How long does it takes to destroy à met after SBRT

[Wakaka]

Hi every oneI have got SBRT in L1 from 31 january tu 7 Fabruary, is it normal that the met is still alive Best regards

[Nusch]

As far as I understood RT the answer is yes. RT doesn’t kill mets, only blocks the cells, when they divide. So it can take a year or more until they are gone.

[Hidden in reply to Nusch]

RT kills ALL cells, the theory is that normal cells start reproducing, and cancer cells dont.

[Nusch in reply to Hidden]

This is what Dr. Google says: At high doses, radiation therapy kills cancer cells or slows their growth by damaging their DNA. Cancer cells whose DNA is damaged beyond repair stop dividing or die. When the damaged cells die, they are broken down and removed by the body. Radiation therapy does not kill cancer cells right away.

[6357axbz]

Based on my discussions with my RO the SBRT should destroy the met, depending on the skill of the RT team.

[Tall_Allen]

Was it an ablative dose? Why do you think it is still alive?

[Wakaka in reply to Tall_Allen]

Yes, the dose was ablationI feel small pain

[Tall_Allen in reply to Wakaka]

Pain is a temporary result of the inflammation caused by the radiation and does not indicate it is still alive. Take NSAIDs.

[slpdvmmd in reply to Wakaka]

Pelvic radiation targeting soft tissues can still cause small microfractures in the pelvis which can at times be symptomatic. Similarly radiation to vertebral bodies or adjacent structures such as para-aortic nodes can cause microfracture in vertebral bodies where once again symptoms can be expressed by pain. Regarding NSAID's two things to keep in mind. One NSAID's refers to a widely diverse group of chemicals with variable response among individuals. And two, while not commonly done in the United States there are firm recommendations overseas that the dose of NSAID chosen should be titrated to effect, starting at the lowest dose. In practice, once I leaned about titration rather than just a standard dose it really changed my approach to NSAID use in both patients and myself. So in summary if you fail one NSAID work with your physician and try another before moving on to opioid's or other options which really don't have a great track record for long term management of bone pain. Also start dosing low. In clinical practice I often found 200 mg of ibuprofen 4 times day on a schedule was very effective with out going higher and risking the known GI complications of NSAID use. And finally if you are a cardiac patient make sure you consult with your physician about even over the counter NSAID's since there is some risk (what risk is the subject of a lot of argument) of increased cardiac events or strokes with accepted dosing.

[kainasar]

May I ask if the SBRT was covered by Medicare ?

[Hidden in reply to kainasar]

Medicare does cover EBRT

[j-o-h-n]

to WAKAKA,

Thanks, I started calling my ex-wife by your ID..... I love it........

Good Luck, Good Health and Good Humor.

j-o-h-n Sunday 04/23/2023 2:19 PM DST

[MateoBeach]

With an ablative dose (SBRT) and normal margins the node is effectively a “dead node walking”. But it doesn’t disappear from follow up scans as some of the cells with lethal DNA damage don’t die and disappear until they go to divide. With slow growing PCa this can take well over a year and does not indicate treatment failure. But must be vigilant with scans to identify recurrence at new sites.