Existing frequent urination issue before radiation treatment

@surftohealth88
I think the side effect issue is really an important thing that you need to look at, does it depend to where you’re being treated. My brother at UCSF had no major side effects from SBRT but they do so many of these every single day.

I had my radiation done at Kaiser, Again, the guy doing it had done many many years of radiation. The fact that I had no side effects at all for about six years, and only some incontinence may be because of the fact that I went to a place that does this constantly. I hear so many people complaining about urinary and rectal issues these days. Makes me wonder what’s going on.

I may be wrong, But I think where you go is important.

@jeffmarc
I have to agree . My husband also had RT at UCSF and the whole team made sure every day that all is aligned perfectly. He had gold markers even though he had just salvage done. They made some tattoo markings also AND at some point they added some photo movement sensors (or something like that).
They also informed him that if he comes with bladder that is not about 90% or more full that he will be asked to drink some more fluid and wait some more. It happened toward the end where he had some urgency and was not sure how full bladder is but they were very patient and left him on the table for 5 more min until bladder was full. They are booked every day but still make sure that nobody is rushed. RO personally checked every day a CT which was done before RT would even start. When he gave an OK, than RT session would start. So even though my husband did not have a spacer (it is not inserted for salvage) he had no changes in BM frequency or consistency.

However, his PROSTOX test was low for both RT types. So he genetically was not super sensitive to RT. Also, his bowels were REALLY empty before RT session and we made sure that he used all complementary supplements. (fiber, L-glutamine, home made broth, probiotics , etc etc.)

Now that I said all of this , I think that multiple factors can actually effect post RT side effects. If patient is not compliant with protocol or has high PROSTOX, than perhaps no matter how good RO is, something can go wrong :(.

@bens1
Never heard of Mridian Mri SBRT, where it it done, in the USA? What is the advantage?

I had radiation cystitis and urgency after RT and brachytherapy for 2 years. I had 40 sessions of HBOT and it stopped both.

@diverjer
The Mridian and another machine, the Elekta Unity, have the advantage of having a built in MRI so that the doctor sees everything in real time as they treat you. What they can see, they can treat so that treatment is not done from a fused and transferred image. It also means that the amount of exposed healthy tissue is less than other types of radiation or radiation machines. This means less side effects and better quality of life. There are a number of centers of excellence that have this type of SBRT, Cornell Weill, MD Andersen, Memorial Sloan Kettering, to name a few.

@larrymaso (20x/day is almost hourly; how do you sleep?)

Are you on any other medications that might affect urinary frequency - blood pressure, BPH, heart, diabetes, diuretics, mood stabilizers, antidepressants, or OTC caffeine products? Maybe excessive hydration during the day?

67 years old with 5.99 PSA and 9/12 cores positive with highest 3+5=8.

I finished 28 sessions of IMRT/VMAT last week. I had the Barrigel and gold markers.
Prior to treatment I got up 0-1 times each night

RO said 50% of men require Flomax during treatment due to increased frequency and burning. RO would not pre prescribe the Flomax.

Around treatment #6
I had some burning and got up 3 times that night. Asked and received the Flomax and it immediately took care of the issue. Only get up 0-1 times are night after. Frequency/urgency during the day slightly increased but not too bad.

I did have some bowl movement frequency increase and stools were smaller. Not too bad. Few days of diarrhea.

I also asked the RO to prescribe Cialis to keep the blood flowing down there. This med also helps a little with urination. Have been active with my wife couple times a week throughout treatment and so far so good. Orgasms are a little painful which I read can be normal this early on.

Full bladder is very important. They won’t proceed with treatment unless you have sufficient full bladder and empty rectum. First 2 treatments had to get off the table to adjust bladder filling and empty rectum. Important to match your simulation levels of bladder and rectum each day of treatment. I had a second simulation half way through as my first was done immediately after the Barrigel was inserted under anesthesia and I was overfilled with IV fluids. After the second simulation treatment was a piece of cake.

Overall the 28 session later not too bad.

Praying for lower psa at 3 months test.

Also praying for no or low short or long term side effects.

Stay strong. We are blessed this cancer is treatable.

My 0.19 decipher and clean PET scan predicts 10 year metastasis free at 95% and reoccurrence free at 85-90%.

I just encountered this thread for the first time this morning, and for what its worth, I thought I'd take a moment to add a few of my own observations about radiation and its potential side effects.

Following my own initial diagnosis in 2018 (Gleason 8/9, PSA=90), I underwent a three-part treatment regimen . . . 1) ADT (Casodex/Lupron), 2) Low-dose brachytherapy, and 3) Seven weeks of daily IMRT (beam radiation). When entering that regimen of treatments (at age 66), I already had significant ED, no real incontinence, and nighttime urination frequency of about one (1) episode or less.

In the months and years after those three treatments, I have had no notable change in ED, still no incontinence, and a relatively extreme (but initial) jump in urination frequency from once per night to as many as 7-8 incidents per night. That jump lasted for several (2-3) years, but gradually improved. Now, a total of eight-years out, my urination frequency is down to a very consistent 2-3 episodes per night (usually two).

So, in terms of any direct radiation linkage to side effects, I seem to have enjoyed very few side effects in my own particular case, and as I've said here previously (in another thread), I would attribute that temporary (2-year) bump in urination frequency, to scarring of the bladder wall by the IMRT (beam radiation).

@toomany
I take Myrbetriq after I started having to get up two or three times a night. I now don’t have to get up at all at night. Gemtesa Works similarly. If you get tired of having to get up two or three times a night, you could ask your urologist to prescribe one of these drugs.

@jeffmarc Thanks Jeff! Honestly, I'm not too troubled by the 1-2 incidents per night (rarely three). Reason being, it's usually 1-2 (often just one), and they typically occur after 5-6 hours of decent rest, when I need to get up and outta bed anyway. However, I will certainly make note of these two meds and ask my urologist about them, if and when needed. Thanks again.