RT to bone metastases 1 or 5 fractions?

User

Posted 14 Nov 2019 at 03:39

I went today with a friend who has PCa which has spread to his pelvis to see an oncologist for the first time. For five years he has been under urology and on HT.

The consultant discussed radiotherapy to his hip area which is giving him pain, and at first he suggested a five-day course of RT, but given the logistical difficulty of my 87-year-old mate getting to and from our nightmarish hospital - parking, a long walk from the car park if you can eventually find a space (even the disabled section is often overflowing!) - the consultant quickly said “Oh, we can do it as a one-day RT treatment”

So I asked him: “What’s the difference between the five-day and the one-day RT?”

“It’s all the same, and the outcome has an 80% chance of pain relief and slowing the spread of cancer.”

So what is the difference between five fractions and one fraction? Apart from four fractions😉

Any advice, because my friend is happy(ish) to make the effort to get to the hospital for five days if he thinks it will be better for him in the long run?

Thank you.

Edited by member 14 Nov 2019 at 08:21 | Reason: Not specified

User

Posted 14 Nov 2019 at 15:42

One has to question why 5, if 1 fraction will do the job as well, reduce overall setting up time and linac time and from a patient's perspective involve fewer journeys? I feel that your friend should have been given a more informative answer, by his consultant who is surely best placed to do so.

Barry

User

Posted 14 Nov 2019 at 15:52

It’s obviously more potentially harmful to give the necessary dose in one big hit rather than in 5 smaller doses , but in this case considered ok. It’s only fairly recently that first line RT treatment has been reduced from 35 to 20 sessions. Same total dose but less sessions.

User

Posted 14 Nov 2019 at 20:29

Yep, I would take the one big hit over 5 trips - the dose will still be less than if he was having radical RT

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

User

Posted 18 Nov 2019 at 03:25

Well, as is usually the case, the NHS came good and Chris’s pre-RT CT scan is today. His oncology appointment was only last Wednesday!

He is going for the single blast of the ray-gun which I expect will follow soon after. When will he get his first tattoo at the age of 87?

I mentioned Dan Dare and his ray-gun to the consultant oncologist last week and he looked bemused.

I told him: “Dan Dare is a spaceman”...more puzzled looks. Must be an age thing.

Cheers, John.

User

Posted 18 Nov 2019 at 07:40

Tattoos are applied during the planning session, so that would be today.

User

Posted 18 Nov 2019 at 09:00

They won’t necessarily tattoo him for palliative RT

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

User

Posted 18 Nov 2019 at 16:54

I have had several "one hit" radiotherapy doses for to alleviate pain from the bones. Always been successful, although initially there will be some bone flare pain which quickly passed.

Regarding the tattoos - don't worry, it is only a small dot the size of a full stop with a ball point pen! Several will be needed as anchor points.

Best regards

User

Posted 22 Nov 2019 at 11:31

So Chris had his preparatory CT scan, and was given The Black Spot, and he hopes it will not result in the same outcome as the pirates of Treasure Island!

His meeting with the business end of a ray-gun, for one fraction, is next Tuesday and he is wondering how long it may be, if he is lucky enough to be in the 80% efficacy group as predicted, before his constant hip pain might start to abate?

Any ideas?

Many thanks.

Cheers, John

User

Posted 22 Nov 2019 at 11:51

A few days to a couple of weeks

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

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