Mild pain and constant peeing six months after radiation

Posted by scottbeammeup @scottbeammeup, Nov 9 8:58am

I completed SBRT in June 2024. I still feel some mild pain in my prostate area when sitting. It's not painful enough to require any medication, but just enough that I'm aware of it and it's annoying.

Has anyone had anything similar? Did it eventually go away?

I'm wondering if bicycling is possibly causing this, but I wear padded cycling underwear AND padded biking shorts so there's a lot of padding when I'm riding.

Also, before radiation, I would get up to pee once a night but ever since I've been getting up 3-4 times to pee and this hasn't decreased. Am wondering if this will improve over time or if it's just part of my "new normal."

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

@bens1

@scottbeammeup offhand I do not remember what you said your final decision and your process was. Did your radiation machine have a built-in MRI? Did you do spaceoar?

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I did SpaceOAR and five sessions of SBRT. I had fiducial markers and the machine was a Varian (not sure which model). I don't think it had an MRI built-in--I think it was CT.

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I posted this is a new conversation, but it may interest you since it seems to apply to your situation. Look up cystitis and prostatitis for more information about treatment.
https://jamanetwork.com/journals/jamaoncology/article-abstract/2826069?mc_cid=1abcc0352a&mc_eid=99575fc699

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@jeffmarc

I posted this is a new conversation, but it may interest you since it seems to apply to your situation. Look up cystitis and prostatitis for more information about treatment.
https://jamanetwork.com/journals/jamaoncology/article-abstract/2826069?mc_cid=1abcc0352a&mc_eid=99575fc699

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@jeffmarc As a layman, I don't think this study proves anything other than after 12 years one can still feel the side effects of removal or radiation. With all do respect, it strikes me as misleading. Their data set included both those that had radiation and those that had their prostate removed. There data collection made no comparisons from one radiation machine to another (or for that matter the type of prostate removal that was done) but instead seemed to say, without addressing any form of radiation, the type of machine, the margins used that impact healthy tissue, that one could have more problems than people who were untreated, after a 12 year period.

I believe that with radiation, how much healthy tissue is exposed to radiation matters. Margins matter, and so do possible microcells, which is why the standard of care for many types of radiation includes the entire prostate plus a margin.

Without including the types of radiation machines, radiation methods and types of prostatectomies, the study conveys an incomplete conclusion that one better watch out, even after 12 years, for bad side effects. I was treated with the Mridian narrow margin built in MRI radiation machine and finished in 2023 with minimal symptoms. Potential microcells notwithstanding (which is one reason why we all continue to test), I would be surprised, if I am alive at 82, that I would be feeling new symptoms or exacerbated symptoms at that time. I am not sure but we will see. Certainly our treatment choices can have a short, medium and long term effect but I believe that is not in a trial/study vacuum that disregards technological advances.

One final thought regarding any study that does not include radiation machine type comparisons comes from the Mirage randomized trial study which concluded "In this randomized clinical trial, compared with CT-guidance, MRI-guided SBRT significantly reduced both moderate acute physician-scored toxic effects and decrements in patient-reported quality of life."

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@bens1

@jeffmarc As a layman, I don't think this study proves anything other than after 12 years one can still feel the side effects of removal or radiation. With all do respect, it strikes me as misleading. Their data set included both those that had radiation and those that had their prostate removed. There data collection made no comparisons from one radiation machine to another (or for that matter the type of prostate removal that was done) but instead seemed to say, without addressing any form of radiation, the type of machine, the margins used that impact healthy tissue, that one could have more problems than people who were untreated, after a 12 year period.

I believe that with radiation, how much healthy tissue is exposed to radiation matters. Margins matter, and so do possible microcells, which is why the standard of care for many types of radiation includes the entire prostate plus a margin.

Without including the types of radiation machines, radiation methods and types of prostatectomies, the study conveys an incomplete conclusion that one better watch out, even after 12 years, for bad side effects. I was treated with the Mridian narrow margin built in MRI radiation machine and finished in 2023 with minimal symptoms. Potential microcells notwithstanding (which is one reason why we all continue to test), I would be surprised, if I am alive at 82, that I would be feeling new symptoms or exacerbated symptoms at that time. I am not sure but we will see. Certainly our treatment choices can have a short, medium and long term effect but I believe that is not in a trial/study vacuum that disregards technological advances.

One final thought regarding any study that does not include radiation machine type comparisons comes from the Mirage randomized trial study which concluded "In this randomized clinical trial, compared with CT-guidance, MRI-guided SBRT significantly reduced both moderate acute physician-scored toxic effects and decrements in patient-reported quality of life."

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You have to realize the study started 12 years ago before they had the new radiation types they have today. I guess we’ll have to wait another 12 years to find out if the current radiation types do make a difference.

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@jeffmarc

You have to realize the study started 12 years ago before they had the new radiation types they have today. I guess we’ll have to wait another 12 years to find out if the current radiation types do make a difference.

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By that time, they may have a magic wand

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