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First SBRT session coming up

Posted by N227 @n227rv, Oct 13 7:08am

My first SBRT session is coming up in two days. Wish me luck. For the record here is where I am at right now..."74 y.o. man with cT1cNx unfavorable risk prostate cancer (GS 3+4 =7, 2/2 cores, iPSA 16.7, MR showing PIRADS 4 lesion right base, probable ECE; PIRADS 4 right apex, broad abutment, no ECE 48cc gland with concern for possible bone lesion in the L posterior acetabulum, PSMA PET negative for mets. IPSS 8, SHIM 14)...All five radiation treatments will be done at Memorial Sloan Kettering in New York. By the way, the bone lesion, whatever it might be, did not light up on the PSMA PET scan.

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

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jrs619 | @jrs619 | Oct 13 10:36pm
In reply to @jeffmarc "@jrs619 I had this same problem. 3 1/2 years after the prostatectomy my PSA started rising,..." + (show)
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@jrs619
I had this same problem. 3 1/2 years after the prostatectomy my PSA started rising, so I had salvage radiation. 6 years later I started having incontinence problems. It got progressively worse over the following 6 years.

I started using a Wiesner penis clamp when I went out. That eliminated the need to wear a pad for up to two hours at a time.

I finally got tired of it and in June I had an AUS (artificial urinary sphincter) put in and I no longer have to use any pads at all. Test done. That device works.

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@jeffmarc
Thank you for the information, I’ll have to check it out.

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retiredboomer71 | @retiredboomer71 | Oct 14 6:59am

Tip: Wear a urine pad for your first SBRT session.

Maybe not essential, but I think it's a good precaution until you know what to expect during your sessions.

Even if you have no urinary issues, the required "full bladder" might overwhelm your bladder control after a 20-30 minute SBRT session -- especially if the start of your treatment was delayed (2 of my 5 sessions were delayed 15 - 30 minutes).

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bens1 | @bens1 | Oct 14 7:08am

@n227rv

I had 5 sessions with the Mridian radiation machine. MSK has the Elekta Unity MR-Linac which is a similarly built in MRI machine. You might want to have them prescribe Flomax ahead of time. After the third session, I had a urinary restriction which the Flomax cleared up overnight.

I was treated in January/February 2023. So far, no real issues to worry about. I rarely get up in the middle of the night to pee and my flow is good.

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N227 | @n227rv | Oct 14 7:14am
In reply to @ezupcic "I may be in a similar situation but wondering how confident doctors are using SBRT to..." + (show)
Profile picture for ezupcic @ezupcic

I may be in a similar situation but wondering how confident doctors are using SBRT to treat possible EPE? All the best.

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@ezupcic I don't know about treating EPE but I'll bet others on the site know something about it.

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N227 | @n227rv | Oct 14 7:16am
In reply to @toolbelt "SBRT is an amazing treatment modality. With your diagnosis are they including ADT? Stay Strong Brother,..." + (show)
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SBRT is an amazing treatment modality. With your diagnosis are they including ADT?
Stay Strong Brother, We Got This.

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@toolbelt My ARTERA results predicted no significant reason to engage in ADT, so at least I am spared that treatment modality.

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N227 | @n227rv | Oct 14 7:17am
In reply to @bens1 "@n227rv I had 5 sessions with the Mridian radiation machine. MSK has the Elekta Unity MR-Linac..." + (show)
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@n227rv

I had 5 sessions with the Mridian radiation machine. MSK has the Elekta Unity MR-Linac which is a similarly built in MRI machine. You might want to have them prescribe Flomax ahead of time. After the third session, I had a urinary restriction which the Flomax cleared up overnight.

I was treated in January/February 2023. So far, no real issues to worry about. I rarely get up in the middle of the night to pee and my flow is good.

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@bens1 Thanks, I will ask about Flomax ahead of time.

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cadaddy | @cadaddy | Oct 14 7:19am

Best of luck to you. I went through exactly the same procedure at MSK nearly a year ago. The prep for each session was bearable and the week post-treatment unpleasant. The side-effects ultimately subsided completely. I am very glad I went to MSK. BTW, which machine are they using for treatment?

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toolbelt | @toolbelt | Oct 14 7:21am
In reply to @retiredboomer71 "Tip: Wear a urine pad for your first SBRT session. Maybe not essential, but I think..." + (show)
Profile picture for retiredboomer71 @retiredboomer71

Tip: Wear a urine pad for your first SBRT session.

Maybe not essential, but I think it's a good precaution until you know what to expect during your sessions.

Even if you have no urinary issues, the required "full bladder" might overwhelm your bladder control after a 20-30 minute SBRT session -- especially if the start of your treatment was delayed (2 of my 5 sessions were delayed 15 - 30 minutes).

Jump to this post

@retiredboomer71
My RO specified a "comfortably full bladder". You do not have to be full to an extreme point. One of the main criteria is to duplicate whatever fullness you had at your CT planning session.

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N227 | @n227rv | Oct 14 1:55pm
In reply to @cadaddy "Best of luck to you. I went through exactly the same procedure at MSK nearly a..." + (show)
Profile picture for cadaddy @cadaddy

Best of luck to you. I went through exactly the same procedure at MSK nearly a year ago. The prep for each session was bearable and the week post-treatment unpleasant. The side-effects ultimately subsided completely. I am very glad I went to MSK. BTW, which machine are they using for treatment?

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@cadaddy Someone else on the list said the machine they use at MSK is a Elekta Unity MR-Linac. I'll find out tomorrow.

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scottbeammeup | @scottbeammeup | Oct 14 2:13pm

I had five sessions of SBRT at MSK. They're fantastic. Side effects started after about the 4th treatment. Burning urination and needed an hour or so nap every day (or as long as my dog would allow before smacking me with her paw for sleeping in the day). Flowmax fixed that.

Did six months of ADT which caused a lot of issues that are finally resolving two years later.

A couple tips:

1. If you are going to be on ADT, get a DEXA scan beforehand to check your bone health, and then another one a few months after stopping to see if you need bone strengthening meds.

2. If you get burning urination, drinking lots of water helps. You'll pee more but it will be diluted and not as irritating.

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