Irradiation of the seminal vesicles

[thierry]

Hello , I finally obtained from my RO that I was granted in addition of 38x2 Gy Prostate RT ( contoured by 3 Gold Grains) , 54 Gy on the SV in also 38 sessions , they measured 7 cm Width and 4,5 cm Height ( and received the dose on the 2/3 proximal tip) , and also six months Hormonetherapy = 2 Lupron shots , all that for an Intermediate Low risk , PSA 5 , GS 3+4 = 7 , two positive cores , less than 7% of GS7 . She maintains that the treatment was appropriate though I think she made no difference between Intemediate Low and High risk , and consequently I think I was really over treated . She says that the 54 Gy on VS can cause rectum toxicity . All that bad experience happened at Monaco Princess Grace Hospital , and I feel quite disappointed . What can I expect now at the real treatment's end ? ED in particular , has the SV irradiation definitively harmed the neurovascular bundles ?

Thanks for your attention . Best regards

[Tall_Allen]

I think you were overtreated too, but that is behind you now. Favorable intermediate risk patients do not need the seminal vesicles treated unless an MRI suggested invasion. The danger is mostly to the bladder. Nerves are pretty much impervious to radiation. When radiation causes ED, it is because it induces sclerosis in the blood vessels supplying the penis. When I had radiation, I took low-dose Cialis for 6 months to protect the vasculature. It also helps to masturbate often (which will be tedious until the ADT completely wears off). The idea is to encourage as much blood flow as possible to keep blood vessels and penile tissues well oxygenated. Fortunately, I've had no ED.

[Penkman]

Hi,

I had 37 doses of radiation to my prostate and Seminal Vesicle as an MRI scan showed it had spread there.

I was then on hormone injections for 3 years which totally destroyed any sexual feelings.

Since stopping the hormone injections I am back to normal in that department.

Following an endoscopy it was determined the radiation had caused radiation proctitis to my lower bowel and results in occasional bleeding.

The numerous damaged blood vessels in the bowel have been treated with an argon laser which works fine for around 6 months and then the bleeding slowly re-occurs.

I have been treated twice now with the laser which is not unduly painful just uncomfortable.

After 5 years my PSA was too low to measure but over the last 4 years it has started to rise very slowly to 0 .2.

I had a telephone consultation yesterday with my urologist who was pleased that my PSA had stabilised and was of the opinion that it had increased due to normal ageing increase from what bit of the prostate was left. He has discharged me from his care with instructions to have my PSA checked every 12 months at my GP Surgery. It is now 9 years since I had the radiation treatment and find the slight discomfort from the proctitis a small price to pay.

I hope your treatment has been similarly successful.

[doc1947g]

I am 73 y.o. with a pre-Rx PSA of 20.4, G(4+3=7) Grade 3, UIR.

My prostate was 45.83 cm3 and they irradiated 139.87 cm3(pelvic bed)

VMAT-RT 3 Gy X 20 Fx in June 2020 with 61.2 Gy in the prostate and the SVs and ADT for 6 months.

Now my PSA=0.03 and my T <5.7684 ng/dL or <0.2 nmol/L.

But I have urinary problems. I just talked with my RO and he told me that I was in the 10% that get the prostatic sphincter that reacted to RT.

Always the exception, it kill me.

Have a good day from Canada. It has been raining since 3 days and my lumbalgia is killing me.

[doc1947g]

Just came back from my Urologist: Results = Cystoscopy in 4 to 6 weeks.

He thinks that my burning sensation may be due to RT but he wants to be sure it is not my Chronic Renal Insuffisancy that starts to act.

So I am getting my next month with a vaccination then a cystoscopy and a bunch of blood tests.