SRT- no of sessions?

User

Posted 13 Dec 2021 at 20:59

Had my first appointment @ the QE hospital in Birmingham today. I had RARP Aug 2020 @ the Royal Marsden but my PSA post op was never low enough ( 0.04, 0.08, 0.08, 0.18) so I had another PSMA scan which showed a lesion on one of my lymph nodes.

Started a course of bicalutamide and Zoladex which has worked well. I was expecting to get a 20 session SRT procedure and was somewhat surprised to be told that it was going to be 33 sessions, 2Gy per session. Is this normal?

User

Posted 14 Dec 2021 at 10:06

The onco @ RM said that he didn't see the value in blasting the prostate bed as he thought that my surgeon would have ensured that nothing had been left at that location.

Obviously, now I'm dealing with a different hospital the onco is talking about blasting where the bed would have been but he mentioned that that space will have been "colonised" by the bowel etc which may lead to some of the usual side-effecets of SRT.

User

Posted 14 Dec 2021 at 19:10

I think we all experience different side effects ( or little or no side -effects) and there is no correlation between the different dosing regimes and the side effects experienced . You just have to take things as they come and deal with them!

User

Posted 15 Dec 2021 at 12:42

@Ulsterman

Always good to hear a success story!

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User

Posted 13 Dec 2021 at 23:06

Different oncologists have their own preferences - the standard for many years was 37 fractions at 2Gy. More recently, we have seen oncos using 33 fractions at 2Gy for salvage RT, 20 fractions at 3Gy or 3.2Gy for both salvage and radical RT and now, 6 fractions at 6Gy.

The science shows that 74Gy over 37 sessions, 66Gy over 33 sessions and 64Gy over 20 sessions all have more or less the same cumulative impact. Your onco may have chosen 33 fractions because some of that dosage is going to be targeted specifically at the pelvic lymph nodes.

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

User

Posted 14 Dec 2021 at 00:13

Music man

I had 33 sessions of SRT.

Thanks Chris

User

Posted 14 Dec 2021 at 10:06

The onco @ RM said that he didn't see the value in blasting the prostate bed as he thought that my surgeon would have ensured that nothing had been left at that location.

User

Posted 14 Dec 2021 at 14:02

Music Man,

i had 33 fractions of 2Gy back in Jan/Feb this year. this does seem to be one of the popular choices the Oncos make, as pointed out by Lyn.

To date, I have had few side effects barring more urgency when needing to pee sometimes. If I am driving and try to ignore the urge for more than say, 10 minutes, I quickly get to the point where I get a sharp pain in my bladder once I get out of the car and walk/hobble stooped over trying to find a loo. Moral is..After SRT is complete, don't ignore the need to pee, plus take the opportunity to go prior to any journey, even if you don't feel the need.

User

Posted 14 Dec 2021 at 15:39

@Me Old Wooker

Your advice re peeing is well understood. I adhere to that advice already. Nothing worse than that overwhelming urge to pee, especially when there's nowhere to go!!

User

Posted 14 Dec 2021 at 18:16

I had 6 weekly fractions at 6Gy. ending early November. After effects becamre more noticeable as the course moved on and did not feel too good for 4 weeks after completion. I'm fine now and happy that PSA has been undetectable for 2 months. Next onco consulation in March. I've no idea what the difference is between 6*6 and, say, 20*3

User

Posted 14 Dec 2021 at 19:10

User

Posted 14 Dec 2021 at 21:11

I had 33 sessions. 3.5 years later my PSA is still <0.006.

User

Posted 15 Dec 2021 at 12:42

@Ulsterman

Always good to hear a success story!

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