SRT IGRT/IMRT urinary urgency beginning after 3rd treatment

[jjpeabody]

I finally started SRT, MD Anderson Phoenix, to surgical bed and pelvic lymph nodes, 39 sessions with typical intensity of about 72/46 gy. I've been on Lupron for about 15 months with 2 month break after the 12mth, PSA pretty steady at <= .01 and testosterone < 7; last 6mth shot 4/22. PSMA PET 2/2021 showed 0.8 cm nodule posterior bladder adjacent to bladder neck. 3/19 3T Parametric MRI confirmed tumor "floating in surgical bed" per RO, MRI on 5/22 showed no presence of cancer with ADT. Gleason 4+3=7, PT3aN0M0, ECE, PNI, Decipher 0.56. Felt good going into SRT due to good exercise and diet/primarily vegetarian. Just after 3rd session started to experience urinary urgency. In such a short time it is a real challenge to fight it off especially when arrive for treatment with a full bladder. RO told me yesterday after session no. 6 it would get worse as we progressed. I'm already really concerned if I will be able to continue with SRT if it gets worse and unable to keep full bladder. No coffee etc, eliminating anything I can think of that my affect it. Was rejected for SBRT after Kishan's swab test indicated not suitable for SBRT but ok for IMRT per Kishan. Really concerned, any aids to counter urgency appreciated. I tried doing a search as I know its been covered here but not very good at searches. Thank you!

[Tall_Allen]

You may want to start on an alpha-blocker (e.g., Rapaflo) immediately. also NSAIDs. You may want to ask for a prescription NSAID. Your bladder doesn't have to be totally full, just comfortably full. Are you being treated on Kishan's Viewray MRIdian? If so, he says that less bladder filling is required.

Are you in Kishan's GARUDA trial (the microRNA swabs)?

[jjpeabody in reply to Tall_Allen]

Thanks for your timely response Tall_Allen. After Dr. Kishan gave me a swab test, I believe associated with Garuda trial but I never joined that trial he just gave me the test to determine suitability of SBRT as I was being considered for Excalibur Trial with him. It came back as not a good candidate for SBRT but he said it would not affect IMRT and that I was perfect for SRT in my situation. After that I was in talks with Dr. Sandler, incredible man per your referral, and asked if he knew anyone in Phoenix and MD Anderson came up, 10 minutes from my house. I think I'm being treated on an Elekta Versa HD. My first concern was they might be hitting bladder too hard but RO told me yesterday some people may be more sensitive and said it would get worse, he didn't mention any medication or option, disappointing. Maybe to early. I will have July 4th weekend to practice filling bladder and work on blanding my diet. I will follow-up with them about alpha-blocker and NSAIDS. I feel relatively fit and want to tough this out, but the potential of this urgency so early is concerning. As this week started I was actually wondering if I had made a mistake and might try to stop treatments, I was panicking. Before treatment, they sent Simulation/treatment plan to Houstan Texas clinic for review and approval. That fact and the IGRT/IMRT technology has me hoping I can rely on their delivery of the radiation treatments with me doing my part and your suggestions re medications. Always a pleasure, I'll further post my experience. Thanks again.

[Concerned-wife in reply to jjpeabody]

Call or portal to obtain some medicine to help during treatment!

(In my husband’s case urgency did get much,much better a little while after radiation. )

[jjpeabody in reply to Concerned-wife]

Thank you, I feel more optimistic, started after 3rd treatment and shocked me a good bit. Good luck

[old64horn]

I had IMRT for 8 weeks last summer.. after the 5th week I had extreme urgency, it was so bad that I had to make sure that a bathroom was close by. I was given medication to relax the bladder that helped some. Few weeks after completion my countenance returned.

[jjpeabody in reply to old64horn]

Thank you for your reply, that sounds like where I'm headed but encouraging as well.

[TnRebel62]

Mine took a couple of weeks to get there but just talk to the RO and they can usually help. Mine kept hammering “tell me what’s going on, symptoms etc. “. He told me it would clear up a few weeks after we finished and so it did.

[jjpeabody in reply to TnRebel62]

Very good TnRebel62, I did mention to RO Wednesday and he said nothing but it would get worse. I have been viewing YouTube and learning more about it, plus all you're valuable posts and support here, really makes a difference.

[Hidden]

Advice given to me by the RO RN after Brachytherapy and IMRT for primary treatment in 2003: “Do not stop drinking water. You need the waterworks to work. If you shit down, you will end up on the ER to be catheterized. Take your Flomax twice a day. (Even after 19 years I take two Flomax a day). Take Sitz Baths and relax. Pee away. It won’t hurt you. You may have to take 4/5 a day from arising in the morning to bed at night. And sometimes in the middle of the night.”

Occasionally I still follow her advice whenever I feel like I am retaining urine. BTW, I confirmed her advice with my WWII RN mother. Good luck.

Gourd Dancer

[Scout4answers in reply to Hidden]

Went on line to look for sitz bath and looks like it is for hemorrhoid relief… why does it help with radiation?

[jjpeabody in reply to Scout4answers]

Hi Scout4answers, as mentioned I'm receiving SRT post RP, have at this point mild internal hemorrhoids, and they are using a rectal baloon on me. Diarrhea can also be a side affect of SRT and just trying hard to have an empty rectum , even with the baloon, a radiation therapist mentioned to watch for that while actually I was already doing everything I could to have an empty rectum. Bottom line people with hemorrhoids have PCa too of course and jumping in a sitz bath sounds like a convenient tool in our arsenal. We will see if it becomes necessary. Take care.

[Hidden in reply to Scout4answers]

Scout, the warm soothing water let’s one relax particularly the smooth muscles of the bladder and ureter...... back in the days of youth and going to camp, ever put a sleeping guys hand in a bucket of warm water?

GD

[Hidden in reply to Scout4answers]

Additionally.... read closely...... clinicaltrials.gov/ct2/show...

GD

[jjpeabody in reply to Hidden]

Wonderful advice gourd_dancer, I will pursue the alpha blockers as suggested, looking into sitz bath, and this 3 day weekend plan to record when I drink and how much and when urge begins to understand better and know better when I can release a little urine just enough to stop urge feeling while maintaining full bladder for treatment...it actually worked today. Thanks for the support and sure to drink abundance of water.

[j-o-h-n]

"not very good at searches" <----youGo to your home page and you'll see the box on the top right labelled "SEARCH". Enter what you wish to search in that box e.g. Zinc and it will pop up on the left side (middle) Zinc of your screen, then depress enter key to begin search. Hope that helps, if not I can search for you.

Good Luck, Good Health and Good Humor.

j-o-h-n Friday 07/01/2022 5:25 PM DST

[jjpeabody in reply to j-o-h-n]

Thanks j-o-h-n, I am getting it to work better after following your suggestion. I searched Urgency on my profile page and also top of page where these posts are listed. Lot of good results. For some reason when I was reading some other posts this week and searched at top of page a drop down list appeared that limited my choices. I got this now. If I could just "turn that rig around and get it down the hill!" Thanks for the support.

[j-o-h-n]

You're very welcome...... just give me lift when you're heading downhill.....Thanks

Good Luck, Good Health and Good Humor.

j-o-h-n Friday 07/01/2022 6:17 PM DST