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Palliative Radiotherapy decisions

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User
Posted 18 May 2024 at 10:04

Hi

not sure if this is an area that anyone can offer advice on but would appreciate your thoughts.

just had most recent follow up appointment and hubbys PSA is still rising - currently on Abiraterone plus Prostap - previously had chemo. (details in bio)

Consultant suggested could have palliative radiotherapy to prostate to try to help with urine flow, leakage and retention problems. He did say this might help but also might make it worse and understandably we are worried about that scenario. 

never had radiotherapy before as cancer is considered too extensive for that option.


Other option on the table was to repeat chemo and we are really not sure what to do.

Does anyone have any experience of this situation or can offer any advice?

We know all options are only palliative but worried about quality of life in the mean time.

currently, continence symptoms are a pain but bearable. Worst symptoms have to be tiredness and lack of energy - so wondering which treatment is less likely to affect fatigue (even though he has had chemo before i can’t recall it affected him for more than a few days in each cycle, but guess that could be different now).

thanks in advance

Maggie

User
Posted 19 May 2024 at 18:01
Thanks Mags. There are people on here way more qualified than me who may be able to inform you better. My belief is that six proper palliative doses are the max a body can take but I guess as you say if it’s in a different area ??

Just wish you strength and hope. It’s an awful illness mentally and physically for both partners. X

User
Posted 18 May 2024 at 10:04

Hi

not sure if this is an area that anyone can offer advice on but would appreciate your thoughts.

just had most recent follow up appointment and hubbys PSA is still rising - currently on Abiraterone plus Prostap - previously had chemo. (details in bio)

Consultant suggested could have palliative radiotherapy to prostate to try to help with urine flow, leakage and retention problems. He did say this might help but also might make it worse and understandably we are worried about that scenario. 

never had radiotherapy before as cancer is considered too extensive for that option.


Other option on the table was to repeat chemo and we are really not sure what to do.

Does anyone have any experience of this situation or can offer any advice?

We know all options are only palliative but worried about quality of life in the mean time.

currently, continence symptoms are a pain but bearable. Worst symptoms have to be tiredness and lack of energy - so wondering which treatment is less likely to affect fatigue (even though he has had chemo before i can’t recall it affected him for more than a few days in each cycle, but guess that could be different now).

thanks in advance

Maggie

User
Posted 18 May 2024 at 16:34

Hi Maggie,

my case has some similarities to your husband's in that the cancer was too far advanced at diagnosis for an operation (if I've read his bio correctly) and I also had multiple mets in my pelvis, spine, ribs etc.

I too had 6 cycles of Docetaxel but this was quickly followed by 18 sessions of radiotherapy targeting the primary tumour in my prostate, which also helped to further shrink my various mets.

I found the radiotherapy to be quite easily tolerable, but the caveat is I was 55 at the time.  I felt a little tired towards the end of the 18 sessions, but I found that the side-effects were by no means as bad as from the Docetaxel chemo.  The biggest problem was having to go to the hospital 5 days a week for nearly 4 weeks.  

I wasn't having incontinence issues before the RT, nor did I have any afterwards.  I was warned of the possibility of incontinence but it didn't happen.

I would ask the consultant how many sessions of RT would be needed for your husband.  If it's only a single session or a handful of sessions, my 10p worth would be to try it.

Best of luck whatever you decide, and please do ask me if you've any questions!

Craig

User
Posted 18 May 2024 at 17:05

Thank you for this Craig

I think, if I understood him correctly, he is suggesting 6, weekly sessions. He said it will not help the cancer itself but could help with the side effects. My concern was that he added ‘it could make them worse’

it came a bit out of the blue as he had previously said he wasn’t suitable for radiotherapy as there were too many mets. It seems that we are now considering radiotherapy to alleviate symptoms. So I think it’s more like your recent targeted RT to relieve your sciatica symptoms.

i think the size of the tumour is putting pressure on the urethra so the RT is to help with that.

It’s Good to hear that you didn’t have any real problems with the radiotherapy - I think tiredness seems to be a given for  each additional treatment regime!! 

