I had the standard IMRT for my pca back in 2013. I was told it was a lifetime dose. Is that true with the newer forms of radiation treatment? I am faced with starting a six dose regimen of taxotere now since ADT does not seem to be working according to PSMA scans. My psa remains at 1.8 even though the scan showed a small tissue met to shoulder area (no bone). The met did not cause any psa increase. I am a bit gun shy on the chemo. Any suggestions? I am currently being treated at city of hope, irvine campus.
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Radiation doesn't have any new forms! There are new machines (linacs), new techniques like MRI guided irradiation and planning tools at the disposal of ROs. Your query can only be answered by an experienced RO provided there is info on current to be targeted areas and the original planning data. Start from the last. Ask the institution you had your original irradiation to give you the planning data. There is always the risk that initial planning was modified during execution without updating the filed data. Thing to take into account.
So for beam radiation there is proton and photon radiation (you had photon prior). These can be given with wide or pencil beam accuracy.Proton has a much smaller radiation field, regular beam radiation is like a bullet which travels completely thru your body and out the other side radiating anything it passes through. Proton is like fireworks, shot into your body and gives up all it's energy precisely at the intended spot.
There is a much better form of beam radiation that you'll need to go overseas for called carbon ion. It currently offered in Japan, China, Germany maybe one other.More centers are being built, but by my memory none yet in the US.
Brachytherapy AC125, low and high dose.
There are new options for radiation injected into your body. LU 177, AC225 that attach to PSMA protein on most cancer cells.
Radiation for your bones only radium 223
As far as a "lifetime" dose, typically your taking about whether a area previously radiated can be reradiated again.
Radiation damaged area may recover after a lot of years? But typically you need to examine the prior radiation plan to determine if a area is in or out of the previously radiated area.
Spot radiation (Stereotactic ) can be used to apply pinpoint accurate beam radiation.
There is a upper level of radiation that the entire body can receive. You're probably not there, discuss this with your doctor(s).
Hi TA, Yes, I started with Lupron several years ago, switched to Orgovyx until financial aid ran out, went back to Lupron until it stopped working. Then added Erleada in Feb, but found out it stopped working. So, I am facing Taxotere plus Lupron at this point. By the way, she is now at City of Hope Irvine (Dr. Liu). The only activity is the shoulder met. She seems to be aggressive.
As TA asked, were these horror stories from people on Docetaxel (Taxotere)? I finished an 18-week cycle in May, and although I lost my hair and got tired overall it was a big nothingburger. Certainly not the hell that people experience on metals-based chemos.
What they don’t put into the consent form for Docetaxel chemo for PC is that it never leads to cure, just suppresses it for a time. Resistance will emerge over time. And side effects can be debilitating and sometimes permanent ( peripheral neuropathy). Took me two years after 6 cycles before I felt and functioned normal. These have to be considered.
You may wish to do a bit of reading and watch some videos on "proton therapy". Copy all between the lines below and place in your search bar. Maybe a conference with your doctors would be helpful. Proton Therapy might--might--be an option even with the lifetime dose you had. That would be up to you and your doctors.
A lot of the improvement in radiation has to do with radiation planning. Simply stated you may be able to be selectively "reradiated" in the same field. However, you would need to have your prior fields available for review and be selective in who and where does your "reradiation".
I'm completely new to this so forgive me if I'm wrong, but what Currumpaw mentioned about proton therapy is definitely worth looking into. After doing extensive reading (seeking a solution to my issue) I recall that proton therapy can be used after traditional x-ray radiation.
Type of radiation, area readiadted and intensity matters. Another was how long ago. I was radiated for testicular Cancer and my RO asked where did it 40 years ago . She found the records and saivI. Was good to go for IGRT & two sessions on HDR Brachy therapy boost
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