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induced cancer by RT adn CT scans

User
Posted 19 September 2016 13:04:22(UTC)

Radiotherapist has commented they may do a quick ct scan prior to every session of RT.

Just had a quick look and the exposure seems excessive and can cause bladder and colon cancer.

Has anyone good links to what exposure is involved, and just how dangerous this is.

 

The more I research, the more I think AS is the best thing to do. That said, I start RT sessions on the 26th!

User
Posted 22 September 2016 09:01:31(UTC)

Hi Guys,

I think you need a sensible perspective when assessing these risks.

There were some headline media figures earlier in the year pointing out that if you have RT for PCa you are 60% more likely to subsequently develop bladder cancer.  However when you examine the figures, men who don't have RT have something like a 0.9% chance of bladder cancer, men who have had RT have something like a 1.4% chance.  Now it is true that 1.4% is a 60% increase on 0.9%, but it is still a pretty minimal number.

The way I look at it is that I am 64, so I have got a pretty good chance, perhaps 50% of dying of something in the next 10-15 years, unless I break records I have a 100% chance of dying of something in the next 20-30 years, and having had RT twice I still have a 98% chance of that death being of something other than radiation induced bladder cancer.

All of us with prostate cancer are at that stage of life when we have already lived most of our lives, we have eaten most of the meals we will ever eat, drank most of the wine we will ever drink and loved most of the women we will ever love.  So put your worries behind you, the end is in sight, but there is still a bit more time left to wine and dine with the one you love.

:)

Dave  

Thanked 4 times
User
Posted 21 September 2016 12:51:34(UTC)

Chris, you have my sympathy, read your bio, looks like you had a rough ride. Hope things are smoothing out a bit now.

Thanked 1 time
User
Posted 03 October 2016 09:46:59(UTC)
Hi,

Sorry, as much my mistake.

I hope the sessions go well. I know I was so relieved when I finally started RT because after months of waiting, something was happening to try and get rid of it.

I think you have to focus on what needs sorting now. Two weeks after finishing my RT, I had a heart attack (nothing to do with the cancer treatment, by the way) and that became my major concern rather than cancer. A heart attack can kill you today rather than years in the future so cancer very much was forgotten about. It's only when those problems were sorted did I start to focus on cancer again.

So, try to relax, things should get better once the RT and any side effects are out of the way.

Good Luck.

Steve
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User
Posted 19 September 2016 23:43:39(UTC)

If you are to have a full CT scan rather than just a simple x ray before each fraction, I would seek clarification on the need for this because radiation from scans takes in all your pelvic area rather being targeted to the specific area of your Prostate and as you say with more CT scans there is a small risk of initiating other cancers. When I had my IMRT the study protocol said one CT scan would be given each week but this did not happen. I asked the radiologist why and was told that I was having a lot of RT already and frequent unnecessary radiation from CT scans was to be avoided and that the CT scans I did have during treatment showed correct positioning.

Barry
User
Posted 20 September 2016 06:12:50(UTC)

Do they still give one several tattoo dots for positioning of RT?
That should alleviate the need for extra scans.

Chris.

User
Posted 20 September 2016 07:53:02(UTC)

I think I had two while the treatment was ongoing. They were checking the bladder was full and the bowels empty. Perhaps they may carry out more scans on men who have difficulty presenting with the full bladder and empty bowels

Bri

User
Posted 20 September 2016 09:32:16(UTC)

I will have a chat with the radiologists to confirm what and why, and express my concerns. Thank you.

User
Posted 20 September 2016 12:28:05(UTC)

I had a pre-scan every day. They never told me why and I never asked, although I was aware fellow patients only had them once a week or so. I think it depends very much on the location and size of your particular tumours and whether your prostrate tends to move from day to day as the purpose, as well as confirming the state of bladder and bowels, is to ensure the radiation is directed accurately at the cancer. Although they used my three tattoo marks for initial alignment I found they often did a small tweak to my position on the table after the pre-scan.

This technique is called tomotherapy (see https://en.wikipedia.org/wiki/Tomotherapy) and the details will depend very much on what LINAC machine they are using. Getting hard information about dose levels from CT scanners and tomotherapy seems difficult and it all seems based on statistics. But presumably the theory is that the benefits outweigh the risks, probably by a huge margin - and let's face it, it is far more important to get the radiation beam accurately pointed where it is needed than worry about probably much lower risks from the CT element.

User
Posted 20 September 2016 20:21:35(UTC)

Yes Chris, the tattoos provide a reference point but as has been said the Prostate can move and if this happens the RT may be a little off target hence they try to get you to present as far as possible in the same condition for uniformity for each fraction. Some hospitals have criteria to follow about water to be drunk beforehand and even on whether bowels have been emptied.  Scans check the positioning and where it is found that there is significant movement in a patient, CT scans may be done more frequently.

Barry
User
Posted 21 September 2016 07:54:50(UTC)

has anyone links to dangers of induced cancer by rt,ct, or similar, before I see my radiologists.

User
Posted 21 September 2016 08:00:56(UTC)

I contacted PCUK when I was trying to make my decision on whether to have RT. They sent me latest reports etc. Eventually I decided against RT but my circumstances are very different to yours. I don't think there is ANY way to tackle PCa without it leaving some permanent blight on your life one way or another I'm afraid. Personally it makes me sick the thought of being irradiated. In my case the outcome wasn't worth the risks. I may have it at a later date though. Phone PCUK and explain it all.




If life gives you lemons , then make lemonade
User
Posted 21 September 2016 12:51:34(UTC)

Chris, you have my sympathy, read your bio, looks like you had a rough ride. Hope things are smoothing out a bit now.

