How often do you get scanned?

User

Posted 24 May 2018 at 22:05

I'd appreciate some advice.

I am currently half way through 33 radiotherapy sessions. I had a prostatectomy about 18 months ago.

On some occasions, just before treatment, I have been scanned. Once, I was told my bladder wasn't full enough and had to go and drink more water. On another occasion, I was told that my bowel was full and was asked to poo without weeing. On yet another day I was told I had a small to medium size bubble of gas. They did treat me, but they did some sort of reassessment whilst I was on the table to make sure I could be treated. On two occasions, they told me I had put weight on and my body contour didn't match my planning scan.

However, on most occasions, I am not scanned. So, today, I asked how we could know that on the days I wasn't scanned whether or not my bladder, bowel etc were in the right position. They told me they just assume the all is well on those days. Now, My Concern is that if a bubble of gas can affect the efficacy of the treatment, have there been days when my treatment hasn't hit the spot? If radiotherapy is all about being accurate, why aren't they scanning every day.

men who still have a prostate get 20 scans and 20 treatments at my treatment centre. I get a weekly scan and 33 treatments. I know they don't want to give me more radiation than necessary, but I'm worried about compromising the accuracy of the treatment. I was told only my oncologist could authorise a daily checking scan.

and Mark, if you're reading this, your inbox is full.

Ulsterman

User

Posted 24 May 2018 at 22:29

Ulsterman

That is a very interesting post , I assumed we were scanned every time, if not it probably explains why I have suffered radiation damage to the bladder. There were days when I got off the table to find I had inadvertently left my Catheter tap open, so the bladder would have been empty.

Thanks Chris

Edited by member 24 May 2018 at 22:31 | Reason: Spelling

User

Posted 24 May 2018 at 22:54

John only had one stand-alone scan, the planning one prior to the treatment starting. However, they could see his pelvic area on their screens from their little cabin so they knew if his positioning was wrong before they started each day. My understanding is that this is the point of IGRT.

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

User

Posted 24 May 2018 at 23:16

Lyn - are you referring to John's physical positioning with tattoos lined up etc, or the position of his bladder?

ulsterman

User

Posted 25 May 2018 at 00:14

No, they lined his tattoos up with the machine first and then from their cabin they could check the x-ray or whatever it was - they could see his insides because they showed me.

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

User

Posted 25 May 2018 at 00:27

But then why would they scan at all before treating if they can see everything?

ulsterman

User

Posted 25 May 2018 at 03:30

perhaps my experience may throw a little light on this. I can't give the exact frequency that was required for the study I was in without digging out the papers but I do remember asking why I was not having all the CT positioning scans detailed in the protocol. I was told that on all occasions they checked my prostate was correctly positioned and there was no point in adding unnecessarily to the radiation I was having. A big effort was made to get it right in the first place though with 5 CT scans as a preliminary set up in one week, so fewer scans during course of radiation fractions.

Barry

User

Posted 25 May 2018 at 07:07

Not sure if my point of view is worth anything , but we all know radiation is bad news so they keep it to the bare minimum. I’ve not even had RT but despite a romping runaway psa I’m now restricted to scans only six monthly ( unless I fall ill ). That’s because I’ve had two whole body CT, two pre PET CT scans , 2 PET scans and 2 Nuclear full body bone scans. I believe a full body CT alone emits the equivalent dose of radiation of being on our planet 7 yrs. With the PETS your bloodstream and major organs are being infiltrated with radiation etc. I believe some men who have had full RT then cannot have RT even for pain management afterwards.

User

Posted 25 May 2018 at 07:26

Hi Ulsterman.

Sounds identical to my experience - weekly scans to make sure everything is still in the same place, and that I'm prepping myself accordingly. It added useful markers for me, as I could get a sense of how loaded/unloaded I needed to be. As Lyn had, my wife on occasion used to watch the process on a screen, even when it wasn't a scan day I think...). I was also on the 33 RT scan, though at Sheffield. Maybe different hospitals use different regimes? I have to say, I did dislike the scans as it delayed the RT by a few minutes, and this could be extremely painful due to overloaded bladder!

User

Posted 25 May 2018 at 08:07

Different hospitals seem to have different protocols on this - the place where I'm having RT scans everybody every session. I usually feel the table move a few millimetres after the scan as they make a small final adjustment before the RT itself. The staff have been able to tell me how full my bladder is and that's been helpful in timing fluid intake the next day. At the weekly review session, they've shown me the scans - interesting (and encouraging) to see the degree of precision in the RT.

User

Posted 25 May 2018 at 10:04

I think that rather than different hospitals doing different things, it is down to

a) whether the hospital is using IGRT or IMRT

b) the word ‘scan’ means different things to different people.

I think everyone gets ‘scanned’ when they first get on the table to make sure they are in the right position according to the computer programme the onco has devised based on the planning MRI scan.

Maybe, Ulsterman, the guys having radical RT are on IGRT but you are on IMRT because you don’t have a prostate for them to zap?

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

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