1. < Prostate Cancer
Profile picture for thanks4sharing

How Important Is Having A Full Bladder During Radiation Treatment?

Posted by thanks4sharing @thanks4sharing, Mar 3 9:22am

My worse nightmare happened right on the radiation table a week ago. I'd drank down two 16 oz bottles of water back-to-back (something I never normally do), encouraged by the techs, trying to ready myself for the procedure. Near 30 minutes later when I got on the table to be pre-scanned, then zapped, my bladder felt full, very full.

Right in the middle of the procedure, I had an extreme urge to "turn on the fire hose" and had to strain fiercely to control myself. Unable to control the urge any longer, I yelled out "I need help!" The three technicians doing the procedure in a different room showed up asking what the problem was. I told them and they gave me a urinal. I walked to the bathroom to empty it and returned to re-do the procedure.

The biggest thing that shocked me about the entire ordeal though, was me being told by the lead technician that my "bladder was not full." She said it in a "disappointing way," as if to say "it was not full enough to do the treatment in a proper way."

If that's the case, it may never be, given that I tend to have "low bladder capacity" that feels like it fills quickly and then wants to empty. I'm afraid the same thing's going to happen on my next round of radiation.

It's my understanding that a "full bladder" helps shield the small intestines from radiation. With this in mind, is it almost absolutely necessary to have one during the procedure?

Interested in more discussions like this? Go to the Prostate Cancer Support Group.

Profile picture for jeff Marchi
jeff Marchi | @jeffmarc | Mar 7 11:37am
In reply to @heavyphil "@jeffmarc My RO said you don’t use it in SRT because cancer cells could be near..." + (show)
Profile picture for heavyphil @heavyphil

@jeffmarc My RO said you don’t use it in SRT because cancer cells could be near the rectum and you need to get those too.
A barrier could actually protect these cells from the disruptive effects of the radiation. When your simulation is done under optimal conditions (full bladder/enema) the rectum is fairly collapsed; this allows them to get into that area directly adjacent and around the rectum so that the software of the radiation machine can actually ‘shape’ the beam to go around the rectum.
This is how my RO explained it and it sounds pretty cool when you think about it.
But this is why it is SO important to follow the dictum of ‘full bladder/empty rectum’…if your bladder isn’t distended enough or your rectum isn’t narrow enough (due to gas or feces), those beams are going to hit tissues that weren’t meant to be hit and that can cause cystitis and proctitis…Best,
Phil

Jump to this post

@heavyphil
That’s why I mentioned it was not something I’ve heard of being done. Then I did a check of AI and they came up with the fact that it does work with SRT. I just wonder how close they have to get to the rectum in order to do SRT. Get too close and you’ve got lifelong problems as a possibility.

I guess it depends on the doctor, I know that some doctors don’t like to use the barriers for any type of radiation.

REPLY
Profile picture for georgemc
georgemc | @georgemc | Mar 7 12:26pm
In reply to @georgemc "@ambika FYI - The amount of water recommended is highly variable. In my case, I apparently..." + (show)
Profile picture for georgemc @georgemc

@ambika FYI - The amount of water recommended is highly variable. In my case, I apparently tend to absorb water rapidly, reducing the amount getting to the bladder. As a result, I am required to drink 32oz of water prior to treatment (luckily, I am allowed to include my morning coffee in that total). In re the spacer, I am undergoing proton beam therapy, and the protocol empoyed is a combination of features of BioProtect and SpaceOAR. BioProtect employs a balloon inserted rectally, which allows flexibility in adjusting the location of the spacer. After positioning, the balloon is filled with a biodegradable gel. Both the gel and the balloon are biodegradable. SpaceOAR injects the gel directly, and once injected, its location cannot be adjusted. In my treatment, a biodegradable gel is directly injected before the start of treatment. Then, each day (5 days/week) after positioning on the table, a balloon is inserted, positioned and inflated, providing additional space, before the treatment starts. The balloon is removed after treatment.

Jump to this post

@georgemc On rereading my post, I found a couple of clarifications/corrections are required. First, the BioProtect balloon is NOT filled with gel. It is filled with a saline solution. Also, it is not inserted rectally. It is implanted via a minimally invasive surgery which allows it to be inserted through a small incision in the perineum. It remains in place until it is ultimately reabsorbed. In my case, the gel was injected, as in SpaceOAR. That was done at the same time markers were implanted in the prostate. Then, at the start of each treatment session, a balloon is inserted, positioned, and inflated to further expand the space between the prostate and the rectum. Sorry for the need to correct/clarify. At the end of the session, the balloon is extracted.

REPLY
Profile picture for cadaddy
cadaddy | @cadaddy | Mar 7 7:32pm

I faced the same situation. SpaceOar was injected and 3 fiducial markers were iinserted into my prostate about 3 weeks prior to my SBRT. While that was done, the team had me drink several ounces of water to see how much my bladder expanded and to use that image as a baseline for the SBRT. During SBRT, I drank 8 oz of water 15 minutes before the treatment. Since the treatment was image-guided, the team could see if the prostate had moved, either due to my bladder or shifts in the intesstine. I had an excellent outcome.

