Hello All….hope you all are doing well. I decided to have radiation rather than surgery. My Gleason score is 7 with PSA 8.1. PMSA revealed no spread. Two lessons on prostate one positive and other negative. I will start 5 day radiation in about 10 days. I opt for 5 days over the 20 day option. Are there any pre and post steps you would advise? Any side effects?
Have a great day!
John
I would add six months of ADT just to be on the safe side. ADT works in synergy with radiation, so you cannot postpone this.
RTOG 0815 says cancer control is better with short-term ADT but survival is no different, so, your choice. That was with IMRT, not SBRT, so it isn't clear that there is still any advantage with SBRT. It seems best to give a little extra to the known lesion - maybe that's enough to preclude ADT entirely.
I took daily Viagra starting with the first day of SBRT and for 6 months thereafter to protect the penile artery. I also took NSAIDs everyday to prevent inflammation.
Nothing is better for helping radiation do its job and protecting healthy tissue than vigorous exercise. I went to the gym everyday for 2 hours before every treatment.
"I took daily Viagra starting with the first day of SBRT"
So it was up and away from the beam!!!!!😉
LOL! It was just low dose, which is protective. But, knock on wood, I never lost any erectile function.
knock on wood??? I guess that makes sense
Yes, I talked my Surgeon into prescribing low dose viagra after RALP, to keep the blood flow going during healing.
It worked, until the ADT decided to not let "IT" work!!
After surgery, it is different. Surgery usually causes ED due to nerve damage, while ED from radiation is caused by vascular stenosis. ED meds after surgery can further encourage incontinence, so it is best used on an "as needed" basis. ADT may not per se cause ED, but with no libido, ED meds don't work- only Trimix does.
Nerve sparring, and it worked. Low dose for 12 weeks during healing. Incontinence 100% resolved in under 6 weeks.
I never needed the real dose!!!!😜
John,
Do some research and find out what the current recommendations/standard of care are. The National Comprehensive Cancer Network is a good place to start. They provide the latest info regarding all forms of cancer. Their material is well presented, comprehensive and quite easy to understand and comprehend. And, whatever you consider, get second and third opinions. And, yes, to viagra/sidendafil. A study I was in recommended it 3 times/wk, 60mg each dose. I also used a penis pump to keep the blood flowing, as it were. I was "on" Lupron at the time and had no interest in anything sexual but I forced myself to use it. Glad I did.
Good luck to you,
EdinBaltimore
My last day of proton treatment. 20 day schedule. Some minor side effects included peeing frequently, fatigue, left hip minor pain and some soft stools. The long-term time will tell.
I was happy that I had to show up only 5 times. Some people have to go for 2 months. I would really go crazy. I did it with Electa Unity MRI Linac and until now (6 months later) I am happy with the results. My PSA dropped from 1.4 to 0.31. I just hope that it will continue that way. I had a CRPC in 95% of my prostate. The SUV max on the psma pet scan was 14. I am on Degarelix injections for 5 years now. I am polymetastatic in my bones.
Best advice..... Ask a friend who you dislike to sit in for you.....
Good Luck, Good Health and Good Humor.
j-o-h-n Tuesday 05/16/2023 8:19 PM DST
Gleason 9, PSMA shows positive lymph nodes, surgery (plus adjuvant adt & radiation) or just adt and radiation?
Delayed Rib Pain After SBRT
Starting ADT soon 
Early side effects from ADT + radiation
SBRT for whole pelvis radiation therapy?
