My MSK Precise / SBRT Journey -- Treatment #1

[Hope4Happiness]

Today I had my first SBRT treatment in earnest and it went very smoothly.

I arrived on time and the first step was drinking a cup of water and then waiting 45 minutes for it to fill up my bladder.

I changed into the gown and was then led into the room with SBRT machine. I was placed on the flat table just like during the simulation, the technicians moved me into place, and then the "mold" was placed over my mid-section and secured firmly.

About 10 minutes was spent getting the machine ready, and then the announcement came over the speakers that the treatment was going to begin. It all was very much akin to an MRI machine experience except that the machine was actually moving around you. I basically just closed my eyes and listened to the music being piped in because seeing the machine move around sometimes did give me the feeling that I was moving but the machine was staying still!

To me, it felt like the actual treatment part of the procedure took about 10 minutes... 15 minutes, tops. I didn't feel anything, of course, and I had no trouble getting dressed and heading right home.

It's only been about four hours since my treatment, so I'm not feeling any side effects or such just yet. As that progresses, I'll follow up with more info in the "reply/comments" section down below.

[Tall_Allen]

Be sure to exercise.

[WilsonPickett in reply to Tall_Allen]

Why is that? Zelefsky’s office did not mention exercise…well not yet anyway.

[Tall_Allen in reply to WilsonPickett]

Several reasons:

• Increased blood oxygenation increases the availability of (reactive oxygen species) ROS which is necessary for radiation to kill cancer cells

• Increased blood oxygenation protects healthy tissue from the effects of radiation

• Exercise is the only thing known to combat radiation-induced fatigue

Now is not the time to "take it easy." I ran every day that I had radiation and spent more time at the gym.

[WilsonPickett in reply to Tall_Allen]

I can't run. Bad knees. Will walking a few miles a day do the trick?

[Tall_Allen in reply to WilsonPickett]

Whatever gets your heart rate up and breathing heavy.

[WilsonPickett in reply to Tall_Allen]

Thanks Allen!

[Mischa1111111 in reply to WilsonPickett]

excercise worked for me and i ended up likeing it as well.

[j-o-h-n in reply to Tall_Allen]

For me, that's women.

God Bless all of our Military Veterans.

Good Luck, Good Health and Good Humor.

j-o-h-n Friday 11/11/2021 7:22 PM EST

[ODave]

Also I’m sure you know but don’t take any antioxidant supplements while in treatment (they forgot to mention it to me)

[Scooter22 in reply to ODave]

What’s the reasoning behind not taking supplements?

[Hope4Happiness in reply to Scooter22]

You want to avoid taking antioxidant supplements during radiation. The goal of radiation therapy is to damage your cancer cells -- Antioxidants could theoretically prevent your radiation treatment from being as effective because they may "protect" your cancer cells. You should specifically avoid vitamin C, vitamin E, beta carotene, and selenium supplements during radiation treatment.

[ODave in reply to Hope4Happiness]

Yeah that.. lol

[Scooter22 in reply to Hope4Happiness]

We’ll, that makes sense but my med. oncologist looked at all my supplements & didn’t mention not taking them except for milk thistle. I also asked about Honokiol. My med. onc. said if it was ok with my rad. onc. it was ok with him to take it on a limited, every other day basis. My rad. onc. said he could not support its use due to limited, confirmed studies. Theoretically, it would seem the supplements may guard against radiation damage to healthy cells. Did your dr.s tell you not to take supplements?

[CAMPSOUPS in reply to Scooter22]

Are you mentally all in for radiation to damage as much cancer as possible?After radiation do you want to wonder if it would have been more effective if you had stopped supplements during radiation ?

Especially if you have progression down the road. You cant do it over. You have one chance to get it right. Why mess around?

IMHO don't take chances. Consensus is that you should not take supplements during radiation.

[Scooter22 in reply to CAMPSOUPS]

Oh, I’m all in for sure. Don’t take my message personally. I’m just trying to understand. Whose consensus are we? Where did this info. originate? Thanks

[Scooter22]

Thanks, I’m undergoing the same type of treatment at Duke. My 1st round of photons begins this Thursday. Good luck to you!

