jerry matson

I'd like to hear from anyone that's had radiation therapy. What kind?
Side effects? Is it curative? I'm meeting with radiologist tomorrow and
will make decision soon. According to my URO my numbers make me a
candidate for this type of therapy.

heather

My husband did. HDR first (2 sessions).....25 EBRT
sessions......finished up 6 weeks ago and side effects were very
minimal. A bit of fatigue, etc. It sure is curative.....or he wouldn't
have had it, grin. Urologist and oncologist both said it was the
treatment of choice for his age (71) and staging.

Off to bed.......Heather

steve kramer

Jerry, I had EBRT. It was for recurrent PCa. I had and RRP first. When
that didn't get it all, they tried EBRT. Side effects may include bowel
irritation, fatigue, urinary track irritation, and one or two other lesser
occurring side effects. Going into it, I was walking about 15 miles a week
and I kept doing that throughout. I started drinking gallons of water
keeping the radiation effects on contiguous tissue to a minimum. And, I
started a regimen of sleeping 9 hours every night. By the time I was
finished (35 treatments), I had slight diarrhea. I also contacted
hemorroids before the radiation and they just would not cure until after.
In the last week of radiation, I had minor (very minor) burning when peeing.
One week later, I had no side effects at all and within a couple of weeks,
my hemmoroids were find.

--
Steve Kramer
PSA 16 10/17/2000 @ 46
Biopsy 11/01/2000 G7 (3+4), T2c
RRP 12/15/2000
PSA .1 .1 .1 .3 .4 .8
EBRT 05-07/2002 @ 47
PSA .3 .2 .2 .2 .3
Erection 05/12/2003 @ 48
Begin Lupron 07/21/2003 @ 48
PSA .1

alan meyer

According to the literature, radiation can be curative - just as much
so as surgery. Your chances for success appear to depend
on how far the disease has progressed, the quantity of radiation
(studies show that the more radiation, the higher the chance of
completely killing the cancer), whether you get adjuvant hormone
therapy (according to the literature this is not indicated for
"low risk" patients, but is for "high" and probably "intermediate"
risk patients), and the skill and technology used by the radiologist.

There are some good descriptions of radiation available from
the National Cancer Institute (http://cancer.gov). You can go
there and search for it.

There have also been many clinical trials of radiation, results of
which can be found at the above site and more particularly
through the published articles for which abstracts are available
at PubMed (http://www.ncbi.nlm.nih.gov/PubMed/). PubMed
indexes all the world's medical literature so you need to be
specific in searching to get reasonable hits. Once you get one,
try clicking "Related Articles" to see similar hits.

Within radiation there are a bunch of options. As far as I know,
there is not yet enough scientific data to be sure which ones are
the best. All of the techniques keep evolving so the "external
beam" radiation today is not the same as it was 10 or 20 years
ago, nor is "brachytherapy" the same. So a lot of results showing
10 year survival and that sort of thing are not showing you results
for the latest techniques. Presumably that means that your
prospects are at least as good as those shown in the studies and
hopefully better.

You've got a disease that can often be conquered.

Best of luck to you.

Alan

doug taylor

Disclaimer for this and most opinions appearing in this group: I'm
just another patient who has gone through the agony of making a
treatment decision for PCa, just like you, but am no medical
professional. Only you and your doctors can decide what is right and
best for your case. So here goes:

The prevailing general opinion is that RP remains the "gold standard"
for cure of confined tumor PCa, as long term statistics are available
for this procedure.

That said, there are a number of reasons to consider the various
radiation treatments.

The older the patient, the harder invasive surgery is to take on the
body, and the more likely the two most common side effects of surgery
- incontinence and erectile dysfunction - will present. And, since an
older patient has a shorter life expectancy, the more likely death
from any cause will occur anyway. Therefore, the older you are,
everything being equal, the more radiation makes sense as the
treatment of choice.

If you are a younger patient and not retired, can you afford the time
off work required to recover from surgery? Radiation treatments are
not invasive, generally painless, and do not require missing work or
most other activities (fatigue and bowel/urinary irritation being the
only major effects experienced). Of course, external beam requires 20
minutes a day for 9 weeks; that may present logistic problems.

