Radiotherapy for prostate local and retroperitoneal nodes

[pj1121]

ADT of lupron and abiraterone has been pretty tolerable so far, almost four months - maybe I got cocky.

Started my SBRT 28 fraction 70 Gy radiotherapy four days ago, mild to moderate urinary urgency and some burn started almost immediately. Diarrhea started at night after day four, mild so far. How unusual is it for symptoms to begin so quickly and does this mean I am in for a rough ride ahead? Anybody have a similar experience or input?

I have taken miralax (moderate constipation from abiraterone) every night to empty my bowels and filled my bladder daily as directed.

[Tall_Allen]

You are causing your bowel problems. You should not be using Miralax while undergoing radiation. Did your RO tell you to do that? Laxatives are strictly forbidden. Even too much fiber causes excess bowel motion. When the bowels move (gas and contractions), parts of the bowels get into the field of radiation, which causes injury. This is especially important when pelvic lymph nodes are treated.

You should only be clearing your rectum before each fraction. If you can't, you can try a fleet enema. Avoid fiber and laxatives. In fact, many ROs advocate a low fiber diet during treatment.

BTW- you are having IMRT, not SBRT.

[pj1121 in reply to Tall_Allen]

Thanks for the correction on IMRT. My RO ok'd miralax at the start as I was moderately constipated. But I seem to be done with it now, I stopped after 4 doses. My concerning question was: How unusual is it for symptoms to begin so quickly?

[Tall_Allen in reply to pj1121]

If you caused excess bowel movement, it can cause those symptoms.

[Caldonia]

I had almost no symptoms from radiation, but later some skin problems in the groin. I was told that I didn’t have to worry too much about emptying the colon as long as I had a movement daily— they were more worried about folks going a few days without a movement.

On the other hand, my ADT wasn’t too bad for the first few months— hot flashes, side fatigue (hard to separate from fatigue from radiotherapy). But around nine months, side effects ramped up noticeably, through now (12 months). Hot flashes increased in intensity: they used to be annoying, but now they’re really sweaty. I’ve developed knots in my Achilles tendons. Both feet have developed knots under the ball of my foot that make it almost impossible to walk barefoot. I think I’m starting to get similar symptoms in my hands. Not looking forward to the next 12 months plus.

Btw-For the hot flashes, I’ve tried all sorts of things: black cohosh, Embr wave, etc. No help. Just a small fan.

[Mgtd]

I hope I am talking about the same thing as you described in your post. If not forgive my ignorance.

I had 5 weeks of radiation to the prostate and the pelvic area. Prior to beginning the treatment I had one month of Lupron and an additional 5 months of Lupron and the SpaceOAR inserted. Before I began radiation I met with the dietitian and she gave me a low fiber diet. We met each week to review what I was doing.

About the second/third week I developed diarrhea and the dietitian gave me some Pedialyte packets to compensation for the water and electrolytes loss.

My RO told me to take Imodium. I could take some huge amount each day if needed. After the third week things quieted down but I continued to have loose soft stools. It was probably due to the restricted diet. The good news is I lost 13 pounds and have been able to keep it off with diet and exercise.

At 78 I am now down to within 4 pounds of my high school weight and now have the first three muscle rows of my 6 Pack visible. The bad news is I went from a 34” to a 32 “ waist. So I had to by new pants.

I am four months post radiation. I have never felt better since all the side effects except loss of libido appear to be behind me. Well I have very minor hot flashes lasting 30 secs or so only at night while watching TV.

My RO prescribed a drug called Flomax and that stopped the urinating issues. She also prescribed a drug to help with night time urinating frequency. Think it is Oxybutynin.

That has been my personal experience. Of course yours may vary.

[pj1121]

Thank you, informative

[Hidden in reply to pj1121]

Psyllium Husk Powder. I used it twice a day during radiation, and 3 weeks following.

When ROs mention low fiber, they mean no fiber from raw vegetables and fruit skins which irritate the colon and rectum, as they are not digested.

Psyllium Husk Powder is a gentle way of moving your bowels.

Never a complaint from the Radiology tech, and they were strict. Delayed a couple times for bladder not as full as the simulation.

Also as TA mentioned Fleet Enema, I only had to do it once. A Fleet enema only works to clear the rectum.

Thats all that needed for EBRT.

[pj1121 in reply to Hidden]

I did psyllium off and on for years but if you google "how to stay regular for RT" they say causes too much gas use citrucel (insoluble fiber), though I never noticed gas before.

[Hidden in reply to pj1121]

Gas? Only with bean burritos!!!😆