REPLY
Profile picture for samidh
samidh | @samidh | Mar 8 6:28am

Everyone here seems to be talking about having a full bladder, which surprises me. During my twenty sessions of Tomotherapy, I was never told that my bladder needed to be full. What they consistently emphasized instead was that my rectum should be empty—that is, that I should have had a proper bowel movement before the procedure. I also did not have a SpaceOAR or any similar spacer inserted or injected.
Could that perhaps explain why I had a single episode of proctitis a few months after the radiation? At the time, I noticed blood and a fair amount of mucus in my stool for about ten days. It resolved with a locally applied ointment/gel and has never recurred since.

REPLY
Profile picture for q95oldies
q95oldies | @q95oldies | Mar 8 3:26pm

That was one thing I had the worst time with. The over active bladder made it
extremely difficult. I cut loose once on the table. I saw many other men after
the treatment in an all out sprint to the bathroom.

REPLY
Profile picture for ambika
ambika | @ambika | 6 days ago
In reply to @jeffmarc "@ambika Rick Davis was a Gleason 8. I don’t remember him ever mentioning having ADT. You..." + (show)
Profile picture for jeff Marchi @jeffmarc

@ambika
Rick Davis was a Gleason 8. I don’t remember him ever mentioning having ADT. You can ask him yourself on Tuesday at 3 PM Pacific time. If you go to ancan.org You can sign up for the meeting and get the newsletter. He sends it out every week. It has some pretty incredible information about the latest things going on in prostate Cancer treatment. You don’t have to sign up that you can just go to the meeting. You need to install GOTO meeting To attend the meeting. Type in answercancer as the name of the meeting. It’s available for every device. If you attend the meeting, get there 10 minutes early and you will be called on first to discuss your case and come up with Solutions. They’ve been doing this for 15 years and know a considerable amount. There’s always at least three doctors in the meetings.

If your husband has even one, Gleason nine, he is a Gleason nine the sevens are irrelevant.

The Urinary problems from radiation are short term in almost all cases. I had eight weeks of it and never had any urinary problems. Radiation seldom causes ED immediately, If you have surgery and they can spare the nerves that also can prevent ED. The thing is radiation, usually destroys the nerves, It’s possible to get an erection for a while, but eventually it goes away for most people.

Hormone therapy takes away the desire for sex and for most people prevents getting an erection. You can work around it by using a penis pump or the most successful thing is Trimix or Bimix. That requires injecting it into the penis, but it is a very small needle and really causes minimal pain. That can get him an erection for a couple of hours. You can also have an implant installed, Works quite well and Has a high satisfaction rate.

A decipher test does not test for genetic problems. You want to get an hereditary, genetic test? It is covered by insurance and most medical facilities will do it. They always have to send it away To be analyzed. Just tell your doctor you want one. If there is cancer in the family, Breast cancer, Pancreatic cancer, Prostate cancer and others then it is more likely that he would have a genetic problem and doctors would Desire to have the test done. Another reason you want to do it is you wanna make sure your children don’t have a genetic problem inherited from him. I inherited mine from my mother.

Estradiol is just as effective as ADT to keep testosterone down to Very low level levels. Do some searching for the Patch clinical trial, That’s the one that showed it definitely works. It has not been approved by the FDA because no one wants to run the test in the USA since the product is so cheap to buy. Richard Wassersug Who wrote a book on ADT has been on estradiol for 22 years, he has not become castrated resistant and has almost no testosterone. It is kept his cancer at bay all this time.

BRCA2 is a genetic hereditary problem that causes an Increased risk of prostate. Breast and pancreatic cancer, As well as a few others cancers. There are a number of genetic problems that caused similar issues. You can look up BRCA2 on the Internet and you will find out a lot of information. I got prostate cancer at 62 because my father died from it, and my mother gave me BRCA2. My brother got it at 77 because my father died from it But he didn’t have BRCA2.

Having a parent or sibling get prostate cancer increases the risk of getting it by over 100%.

Jump to this post

@jeffmarc
Thanks so much for all that information. What is the name for hereditary, genetic test you mentioned? Are they called Guardant 360 and Foundation One? I got that information from Dr. Mark a scholz videos.
Decipher and Prolaris are genomic tests to assess and predict prostate cancer spread and aggressiveness.

I still don’t know the difference between genetic and genomic tests though.
I think a patient can ask for both genetic and genomic tests to be done because unless those tests are done no one knows what one is predisposed to.
You mentioned BRACA mutation tests (Dr. Scholz says in his videos that 5% of people have BRCA mutation and they are given PARP Inhibitors that blocks PARP enzyme in cells.
I guess I can ask for the BRCA mutation tests too.

