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Existing frequent urination issue before radiation treatment
Prostate Cancer | Last Active: Sep 27 11:42am | Replies (33)Comment receiving replies
@surftohealth88
What is the protocol your husband was given?
I'm right in the middle of getting the SBRT treatments.
Did the spacer and gold markers surgery.
Did the CT and MRI mapping.
Saw the doctor with all my questions prior to the first radiation and he assured me that all was good and the computer locks in the treatment. They said they would mark me up on the CT scan day but I don't really see marks?? Anyway, I had two treatments this past week. No ill effects from the first one on monday. Little tired but not sleeping well to begin with so....
Second one was on Thursday and I was in at 9 am and done by 10:05 am included the enema portion of the program 😉
I'm drinking a little more water but I definitley notice more trips to pee in the last day+ .
I didn't see the RO on the second visit and am wondering if the Tech is running the show with the nurses? I'm at Bangkok Hospital Bangkok Cancer Center. It's highly regarded. I just don't know how to measure if I'm getting lined up correctly for the treatments and if I should insist on "seeing" the doctor or knowing who is in charge of administrating the doses. My next (3rd) treatment is on Monday and I think I will go early and make a nuisance of myself.
Any advice on protocol is welcomed. I've cut out alcohol and sugar and added proteins (fish and supplements mainly) to my diet. I've got 3 sessions left and I want to make sure they go as smoothly as possible. Thanks in advance
Replies to "@surftohealth88 What is the protocol your husband was given? I'm right in the middle of getting..."
Like @jeffmarc stated, it sounds like they are doing everything right. Perhaps an enema is standard procedure in Bangkok, especially with SBRT where you are getting such a high dose of radiation every day. I'm 19 days into 28 day PBRT sessions, I meet with my RO as well as a nutritionalist every Wed before treatment to go over any issues or SAs. Prior to treatment I have an initial x-ray, then a CT scan. These scans are sent to my RO who reviews them, and upon his approval, treatment begins. The techs are there to do the x-rays and CT, get me properly lined up, the gantry on the machine make minor adjustments to line up with the fiducial markers, sends the images to my RO, and once all is set up according to treatment plan, the computer and machine take over.
My husband had VMAT RT so it might be different how the whole process looks like.
We were explained that RO makes original mapping and decides where and how much of a boost is done, physicists do Gys calculations and program the field , and tech group administers radiation. Tech group "presses the button", so to speak after they adjust your position and check that programed field is aligned with your position, bladder is full and rectum empty, gold markers aligned with initial simulation CT. They might be the last in a group but they are equally important in the whole process.
Our RO was exceptional in his care and involvement because he was involved every day and checked if positioning is good and he did it this way: technicians would make initial CT, than they would send that image to RO and if he OK-yed it, than tech would "press the button". It was like that every single day. That is rarity - many ROs do not do that nor ever meet in person with a patient during RT program. Our RO met with my husband every week to go over his vitals and ask about possible SAs etc even though my husband had none till the very last 4 days when he had some night urgency (that was resolved by AZO supplement ( one with pumpkin seeds and soy).
My husband did not have any enema since he is very "regular" and had BM every morning naturally but if you need to have one to make sure that bowels are clear there is no reason IMHO not to have it, especially since you have only 4 sessions total.
SBRT to my understanding is much stronger RT and can cause some more irritation initially, but on the long run results are almost the same.
I hope this was of some help , although I know that our RO is more of an exception than a rule - I am forever grateful to him and his care. His kindness and dedication was the reason why we chose him over more senior RO. I just had enough of my husband being treated like he has "regular" PC and not very aggressive one. I knew that this RO would go above and beyond in his care and it proved to be true.
Wishing you the best of luck with your RT and as soon as you finish that start with taking Vit C and E supplements - you might want to read those studies :
https://hospitalhealthcare.com/specialisms/oncology/can-dietary-fibre-mitigate-prostate-cancer-radiotherapy-side-effects/
https://www.sciencedirect.com/science/article/pii/S2666555724000303
https://acsjournals.onlinelibrary.wiley.com/doi/full/10.3322/canjclin.51.4.209
https://pmc.ncbi.nlm.nih.gov/articles/PMC4254677/
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@dantewedge
All of the radiation treatments are programmed into a computer that is loaded into the machine that does the radiation. The people doing the actual treatment, only consider positioning, your bladder and your rectum as issues. Everything else is just programmed without them, having to know anything about the details of the treatment.
As a result, there’s no need for the doctor to meet with you until after the treatments are complete. The doctor doesn’t even make up the program. There’s a person who has a job specifically to do that, they are called a Dosimetrist. Yes, the doctor does review what they have come up with, but they don’t do the actual programming of how the radiation is applied.
Sounds like what you’re having done is pretty normal. I have never heard of an Enema needed during radiation, But they do want the bladder and the rectum at certain levels so that is one way to do it.
Sounds like they did just about everything to get the treatment as accurate as possible.