If quality of life is a major concern, modern external beam radiation
treatments such as IMRT (the treatment I chose) has a positive cure
rate, a much, much lesser chance of incontinence resulting, and a
lesser chance of ED resulting, than RP. I'm 6 months post treatment
and am about 95% the same as before treatment.

Talk to more than two doctors before deciding: 1) surgeon; 2)
radiation oncologist; 3) objective third person (knowledgable family
Dr.?)

Good luck. There are much worse things in life.
--dt

keith340

Hello Jerry....I am 5 mos post Proton beam treatment....I had no other
form of treatment in conjunction with it due to low numbers.....the only
side effects were sunburn on both hips, slight fatigue after treatment
25......some minor urination burning decreased with Flomax....erections
are fine but ejaculate is down to dribbles......other wise my life has
returned to normal.....I am aware that some side effects such as rectal
bleeding could occur several years down the road.....during the proton
treatment process, the bladder is always full ofwater and a pediatric
condom filled with water is placed in the rectum befor each treatment to
protect and keep the rectum from moving......every treatment requires an
xray to determine where the prostate is and is lined up to the original
CT picture before each treatment is begun so the beam goes (as exactly
as possible) to the target area without affecting the surrounding
healthy organs......I had 200 rads per treatment for a total of
8000.....this is considered high dose radiation

Keith Lundy/So. California
40 Proton Beam Radiation Treatments
Loma Linda Univ.Med Ctr..3/03-5/03

dave p

IMRT 38 sessions 68,400 GY - After RP and elevated PSA .3
No long term side effects
Short term fatigue at times and burning hemoroid from the IMRT that went
away.
Undectable PSA at this time <0.01

Good Luck Jerry

jerry matson

What is the difference between EBRT and IMRT? Met with oncologist yesterday
and he stated that Kaiser Permanente has IMRT, but it is not currently used
for Prostate Cancer. Only brain cancers etc. He seemed to think that the
difference between the two was minimal. He mentioned that an oncologist in
private practice would try to pust the IMRT in order to elevate his fee. Is
EBRT just as effective as IMRT? What is the difference between the two?

dwight fitzmaurice

Hi Jerry,

I don't know where you are but I had 3D IMRT at Stanford through Kaiser.
This was because the local Kaisers did not do Radiation though. I was glad
to have the 3D IMRT as the tool Stanford used is very good at focusing the
shot and does it through many angles so only the treatment area is greatly
affected. I had slight bowl irritation near the end of 40 treatments but it
cleared up after just a few weeks.

Dwight

alan meyer

Intensity Modulated Radiation Therapy (IMRT) is External Beam Radiation
Therapy (EBRT). It's one technique for giving EBRT.

As I understand it, in the bad old days the entire pelvic region was
radiated.

Then they began to concentrate on the prostate.

Then came "3D Conformal" radiation - using computers to guide Xray
beams from different angles and at different focal lengths to concentrate
the radiation right on the areas of concern.

IMRT is a further refinement of that. It modulates the intensity of the
beam
as well as the focal length and angle in order to try to concentrate the
radiation where it's most needed. The idea is to deliver even stronger
doses to those spots where you aren't going to damage anything else.

Two doctors have told me that whether intensity modulation is an advantage
or not depends on the shape of what they're going after and the purpose.
One rad onc told me he uses plain 3D conformal on some and the IMRT
refinement of 3D conformal on others.

One possible consideration is whether the EBRT is being used as the
primary therapy, or as an adjunct therapy to brachytherapy. As an
adjunct, as I understand it, they're not going after the center of the
prostate as much - that's being treated by the brachytherapy. So the
high intensities of IMRT are not used.

Anyway - that's my layman's understanding of it. Someone please jump
in who knows more than I do.

I'm planning to get the HDR type of brachytherapy and was told by two
different rad oncs that they'd probably use plain 3D conformal for the
adjunct EBRT.

Alan