass. Rid the pc from you ! ❤️🙏

[Scout4answers in reply to Hidden]

Scouting even back then. Circa 1950

[Hidden in reply to Scout4answers]

True that. I can see it. Weren’t you the wolf of Wallstreet too? Are you all

Out?

[Hidden]

Great info! 👏🏼👏🏼👏🏼

[Hidden]

Lots of fresh spring water daily throughout to stay well hydrated. Even if peeing is a burden , let it flow. Pee out the poisons. 🍀✌️

[Spyder54]

I rang the Bell at MSKCC on Jan 20th. 5 days of 8Gys =40 Gys to Prostate only. 3 days of 8 Gys=24 Gys to T5 in spine. MSK Precise is Image Guided SBRT. 3 gold seeds in prostate. 10 tatoo’s to line up w 10 laser beams on ceiling. 2 Body casts. 1 for pelvic region. 1 for chest and T5. Enema every morning before procedure. Fibrocil the night before. They want no gas in rectum. No spicy foods. Lots of water. Waked everywhere in NYC. No taxi/uber except airport. Ice skated for a couple of hours. Most important. No Pain. No less fatigue than Triplet ADT. No diahrreah. Slight urinary constricture. Slight dull pain in T5. All good. Went skiing in Colorado one month later with Family for 68th Bday. PSA last week .032. New low nadir. 19 months since diagnosis.

Radiation complete Jan 20, 2022

[Scout4answers in reply to Spyder54]

Lookin’ good Mike

Sounds like you are on the right trajectory.

Joining the gold seed club on Monday.

[Spyder54 in reply to Scout4answers]

No one asks for seconds on the gold seeds😂. They asked if I would like Lorazepam. I said….could I have 2? They said yes, that is normal. Over before you know it.

[Hidden in reply to Spyder54]

Hec yah! That was a great day! I pray that you are healed now! 🙏👏👏👏Keep rolling winter sportsman! 💪✌️

[tad4]

I had 23 ebrt after brachytherapy and the only problems were the peeing, mainly from brachy. Was on Zolodex throughout and have to take Duobluts to help me pee. Will be on Duobluts for ever now. Just do it, success outweighs the side effects of lethargy.

[cancerfox]

Don't eat 2 or 3 hours before your scheduled treatment or the food exiting your stomach will wreak havoc on the real-time image guidance system if that's what is being used. Try to have a bowel movement before you go for the radiation treatment for the same reason. I had a twitchy bladder and that caused some problems again with the real-time image guidance system, so I blessed myself for luck as a joke as they left the room to start the radiation treatment one time and the session went smoothly, so the technicians started reminding me to bless myself before they left the room every time after that. 😆😆😆