Questions about radiation for prostate cancer: Can I drive myself?

@paulcalif, I’m about to start a very similar therapy. As was already said, reading about our experiences gives me much encouragement to face the treatments ahead. One question, I’m also having a SpaceOAR installed to protect the rectum, but I haven’t heard about “Urethral steering.” What the heck is that? Also, for the original questioner, my RO told me I should be able to make the daily, 75 minute drives on my own. I live on an island north of Seattle and there are few options for obtaining IGRT.

@marlow2 Yes they are the same. I was asked to do a PET scan at UFPTI. I had it done showed no spread of cancer. Then I kept reading on MCC about PSMA and I was confused is it different or same.

So I asked my oncologist/radiologist and he said it is the same. One thing I see everyone comments on is the extensive use of abbreviations when dealing with prostrate cancer, tests, and treatments. When I first came on MCC I was completely confused about all the abbreviations.

The monitor (Collen) did a great post citing most of the abbreviations and what they meant. If we did list the entere spelling of these the post would be twice as long. I am very guilty of doing long posts as my fingers show how fast my brain is thinking and don't even know they are that long until I see them on MCC.

My SBRT was 5 fractions of 7.25 GU per fraction (36.25 total to entire prostate and proximal seminal vesicles) with a boost to the tumor to a total of 40GU. This focal boost SBRT treatment plan is fairly new having been implemented within the last 3-4 years.

When I had my MRI taken 7 days after my Barrigel rectal spacer placed my RO ordered very thin image "slices" taken. I think the image was sliced every 1mm. This enabled him to visualize my urethra as it passed through my prostate. He then fused my CT, MRI and PSMA PET and was able to visualize the tumor's position with respect to the urethra. Having that positioned they can either do urethral sparing ( lower radiation dose to the urethra) or urethral steering where they ensure no area of the urethra receives a "hot-spot" dosage that would exceed the whole gland dosage. When they treatment plan the radiation they put a bullseye on the tumor, and then have concentric isotonic rings representing the specific dose in each ring. With the prostate being the size of a walnut those "rings", are small. Any overlap would cause a higher dose in that area. Using the "steering" they make sure the urethra receives the whole gland dose of 36.25, but no more. Urethral sparing lowers the dosage to the urethra below the whole gland amount and may lead to less than optimal results if any cancer cells approximate or invade the urethra.

Steering within SBRT is fairly new, here is a paper from September 2023.
https://link.springer.com/article/10.1007/s00345-023-04579-6#Sec8
Please let me know if you have any additional questions.

Stay Strong Brother!

Thank you for the study info. I looked it up. Looks like ADT plus RT for older intermediate risk patients may not be necessary as opposed to RT alone.

The qualifier here is favorable vs unfavorable intermediate. I was 4+3 with a Decipher of .84 which made me unfavorable and tripped ADT for 6 months with Orgovyx.

Small consolation for getting old. LOL

I was a 4+3 also with a Decipher of .54 with a PSA of 2.9 and 4 cores of 30 showed cancer all from the same location of the lesion. So, my only factor was one core of 4+3.

Would Jim have to have another PET Scan or is the PSMA Pet scan totally different? He had a PET Scan about 6 weeks ago which did show no metastasis.

PSMA pet scan utilizes a dye with a radioactive tracer that is used to attempt to determine metastasis, which I would assume is the test you received. Would not think you would need another. I had PSMA pet scan in March with proton therapy starting six weeks later.

Hello, As for the question about being able to drive to and from your radiation appointments. I had 30 appointments and thank the lord for my wonderful wife, she was with me each day I went. Many days I was just to weak after the appointment to be able to drive back home. She would handle the driving on those days. I am now 14 months since my last radiation appointment and I chose to stop the Lupron after the first 6 month injection due to the side effects it created. I am happy to say that aside from any sex drive my life has returned to somewhat normal! Best wishes to you as you start down the path of treatment.