In middle of SBRT treatment

[rennagade03]

In middle of SBRT treatment at Medstar Georgetown what should I expect after treatment and how do I know it was successful. So far, I feel just fine and have never had any symptoms of Pc just a little worried about this whole thing. Don't know if this means anything started out with PSA 5.65 in March 2022 and before any treatment had PSA test again about 5 months later Aug 2022 PSA was 4.99 and the before treatment started had base line PSA 4.99 it's all very confusing.

[Jpl506]

Not much to worry about really. I had a little burning during urination and a few days where it was difficult to get it started during the couple of weeks following my final treatment. Otherwise I was like you, wondering why I felt fine and when the worst of it starts. It’s going to take a while before you know if it works. I had another biopsy for research purposes two years after treatment and it showed no active disease. Time will ultimately tell.

[JWS13 in reply to Jpl506]

Any ED with it?

[Jpl506 in reply to JWS13]

Nope none. Completely back to normal after 26 months of ADT.

[JWS13 in reply to Jpl506]

any side effects with the adt? any tips on how to minimize the side effects? need 4 months orglovyx (daily pill) any cardiac side effects (afib, tach, palps, high hr, qt , etc.)..good luck to you..

[Jpl506 in reply to JWS13]

Outside of the normal fatigue and reduced libido I didn’t have any to speak of. I ramped up a fitness routine that consisted of brisk walking 5-6 miles per day and alternating resistance and cardio training every other day. Hopefully you won’t have many either with a 4 month stint.

[JWS13 in reply to Jpl506]

did you take the pill orgyviyx ? or lupron? how long were you on hormone?

[Jpl506 in reply to JWS13]

Lupron/Eligard + Apalutimide for 26 months.

[Tall_Allen]

Is that with Sean Collins - he's one of the best!

You won't know for several years if it was successful. Radiation therapy takes patience, and long-term outlook (PSA bounces are common). You'll have your first post-treatment PSA 3 months after completing your SBRT. PSA usually drops by 25%-75%. Later readings are usually smaller drops or bounces.

Here are some common early side effects:

prostatecancer.news/2018/10...

Exercise is important for many reasons. During therapy I exercised for at least 2 hours everyday.

[rennagade03 in reply to Tall_Allen]

Yes it is with Collins. And from what I have heard he's top of field. Sure do hope so. Just trying to wrap my head around this. Any advice as to what to do after treatment there is so much out there. You seem to be the go to guy for good solid advice for what to expect and do. Thanks.

[Adf2529]

"It's all very confusing" is a common theme here. With good reason. Fortunately this list serve has some good people with direct experience and even expertise. What exactly are you confused about?

[WilsonPickett]

I have had ongoing discomfort, minor leakage, burning, no more ejaculation, but hard-ons are still good (whew!), and I continue to have to take medicine almost a year after due to restricted flow. I think I’m a sensitive case as I had prostatitis before hand and the radiation just aggravated it and my hemorrhoids. Still, I feel fortunate. PSA continues to decline. Small price to pay if I’m PC free. But like Tall Allen said, this treatment is a long game…

[JWS13 in reply to WilsonPickett]

no ED ...how long after sbrt have you been ed free?

[Yearofthecow]

I just finished viewray SBRT at UCLA on Sept 24

Middle through treatment I had some urinary retention, was given .4mg of tamsulosin which within 24 hours resolved, and had some burning during urination which resolved within two weeks.

No ejaculate, but able to have sex.

I also had SpaceOar before treatment, and have no bowel adverse side effects.

I now feel as good as I did before treatment.

It will be a waiting game, and will have my first PSA after treatment in December. Three months after treatment

It will be some time before I know if it was successful

When you have finished treatment, they should provide information of possible side effects from treatment.

Judge any side effects by comparing how you felt before treatment to after treatment, and any side effects that you find troublesome, be sure a contact your medical team. There are treatments and therapeutics that can help.

All the best

[JWS13 in reply to Yearofthecow]

Going to have SBRT at UCLA in couple of weeks..really worried about ED side effects ..can I talk with you..please reply to [e-mail]. Thanks

[Yearofthecow in reply to JWS13]

If you had no ED issues before treatment, you should have little or no ED issues after treatment, however, you will have reduced or no ejaculate after treatment, which should eventually become no ejaculate as the normal prostate tissue functionality becomes affected by the SBRT. That can take time to happen though. Because of that, orgasms may feel different.

If you haven’t already done so, I suggest you discuss possible side effects with your physician

So far my experience has been uneventful, and except for some urinary retention, which was treated as resolved with tamsulosin, I feel as I did before treatment, which is good.

All the best

[Jpl506 in reply to JWS13]

UCLA ViewRay was my treatment. Dr. Kishan. I was one of the first treated. Great results, no SpaceOar, two year follow up biopsy showed NED. No remaining side effects.

[Mike404]

I finished SBRT with Kishan at UCLA a couple weeks ago. I added the SpaceOAR “belt” to the ViewRay “suspenders”, so I had very minor bowel issues. I had some urgency and frequent movements the first day, which Imodium solved. I started FloMax before treatment, as I had prior urethral dilation done, and I do have a weak stream and some minor burning. I got up during the night more initially, but that’s getting back to baseline. A bit of fatigue the first week after, but mostly gone now.

You didn’t mention your Gleason grade. I’m intermediate unfavorable, so I have to add six months of ADT. I’ve not had any ED issues from either treatment, but completely dry in that department. I assume that means my prostate is fried. Whether all the cancer was eliminated will take years of followup to assess, as others have pointed out.

Overall, I would say SBRT with MRI guidance is the best option with lowest side effects. I made my decision based on that, and so far have no reason to second guess that choice.

[trregan]

I'm 6 months out from initial treatments and 3 months out from radiation treatments. Somewhere in the portal, I've given my experiance. But, I can't find it so, heres how it is for me.

I felt ok during radiation with no side effects until immediately after #5. Then, it was the shits...literally. And frequently, with great importance. Everything in the pdf that Tall Allen provided, but with more descriptive adjectives. Urgency has a new nuance...and having to urinated and wait for it...its coming...almost...yikes, that hurts. For me, very painful. I had already been on Flomax!

I'm a bit of a baby..... Reread the pdf! Since the treatments. Add dramatic words. I've had less and less energy and can say I'm fatigued. I do work out and walk a lot...but I think its not enough. Emotionally, I have been gloomy [surprisingly, since that is not my normal] and I feel angsty...although everything in my life is ok...reality wise. Its existential to be sure.

The physical stuff - urination, poop - has been challenging. I pee a lot and have given up going upstairs in my house...the garden is just fine. My sleep is very interrupted because of having to pee and sweats....the sweat medication made me feel like cotton candy and it makes you fat. I'm having none of that...hot flashes are my new norm....but they are momentary. Apologies to all of woman-kind! I'm on flomax and might switch to a recommendation by TA.

Don't make any plans post radiation...life will be unusual to say the least. It hasn't been easy, but it hasn't been intolerable - except for my persevering husband, I suppose.

Currently, my psa is .6. which is less than my 2009 level and less than my pre-treatment level of 25.8. My RA hasn't talked to me since the procedures and I think he's done unless that number was unacceptable. My urologist - ditto.

Thanks for this site which has more info and more connection that my busy doctor. It will be ok.

73 y.o

[NotDFL]

All good comments.

As another (SBRT) patient of Dr Collins, I will just add that not all side effects are likely to happen to anyone patient.

I developed proctitis after a year or so and underwent laser plasma coagulation therapy (at Georgetown). Fortunately, that solved my problem.