You said “ Estradiol is just as effective as ADT to keep testosterone down to Very low level levels”. Did you take Estradiol instead of ADT drug’s? The radiation oncologist such as Dr. Mach Roach (if he recommends ADT) perhaps will not agree to Estradiol or will not prescribe it. In that case how could one find a doctor who will write Estradiol prescription.
I am assuming that you are suggesting Estradiol not just on the grounds of cost but also for escaping ADT side-effects.
I will definitely set up a meeting with Rick Davis
Thanks a lot for your support. I highly appreciate that.

REPLY
1 reply
Profile picture for q95oldies
q95oldies | @q95oldies | 6 days ago

I was sent back out to the waiting area several times and told to drink more water, then come back in!

REPLY
Profile picture for kenporter
kenporter | @kenporter | 6 days ago

I had 44 radiation treatments. 5 days a week for 9 weeks. Empty bowels and full bladder were the requirements. Luckily I never had a problem, but drank 16 oz of water around 20 minutes prior to getting on the table. My issue was having had bladder cancer I can’t hold it for long but managed to get through the procedure without “leaking”. My thoughts are you are drinking too much water and to soon before getting on the table. It sure can be stressful and I wish you the best of luck going forward.. God Bless. Ken

REPLY
Profile picture for jeff Marchi
jeff Marchi | @jeffmarc | 6 days ago
In reply to @ambika "@jeffmarc Thanks so much for all that information. What is the name for hereditary, genetic test..." + (show)
Profile picture for ambika @ambika

@jeffmarc
Thanks so much for all that information. What is the name for hereditary, genetic test you mentioned? Are they called Guardant 360 and Foundation One? I got that information from Dr. Mark a scholz videos.
Decipher and Prolaris are genomic tests to assess and predict prostate cancer spread and aggressiveness.

I still don’t know the difference between genetic and genomic tests though.
I think a patient can ask for both genetic and genomic tests to be done because unless those tests are done no one knows what one is predisposed to.
You mentioned BRACA mutation tests (Dr. Scholz says in his videos that 5% of people have BRCA mutation and they are given PARP Inhibitors that blocks PARP enzyme in cells.
I guess I can ask for the BRCA mutation tests too.

You said “ Estradiol is just as effective as ADT to keep testosterone down to Very low level levels”. Did you take Estradiol instead of ADT drug’s? The radiation oncologist such as Dr. Mach Roach (if he recommends ADT) perhaps will not agree to Estradiol or will not prescribe it. In that case how could one find a doctor who will write Estradiol prescription.
I am assuming that you are suggesting Estradiol not just on the grounds of cost but also for escaping ADT side-effects.
I will definitely set up a meeting with Rick Davis
Thanks a lot for your support. I highly appreciate that.

Jump to this post

@ambika
An hereditary genetic test is just that an hereditary genetic test. There is no other name for it. Ask your doctor for it and they will give it to you since it is covered by insurance. If there is a history of breast cancer, Pancreatic cancer or prostate cancer in the family that test is essential.

Genomic and genetic are the same thing.

If you have an Hereditary, genetic test it will test for dozens if not over 100 genetic anomalies. BRCA1 or BRCA 2 will just be among The things tested. You don’t test for them alone.

There is also a somatic, genetic test, which test your blood or tissue from a metastasis. You actually can have a genetic problem that is not Inherited (hereditary) But it actually happens to the cells of your cancer. In that case, there might be an additional treatment available for that as well.

I cannot take estradiol because I have BRCA2 and it would lead to a much higher incident of breast cancer for me.

Here is a bunch of information on estradiol, I don’t know if Doctor Roach Would prescribe estradiol. You could tell him that the patch studies said it was just as effective as ADT, but has fewer side effects. You could mention that it’s discussed on Ancan.Org And that Richard Wassersug PhD Who wrote one of the books on ADT has been on it for 22 years.

Estradiol patch info
https://ancan.org/
More information from Richard Wassersug After I emailed him a question about estradiol.
https://connect.mayoclinic.org/discussion/a-note-from-richard-wassersug-phd-about-the-use-of-estradiol-over-adt/
If you missed the session two weeks ago featuring the Emperors of Estradiol, Drs. Schellhammer and Wassersug, here is that session.
https://ancan.us14.list-manage.com/track/click

REPLY
1 reply
Profile picture for capatov
capatov | @capatov | 6 days ago

Going into my 5 week daily IMRT sessions, it took me only 2 days to figure out how to get my bladder full and my rectum empty for the 20 minute sessions. My house is 30-50 minutes from the hospital and I stopped daily to pick up a cup of decaf coffee and a large 22 oz bottle of SMART water. I drank the coffee first and then the water.

By the time I got to the hospital, I needed to relive my bowels. I finished the water just before walking in and I was never rejected for any procedures. In fact, the techs often said my bladder was 100% or more full. Also never had any discomfort or emergencies while on the IMRT bed

Good luck going forward

REPLY
View MoreView Less
Please sign in or register to post a reply.