"late toxicity" issues when dealing with radiation therapies.

[drzaius]

SBRT seems like it has good results comparable to a Prostectomy, and better for side effects initially but I worry about the "late toxicity" issues when dealing with radiation therapies. From what I read, side effects can start appearing even years afterwards. Having a prostectomy, at least you get it over with, abiet with more likely side effects.

[Hidden]

I had the higher dose IMRT in 2019. I had 3 quadrants of hemorrhoids removed in 2008 and all was good. Now occasionally when I wipe myself, there is a tinge of blood and then nothing for weeks. It could be latent radiation damage or could just be one of the hemorrhoid veins has gotten thin walls like all the other skin on my body. I've watched the YouTube videos and read articles about the latent radiation effects and I can say I have not had any that are of concern.

[drzaius in reply to Hidden]

thank you - your information is helpful.

[Tall_Allen]

What you've read is pure myth. Here are the 12-year outcomes of prostatectomy, radiotherapy ,and active monitoring:

evidence.nejm.org/doi/10.10...

[drzaius in reply to Tall_Allen]

Wow, great study - thanks so much for this. Your efforts are very kind and meaningful.

[Nous in reply to Tall_Allen]

thanks for sharing TA 😀

[London441]

Radiation is not mother’s milk, but it’s a better choice than surgery for several reasons. I would never choose surgery if I had to do it again.

Long term side effects of radiation are possible; immediate and permanent side effects of surgery are virtually guaranteed.

[drzaius in reply to London441]

Thank you for sharing.

[Mike404]

radiation is also improving, so I expect those numbers to improve. Margins are improving which reduce healthy tissue damage. I had MRI guided SBRT a year ago with very minimal acute side effects that have resolved. I’m not expecting any long term effects.

[drzaius in reply to Mike404]

Good to know--thanks for sharing.

[Blueslover]

I had a really bad case of radiation cystitis at least 10 years after salvage prostate bed irradiation.Urinary and fecal incontinence problems are of course ongoing throughout life.

Hugh

[drzaius in reply to Blueslover]

Thanks for sharing.

[Hidden]

Then 4 years after Prostatectomy, you get EBRT to radiate your lymph node recurrence!!

I did!.

[drzaius in reply to Hidden]

Thanks for the information.

[binati]

I can only share what I have learnt through my own experience and that of some people I know who have had prostatectomy and RT. In my case I had RT in 2019 as a high risk case (Gleason 9/10) with no mets. I was told by my cousin who is a radiation oncologist in India and a friend who is in the same profession in the US - he has worked in MDA and Mayo. They told me to look around for the clinic that has the best reputation and quality. After a lot of search we selected one. I have had mild obstruction from the thickened walls of the bladder and there have been two blood clots I passed out while urinating. I do have nocturia getting up once per night. Beyond that at 4 years there is no other SE in that area.

I have had rectal bleeding which was probably from the hemorrhoids. Initially after 2 years it was visible and has now reduced to only traces. Cannot project for later years.

I do have reports of horrible radiation side effects from some of my friends here in India and one in Canada. These were mostly 7-10 years ago. I guess RT is using much more advanced technology to keep more accurate margins while radiating. Hence, I suspect the side effects might have reduced in general.

The younger patients - eg 50s and 60s who are physically fit recover fairly quickly from prostatectomy though there will be outliers. Those who are at the top end of 60 might have more problems. Of course one has to select the best surgeon who has a reputation for excellence and good outcomes.

[drzaius in reply to binati]

Thank you so much for sharing--this information is very helpful. I appreciate it.