[SpecialName]

Thanks for the report. We have similar profiles. I elected to have surgery at MSK over SBRT, but was on the fence for months. It’s nice to hear your detailed account of my road not taken.

[Hope4Happiness in reply to SpecialName]

You should detail your journey here on the message board. Most folks like us spend hours researching treatments from medical and scientific perspectives. I think men with prostate cancer need to read more about the "on the ground" experiences of those experiencing particular treatments.

[SpecialName]

Indeed. Will do.

[jdfamily]

Thanks eager to hear how it goes

[WilsonPickett]

Right behind you brother. Simulation on Tuesday. Thanks for shining the light just ahead of me. It really does help.

[aceace12]

good luck

[Nous]

thanks to all for the posts in this thread ... please continue ... much appreciated ... Nous

[j-o-h-n]

My 8 weeks of radiation to the bed at MSK..... was a breeze.... no after effects..... except 2 years later my one urinary tract was Kaput. Doctor think it was because of the toasting........

Good Luck, Good Health and Good Humor.

j-o-h-n Saturday 11/06/2021 8:35 PM DST

[Hope4Happiness]

Side effects report approximately 48 hours after first treatment:

Urination -- increased urgency, increased times having to go, somewhat delayed start, slight burning while urinating.

Sexual -- erectile normal, penetration fine, ejaculation with a burning sensation.

For clarity, I had no real urination or sexual symptoms prior to my treatment, so the baseline is relatively "normal."

In addition, I haven't had alcohol or caffeine since about 10/15 because I was told these two would be the biggest irritants to urination during the treatment.

One thing I've learned about myself -- coffee is a lot harder to give up than booze!

[chrisNYC in reply to Hope4Happiness]

H4H-

congrats on your choice and early success.

i am also considering CK/SBRT.. can you share your decision process?

i am 55, have a recurrence after a focal laser ablation 5 years ago... 6/14 cores, need full gland treatment this time around and am not inclined toward surgery,.

thanks

[Hope4Happiness in reply to chrisNYC]

Hi chrisNYC,

I was on active surveillance at MSKCC in NYC for four years after a Gleason 6 diagnosis in 2017 at age 52.

I was lucky because that gave me quite a lot of time to research various treatment options. At the time I was diagnosed, I was hoping to make it on active surveillance until I was at least 60ish. That wasn't to be because an MRI revealed a PIRAD-3 lesion, and after a biopsy, Gleason 7 (3+4) cores -- Gleason 4 was 10%.

I investigated surgery and talked to two surgeons, but it seemed like the advances made here were relegated to reducing complications with the surgery, but long-term side effects really hadn't changed that much. It appears the DaVinci machine reduced complications regarding the surgery itself, but the ED and incontinence issues were still wildcards.

After seeing that surgery and certain types of radiation were delivering the same level of success rates for my type of prostate cancer, I began focussing on radiation. I narrowed it down to high-dose brachy or SBRT.

Dr. Michael Zelefsky came with high marks and such positive opinions from folks that I talked to on message boards and those who were actual patients. I met with him while on active surveillance for a quick overview on SBRT and then for a much longer detailed meeting after my Gleason 7 diagnosis. SBRT seemed to cover the bases that were important to me regarding long-term success in combination with side effects.

[kayak212 in reply to Hope4Happiness]

Have you been happy with Dr.Zelefsky? Im looking around for a new RO in case i need one. My current RO hasnt met with me since 2 weeks before we started SBRT treatment planning.Now, 3 months after treatment ended and i just got my first PSA test, he has his NP setting up a telehealth meeting with me. Not even close to what i expect. I just sent him an email to that effect so i may need a new RO very soon. I am beyond aggravated whether i should be or not.

[Hope4Happiness in reply to kayak212]

So far, I have been very happy with Dr. Zelefsky. But, I have only been his patient, in earnest, since August 2021. My meeting with him in August was great because he took quite a lot of time to go over my diagnosis and how SBRT would work. I had my wife on speakerphone, and he was incredibly diplomatic often pausing to see if she had any questions.

I spoke with Dr. Zelefsky again shortly after I came out of the anesthesia following the fiducials/SpaceOAR placement. I'll be meeting with him again right before my final fifth SBRT treatment.

[chrisNYC in reply to Hope4Happiness]

H2H - thanks for your reply and insight.