44 sessions of EBRT

Posted by Russell @nrfuls66, 1 day ago

Finally saw my RO, and I'm starting 44 sessions of radiation. Any suggestions on filling bladder and empty bowel? How to deal with the daily repetition? I've got the mindset of treating it like a job. Drive to your job, do your job, and drive home. Forty four sessions seems like such a huge task, but I'm up for it.
Any suggestions would be greatly appreciated.

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Profile picture for jim18 @jim18

@stew80 You probably had a Biologically Equivalent Dose (BED). 3Gys x 20, 2.5Gys x 28, 2Gys x 38, or 1.8Gys x 44 are all about the same. Short term side effects are higher with fewer treatments at higher doses. Lucky that you had none.

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@jim18
Exactly 👍. It is not about number of sessions but total number of Gys.

Also, if SBRT is used , than it has different effect on tissue. Much higher energy is used during every session and than even lower number of Gys have the same effect as the higher number of Gys. I naively thought that getting 35 Gys in 5 SBRT is better since it is lower total amount of radiation but it is NOT the case ! It gives the same amount of damage as, lets say, 64 Gys administered over 7 week period. 😵‍💫

All in all, really fascinating field !

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I had40 sessions of pelvic IMRT @ 2gy per session for a total of 80gy. Was told by my RO that in my case I was less likely to have long term side effects when administered over a longer time frame. Even though they routinely did SBRT at this center of excellence she didn't think I was a good candidate. Perhaps also that I had a prior focal treatment was a factor as well? Anyhow, It certainly helps if you can have regular bowel movement prior to your trip to the radiation center. I had no issue with this. A healthy diet with enough fiber helps, but not so much that you have a lot of gas. The radiation techs did have a sense of humor. I asked what if I have to pass gas during the procedure. She replied "let it rip" Lols! My struggles started after the first couple weeks. I was having trouble holding my urine after drinking the prescribed amount. The few minutes of treatment seemed like an eternity. I had to have them stop the machine a couple times to jump off and pee. Even after I finished my session and relieved myself, I couldn't make a half hour ride home without peeing again. The urgency was intense. A common side effect of the treatment according to the RO. I ended up taking an old towel and an empty wide mouth half gallon juice bottle just in case you need to pull off the road and relieve yourself. That saved me from wetting myself on a couple occasions. I know all this stuff you're reading can stress you out, but once you get in the routine it's no big deal. It did sorta seem like a job. You just need to be there on time and hydrated properly. They can see if your bladder full and rectum is empty. So they won't radiate you if that's not the case. All said and done after a few months of dealing with urgency and getting up a few times at night to pee things have returned to almost normal after a year. Hang in there!

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Profile picture for diverjer @diverjer

EBRT is the general method of aiming radiation from outside the body, while IMRT and SBRT are specific, advanced techniques that shape and focus the radiation beams differently. I think IMRT and SBRT are more advanced and accurate. For some reason SBRT can be done in like 5 sessions and IMRT is maybe 40. I would guess SBRT uses high dose of radiation and may be more accurate and used for small area. But as said I am new to all this and learning as may need radiation depending on how PSA does after prostatectomy.

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@diverjer
Actually both IMRT and SBRT are specific, advanced techniques used to deliver EBRT. If you were told you’re having EBRT, you need to ask what type of EBRT.

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Profile picture for Jeff Marchi @jeffmarc

@diverjer
Actually both IMRT and SBRT are specific, advanced techniques used to deliver EBRT. If you were told you’re having EBRT, you need to ask what type of EBRT.

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@jeffmarc
Thanks, so Russell must be getting IMRT with 44 sessions as I think SBRT is fewer sessions with more grays per sessions.

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Profile picture for diverjer @diverjer

@jeffmarc
Thanks, so Russell must be getting IMRT with 44 sessions as I think SBRT is fewer sessions with more grays per sessions.

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@diverjer
SBRT To the prostate is usually five sessions So it sounds like you have figured it out.

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Profile picture for Jeff Marchi @jeffmarc

@diverjer
SBRT To the prostate is usually five sessions So it sounds like you have figured it out.

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@jeffmarc All SBRT is 5 sessions or less at least in USA. CMS and insurance will pay for 5 SBRT sessions; any more are reimbursed at IMRT rates which are less than 50% of SBRT. So financial vs. medical constraint.

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