Wishing you all the best on your journey 

User
Posted 18 May 2024 at 17:51
I believe when talking about palliative RT , six cycles is the maximum the body can take. I rejected Hormone Therapy for the longest time for my own reasons. I was 52 and had already had surgery. I also rejected the salvage radiotherapy sessions for my own reasons. I did decide to have 3 sessions of palliative radiotherapy to upper back , lower back and right ribs. Was totally painless at treatment and only 15 minutes each time. However I suffered severe sore throat and cough from the radiation that passed through. Also developed gastro issues and piles for the first time in my life. Apparently this RT can cause the tumours to flare and cause very bad pain but not in my case. Good luck
User
Posted 19 May 2024 at 09:03

Thanks for this Chris

i didn’t realise that about the six sessions. So if he were to have those, does that mean he couldn’t have any to any of the bone mets later on or is it six to one area?

I really admire your decisions to go for QoL. It’s always hard to know what’s best at the time but I think there should be more discussion around QoL v survival benefits.

hope you are keeping well now. 

 

 

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User
Posted 18 May 2024 at 16:34

Hi Maggie,

my case has some similarities to your husband's in that the cancer was too far advanced at diagnosis for an operation (if I've read his bio correctly) and I also had multiple mets in my pelvis, spine, ribs etc.

I too had 6 cycles of Docetaxel but this was quickly followed by 18 sessions of radiotherapy targeting the primary tumour in my prostate, which also helped to further shrink my various mets.

I found the radiotherapy to be quite easily tolerable, but the caveat is I was 55 at the time.  I felt a little tired towards the end of the 18 sessions, but I found that the side-effects were by no means as bad as from the Docetaxel chemo.  The biggest problem was having to go to the hospital 5 days a week for nearly 4 weeks.  

I wasn't having incontinence issues before the RT, nor did I have any afterwards.  I was warned of the possibility of incontinence but it didn't happen.

I would ask the consultant how many sessions of RT would be needed for your husband.  If it's only a single session or a handful of sessions, my 10p worth would be to try it.

Best of luck whatever you decide, and please do ask me if you've any questions!

Craig

User
Posted 18 May 2024 at 17:05

Thank you for this Craig

I think, if I understood him correctly, he is suggesting 6, weekly sessions. He said it will not help the cancer itself but could help with the side effects. My concern was that he added ‘it could make them worse’

it came a bit out of the blue as he had previously said he wasn’t suitable for radiotherapy as there were too many mets. It seems that we are now considering radiotherapy to alleviate symptoms. So I think it’s more like your recent targeted RT to relieve your sciatica symptoms.

i think the size of the tumour is putting pressure on the urethra so the RT is to help with that.

It’s Good to hear that you didn’t have any real problems with the radiotherapy - I think tiredness seems to be a given for  each additional treatment regime!! 

Wishing you all the best on your journey 

User
Posted 18 May 2024 at 17:51
I believe when talking about palliative RT , six cycles is the maximum the body can take. I rejected Hormone Therapy for the longest time for my own reasons. I was 52 and had already had surgery. I also rejected the salvage radiotherapy sessions for my own reasons. I did decide to have 3 sessions of palliative radiotherapy to upper back , lower back and right ribs. Was totally painless at treatment and only 15 minutes each time. However I suffered severe sore throat and cough from the radiation that passed through. Also developed gastro issues and piles for the first time in my life. Apparently this RT can cause the tumours to flare and cause very bad pain but not in my case. Good luck
User
Posted 19 May 2024 at 09:03

Thanks for this Chris

i didn’t realise that about the six sessions. So if he were to have those, does that mean he couldn’t have any to any of the bone mets later on or is it six to one area?

I really admire your decisions to go for QoL. It’s always hard to know what’s best at the time but I think there should be more discussion around QoL v survival benefits.

hope you are keeping well now. 

 

 

User
Posted 19 May 2024 at 18:01
Thanks Mags. There are people on here way more qualified than me who may be able to inform you better. My belief is that six proper palliative doses are the max a body can take but I guess as you say if it’s in a different area ??

Just wish you strength and hope. It’s an awful illness mentally and physically for both partners. X

 
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