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User
Posted 21 September 2016 14:52:34(UTC)

Toad,

Some interesting info here, the risk is not great and where it does happen it is usually in the long term. Furthermore, toxicity is reduced by the more accurate means of delivery to the prostate these days. http://www.ncbi.nlm.nih....pmc/articles/PMC3126090/

Do let us know what your consultant says on the subject.

Barry
User
Posted 22 September 2016 08:08:11(UTC)

" In the treatment of prostate cancer, the risk of dying from a secondary radiation-induced bladder cancer may be greater than the risk of dying from the primary prostatic tumor following surgery or watchful waiting. "

Wish I has ben aware of this before. It probably would have changed my option of treatment.

Thanks Man with PC. Good link, good information. I will speak to my radiologists.

User
Posted 22 September 2016 09:01:31(UTC)

Hi Guys,

I think you need a sensible perspective when assessing these risks.

There were some headline media figures earlier in the year pointing out that if you have RT for PCa you are 60% more likely to subsequently develop bladder cancer.  However when you examine the figures, men who don't have RT have something like a 0.9% chance of bladder cancer, men who have had RT have something like a 1.4% chance.  Now it is true that 1.4% is a 60% increase on 0.9%, but it is still a pretty minimal number.

The way I look at it is that I am 64, so I have got a pretty good chance, perhaps 50% of dying of something in the next 10-15 years, unless I break records I have a 100% chance of dying of something in the next 20-30 years, and having had RT twice I still have a 98% chance of that death being of something other than radiation induced bladder cancer.

All of us with prostate cancer are at that stage of life when we have already lived most of our lives, we have eaten most of the meals we will ever eat, drank most of the wine we will ever drink and loved most of the women we will ever love.  So put your worries behind you, the end is in sight, but there is still a bit more time left to wine and dine with the one you love.

:)

Dave  

Thanked 4 times
User
Posted 22 September 2016 17:50:52(UTC)

Essentially I go along with Dave. Would also add are you more likely to recover from damaged cells now than when older? Dave is a good example there as would he have recovered so well if he had been 10 years older?

When I first read your post I sensed understandable RT nerves?

Ray

User
Posted 23 September 2016 07:57:49(UTC)

Originally Posted by: Online Community Member
"In the treatment of prostate cancer, the risk of dying from a secondary radiation-induced bladder cancer may be greater than the risk of dying from the primary prostatic tumor following surgery or watchful waiting."

Where did that come from?

Few people die from the primary prostatic tumour: but if the primary prostatic tumour isn't treated, the metastases may lead to death later.

Modern radiotherapy is highly sophisticated, and the risks of secondary radiation-induced bladder cancer is very low indeed.

.

-- Andrew --

"I intend to live forever, or die trying" - Groucho Marx
User
Posted 23 September 2016 15:23:11(UTC)

Its the conclusion of the link given above
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3126090/

http://www.ncbi.nlm.nih.gov/pubmed/16878323
this one has the following conclusion
"CONCLUSIONS:
Patients who received with EBRT had significantly higher odds of developing second cancers both overall and in the areas that were exposed to radiation. It is noteworthy that, to the authors' knowledge, this report shows for the first time that, despite the higher doses of radiation delivered, patients who received radioactive implants had the lowest odds of developing second cancers."

its the "significantly higher odds" thats worrying.

I am hoping that the IMRT I am having is a little less harmful than the EBRT that the paper is written about.
But what also concerns me is that I may have a CT scan prior to every session. I will find out more on Monday.

User
Posted 30 September 2016 07:31:02(UTC)

slightly reassured last session by the radiologist, that the 37 mini ct scans I have add up to one half a full ct scan.

Still have the worries about the induced from radiotherapy tho. I am going to see if there will be active surveillance for bladder and rectal cancer for the first 5 years post.

User
Posted 30 September 2016 14:59:56(UTC)
Hi,

I'm pleased you've finished your RT.

Try to relax now and not worry about the possibility of something happening because of a particular treatment you've had. Try to deal with one thing at a time. What you're concerned about, may never happen so focus on recovering from the RT.

I hope you have a nice weekend and do things you enjoy.

All the Best,

Steve
User
Posted 03 October 2016 08:10:02(UTC)

sorry, I meant at my last session, not my last session. Only one week in. So far so good, but told it starts to affect after about 3 weeks.
Fingers crossed.

User
Posted 03 October 2016 09:46:59(UTC)
Hi,

Sorry, as much my mistake.

I hope the sessions go well. I know I was so relieved when I finally started RT because after months of waiting, something was happening to try and get rid of it.

I think you have to focus on what needs sorting now. Two weeks after finishing my RT, I had a heart attack (nothing to do with the cancer treatment, by the way) and that became my major concern rather than cancer. A heart attack can kill you today rather than years in the future so cancer very much was forgotten about. It's only when those problems were sorted did I start to focus on cancer again.

So, try to relax, things should get better once the RT and any side effects are out of the way.

Good Luck.

Steve
Thanked 1 time
User
Posted 03 October 2016 10:28:26(UTC)

WoW , Steve, just read about your heart attacks,, never rains but absolutely chucks it down on you. Suffering a bit of stress myself, and have a treatment review tomorrow. I will bring that up.
All the best
Paul.

User
Posted 03 October 2016 11:19:17(UTC)
Hi,

Don't worry about that because it probably had nothing to do with my RT or HT as my cardiologist told me that he was certain I would have had a heart attack within 12 months anyway. I had an undiagnosed heart problem. My dad died of a heart attack aged 47, my grandad only 43 so it was bound to happen to me at some point.

So, relax. Eat healthy, take exercise and things will be fine.

Steve
 
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