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Seminal Vesicles and Radiotherapy

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User
Posted 13 Feb 2018 at 15:22

Just noticed on my consent form that the seminal vesicles were also zapped when I had radiotherapy.

No one mentioned this, though I understand they are removed with RP

Is this standard treatment with Radiotherapy ?

TIA

User
Posted 14 Feb 2018 at 23:06

It doesn't necessarily work that way - John has no ED as a result of the RT at all. In a way, you could consider that it was lucky you had PNI - at least there is a likely explanation for the biochemical recurrence and therefore good reason for them to be targeting a specific area. Rather different if there was no likely explanation at all and the RT was a bit like shooting in the dark :-(

Be hopeful - John had PNI and bladder involvement, biochemical recurrence and salvage RT/HT but rejected the HT early because he hated it so much and yet 5 years later is tootling along with no ED and a PSA of 0.1

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 13 Feb 2018 at 20:15

When the RT planning is done the objective will are far as possible be to radiate tumours in the prostate and with a margin beyond as necessary whilst minimizing the dose to vital organs . So the target area for one man may be quite different to another. Your cancer may have been so located that the seminal vesicles was included but this would not always be the case for everyone I think.

Barry
User
Posted 13 Feb 2018 at 22:15
I had recurrence on the Prostate bed and in a seminal vesicle remnant. This was targeted during salvage radiotherapy.

Like you I thought the seminal vesicles were removed during a radical prostatectomy but I was told that margins are so tight that pieces can be left behind. Hopefully someone else can comment on that. My radiotherapy plannng made sure the beams targeted wider than just the Prostate bed otherwise the treatment would be futile.

Ido4

User
Posted 13 Feb 2018 at 23:56

The seminal vesicles grow into the prostate like fingers so I guess they have to include them in the mapping.

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 14 Feb 2018 at 12:54

when i had my rt i asked if my seminal vesicles were targeted the radiotherapist nurses said that they were.

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User
Posted 13 Feb 2018 at 20:15

When the RT planning is done the objective will are far as possible be to radiate tumours in the prostate and with a margin beyond as necessary whilst minimizing the dose to vital organs . So the target area for one man may be quite different to another. Your cancer may have been so located that the seminal vesicles was included but this would not always be the case for everyone I think.

Barry
User
Posted 13 Feb 2018 at 22:15
I had recurrence on the Prostate bed and in a seminal vesicle remnant. This was targeted during salvage radiotherapy.

Like you I thought the seminal vesicles were removed during a radical prostatectomy but I was told that margins are so tight that pieces can be left behind. Hopefully someone else can comment on that. My radiotherapy plannng made sure the beams targeted wider than just the Prostate bed otherwise the treatment would be futile.

Ido4

User
Posted 13 Feb 2018 at 23:56

The seminal vesicles grow into the prostate like fingers so I guess they have to include them in the mapping.

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 14 Feb 2018 at 12:54

when i had my rt i asked if my seminal vesicles were targeted the radiotherapist nurses said that they were.

User
Posted 14 Feb 2018 at 15:18
Ah I was wondering recently about this and spread post RP

My histology reported t2c, clear margins, no lymph node involvement, no seminal vesicle involvement, perinneural involvement

So I wondered how the hell it recurred last year, but yes it seems there are many ways the sneaky little blighters can avoid eradication

For me I reckon that perineural invasion might have been the way out to spread although the histology reported invasion into nerves nside the prostate rather than externally

Edited by member 14 Feb 2018 at 15:19  | Reason: Not specified

User
Posted 14 Feb 2018 at 18:46

Perineural invasion significantly increases the risk of recurrence.

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 14 Feb 2018 at 22:21
Originally Posted by: Online Community Member

Perineural invasion significantly increases the risk of recurrence.

Thought so, well at least I can try and hope that the salvage radiotherapy kills em off as the nerves are getting targeted - even though that will also kill off the nerves and I’ll be back on the ED situation after a full recovery after the RP

Ah well, life goes on (I hope)

User
Posted 14 Feb 2018 at 23:06

It doesn't necessarily work that way - John has no ED as a result of the RT at all. In a way, you could consider that it was lucky you had PNI - at least there is a likely explanation for the biochemical recurrence and therefore good reason for them to be targeting a specific area. Rather different if there was no likely explanation at all and the RT was a bit like shooting in the dark :-(

Be hopeful - John had PNI and bladder involvement, biochemical recurrence and salvage RT/HT but rejected the HT early because he hated it so much and yet 5 years later is tootling along with no ED and a PSA of 0.1

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 15 Feb 2018 at 10:11
It’s information like this that makes this site such a valuable resource Lynn

I shall endeavour to be more optimistic 👍👍

Thanks

User
Posted 19 Feb 2018 at 14:44

Found the answer, so I'll post it

http://www.redjournal.org/cms/attachment/2004839735/2020476185/si4.gif: A portion of the Seminal Vesicles should be included in the CTV, (RT) only for higher-risk patients (Localised PCa) (PSA ≥10 ng/mL, biopsy Gleason ≥7, or clinical T stage ≥T2b).

When treating the Seminal Vesicle for prostate cancer, only the proximal 2.0–2.5 cm (approximately 60%) of the SV should be included within the CTV.

(Short) Details of Study here

http://www.redjournal.org/article/S0360-3016(02)03011-0/abstract

Strange to see original post and thread on Google, 3rd form top, and to be able to see names of postees when not logged into Forum ?

 

 

 

 
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