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How long between IMRT and brachytherapy boost?
Prostate Cancer | Last Active: Dec 4 11:16am | Replies (9)Comment receiving replies
"First off, my sympathies. The combination therapy is a bit of a barrage to the prostate. I believe that boost first then IMRT is fairly standard. However, I have also found reference that the sequence doesn't seem to matter. I had LDR brachytherapy with Palladium seeds on October 3 and started IMRT four weeks later. That was the preference of my RO. The last of my 25 treatments is tomorrow. I'm also on six months of Orgovyx.
I have had some days that were better than others. Some with more frequent urination, some with more bowel symptoms, hemorrhoids, many nights with little or no sleep as a result. Ibuprofen has helped with the prostate inflammation, phenazopyridine not so much. I take Tamsulosin twice daily but am not sure if it is necessary (I'll reduce the dose once radiation concludes)."
Congratulations on finishing your radiation therapy!! Did you get to ring the bell?
Did your side effects "stack up" when you began the IMRT? That is, were you still suffering the side effects from the brachytherapy when you began the IMRT? Those sleepless nights were/are the worst!
Replies to ""First off, my sympathies. The combination therapy is a bit of a barrage to the prostate...."
Good to hear that you have finished the IMRT. For your particular case, that probably was important.
If you decipher score had been lower, I suspect they would’ve not done the IMRT right away. With your Relatively low Gleason score normally they would’ve only done the brachytherapy, And maybe put you on ADT for six months. But that decipher score implies recurrence so they want to try to prevent that from happening with IMRT. Your doctor was probably right, it gave you a chance of Long overall survival.
Wish you the best of luck in the future
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Hi Mario, did I ring the bell? You bet, got lots of hugs from the radiology crew too. Just completing the process is a relief psychologically. I'm hoping that the bowel and urinary side effects will subside over the next several weeks.
Regarding the "stacking" I'd have to say yes, there likely was an additive effect due to overlap of the radiation therapies. First off, there's the direct inflammatory effect from the prostate getting "poked" during the implant. Then too, the seeds are giving off radiation. The half life of Palladium seeds is 17 days, so, by the time I started IMRT over 50% of the radiation dose had been emitted by the seeds. But as you can see, there's still an overlap of the two forms of radiation and hence, to answer your question, an additive effect.
I've never been a good sleeper, so the frequent nocturnal trips to the bathroom haven't helped. Surprisingly, over the past week, I've had a couple of nights where I was able to go 5 plus hours without waking and making the trip. So, I'd have to say that things have improved on that front. For me, 5 hours of sleep is a world event. Given my history, I don't anticipate the sleep thing improving significantly, just a consistent reduction of nightly urinary frequency.
Did you get to visit with your RO?