Hi All
This is my first post, but I thought it might be helpful to talk about my experience on being treated on the MRlinac at the Cromwell Hospital. I'm having my last fraction tomorrow. I have read the experiences of others having various treatments and it's helped me to think about what treatment I wanted and what to expect.
I was diagnosed with a Gleason 4+3 on the 26th June this year. Initially my PSA was 5.1 and my GP thought a MRI would be a good idea. The local NHS hospital dealt with this and the initial report was 'no cancer'. Following a MDT meeting they changed the view, to 'there was a possible tumour' and a biopsy was recommended. Given the two different views I used my insurance and sought a second opinion in one of the Cancer hospitals in London. The urologist I saw was not convinced there was cancer and suggested keeping an eye on the psa. The next psa was 5.6. Three months later it had moved to 8.4. The urologist then recommended another MRI. Following that there was something worth doing a biopsy on. The biopsy resulted in a 4+3. This wasn't what I expected and the fact that 4 was at the front was a blow. The urologist suggested 6 months of ADT with either surgery or radiotherapy. By this time I had read everything I could about Prostate Cancer and watched numerous YouTube videos. I think being a knowledgeable patient is important. On the basis of what I had learnt I felt the surgery route was not for me. The possibility of incontinence was something I wanted to avoid. Because I elected radiotherapy my urologist referred me to an oncologist colleague. The oncologist explained in great detail the issues with my tumour. I was a little taken back when told she thought it was a T3b. This was on the basis that it may have gone to the seminal vesicles. She felt that was a risk, but did think possibly T3a/b as it wasn't that clear it was 3b. However, she wanted me to think about 18 months of ADT rather than the 6 first suggested. I wanted radiotherapy, but SBRT. Five sessions over two weeks appealed rather than twenty to thirty over seven weeks. The next bombshell was when she told me my prostate was too small to have the seed implants for SBRT. This was a bad news /good news moment. She then said there's a very advanced machine which doesn't require seeds and uses an MRI in conjunction with a Linac. It turns out that it's highly accurate and the margins are very small, which limits damage to the surrounding tissue. It all sounded promising. The Cromwell Hospital then handled everything by liaising with my insurance company.
The treatment firstly involves a planning appointment. This was all pretty easy, but it was at 7.30am in London, so a night in a hotel prior. The planning involves an MRI on the MRlinac and then a CT. It was all over in a short period of time. Following the planning the clever people then prepare a plan, which I understand is checked and checked a few times by different specialists. A week later I had my first fraction of radiotherapy. It was all very easy with no pain. The only issue is if you have any gas they do tell you to pass it. I had no problem as I have 73 years experience. You have to have a pee before the treatment and then drink a couple of cups of water. The worst part is trying to remain still for about 45 minutes. Day 2 and 3 were just the same and I didn't feel like anything had happened. There is a day's gap after each fraction. Weekends are free. The following week 2 more fractions. My last one is tomorrow.
I'm told that any side effects usually start towards the end of the treatment and can get to the peak at two weeks. After 4 fractions I do feel a little bit of discomfort in the urethra, but it is tolerable. I'll comment on the next few weeks so as to paint the full picture. Like most of the prostate cancer journey, being fit really helps. I've always been active, but made a point of being in the gym every other day when I got my diagnosis. It's paid off on the ADT, so I'm hoping it will with the radiation.