At just about the 3yr anniversary of a successful RALP we noted a rise in PSA. Two PET scans in Jan and Dec of last year turned up nothing, but the PSA lingers in the .13 to .15 range. We discussed a delay to salvage radiation but the trend line is going up and decided I’d just assume get on with it. I’m getting back into professional flying and I’ll need to deal with the FAA to maintain a class 1 or 2 FAA physical. The plan is for 5 days a week for 7 weeks. I’ve asked for the early slot, 7:00. I’m an early riser and this is the best way to deal with the daily commute down into Dallas from the suburbs…It’s going to be a grind.
A close friend did this about a year ago, characterized it as a “non-event”…I’ll be meeting with my RO Wednesdays, he said to expect loose stool and frequent urination, watch for bleeding.
What else in terms of side effects should I expect?
Any thoughts on how to mitigate side effects?
Dan in Dallas
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Hostage46
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I edited my post for clarity… I’m looking for advice and tips on side effects of the radiation treatment. Pointers on how to mitigate by being proactive…etc
Here are the common acute side effects after primary radiation. After salvage radiation, the urinary side effects are usually worse. An alpha-blocker (e.g., tamsulosin) and NSAIDs started early may help prevent some. I also took daily Cialis for 6 months:
I just finished 7 weeks of sRt 2 weeks ago. Pretty painless. My only issues were mostly Bowl related. Loose stool, Also some leaking,Which I didn’t have before radiation. I was totally continent. I also asked for early treatment times. But found it stressful once I started because having a bowl movement before your treatment is essential. And a couple sessions I wasn’t able to have a bowl movement before my treatment. (But not for everyone ) I Had to come back later that day. But after a couple weeks it really becomes routine with no issues. I’m just now getting back to feeling normal with my bowl and urination issues. But I agree with Tall_Allen that exercises is the key. I worked on cardio an hour a day, and did weight lifting 3 or 4 days week. Also diet is important. No gassy foods. Just curious are you doing a short term ADT in combination with your treatment?
Your post says 1.5 - 1.6 PSA range but later on you have .15 - .16 on graph in a reply so assuming the 1.5 - 1.6 is a type-o? Is this fossa only radiation?
I don’t think to ‘expect loose stools’ is necessary, even if possible. I had none of that and I’ve heard from many men that their radiation side effects were minimal. Urinary side effects only but I already had those from RP. Of course I was on ADT also, so likely any side effects from the radiation couldn’t compete and went unnoticed.
I was recommended a bland, no fiber diet but constipation unrelieved by meds I did not want to tolerate. They agreed on return to my normal diet and it was fine.
Make best friends with your ‘godforsaken Peloton’. It will do more to lessen and eliminate side effects than everything else combined.
Were you not recommended ADT in combination or did you decline it?
Had my radiation 1 yr post RALP. Your friend is right the actual radiation was easy for me. Only issue was that it caused some urinay leakage a few months out and that has not abated.
Good Morning, I had a RALP in June of 2020. Undetectable for 17 months, PSA started to rise slowly from (0.1)11/21 to (0.31) 09/22. After meeting with my RO decided on RTPB, 66 Gray in 33 fractions. I did Kegel, Planking excerises before and after treatment, also maintaining our 6k power walks daily. The only possible side effects I had was a change in the stool about a month after last treatment. I also tested positive for Covid with flu like symptoms about the same time frame. I what I understand, Covid can also change the consistency of the stool. Last PSA post RT 1/18/23 was 0.02, good luck on your journey! Harlow
I am now about 5-6 mos. post salvage radiation to my prostate bed and pelvic lymph nodes. I really don't feel like I had or am having any significant SE from the radiation at this point. My most difficult remembrance was arriving with a full bladder and (trying) to hold it during treatment. I also had to "walk off" gas bubbles before treatment several times. My ADT during with treatment gives me very annoying hot flashes during the day and waking me at night.
My profile: At age 66 Robotic RP and pelvic lymph node dissection 7/2019. Gleason 9 (4+5) T3a N0MO with 2 ECE no SV involvement. Margins negative. PSA <.1 for 9 mos, .1 for 30 mos. PSA jumped to .21 on 12/3/21. PSA dropped from .21 in Dec 21 and Feb 22 to .18 3/28/22 and .15 5/18/22. Gallium 68 PSMA scan done 5/18/22 was negative. Met with R.O. one week after scan and he is "o.k." with holding off on salvage radiation as long as psa stable/dropping. We did discuss the spport trial. 7/22/22 PSA increased to .17. Started salvage radiation 8/17/22 to prostate bed and pelvic bed and received hypofractioned dosing for 20 sessions. Began lupron (4mo) 2 days prior to start of salvage radiation. Along with lupron taking casodex 50mg/day and avodart (dustasteride) .5mg/day. Will take casodex for 6 mos, may extend dustasteride for ? 2 years. On 12/12/22 Testosterone 34. PSA <.04. Will recheck PSA once testosterone recovers
Hostage46, look into the the radiation protective effects of annatto tocotrienol. Also research possible prostate cancer fighting properties. Always consult your health care provider before using any supplement.
I had 33 sessions of salvage EBRT over 7 weeks. Didn't have any fatigue problems but crashed for a day or two after it was all over - I hadn't realized how stressful it all had been. It took a while to regulate the amount of liquid in my bladder that was right for the radiation. I worked with the technicians for several days to get things right, depending on how much I drank and how long before each session. Bladder and bowel problems didn't start until half way through the process, and slowly progressed after that. Bladder issues involved more times getting up to pee in the night. Soft stool issues increased in intensity and lasted long after radiation had been completed. Everyone is different, of course. Best wishes.
I've had 39 treatments (8 weeks, 5 days a week minus 1 day). I did NOT have any side effects during the actual "FRYING". However years later it was discovered that my left urinary tract had become scarred/constricted and required many "in and out stents" for my kidney and urine. BTW the in and out of the stents were "a walk in the park". No Pain or discomfort. Rad was done at Memorial Sloan Kettering cancer center in NYC in 2005.
Just be wary of the damage that Rad can do (even if it's silent).
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