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prostate radiotherapy how do they "attack" it?

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User
Posted 05 Jul 2014 at 20:19

Hi all,Christopher here,(Chris by name cross by nature )http://community.prostatecanceruk.org/editors/tiny_mce/plugins/emoticons/img/smiley-laughing.gif


Have been having hormone therapy for the last four months in preparation for radiotherapy for prostate cancer.Due to see cancer doctor this Monday 4th July to find out if the hormone therapy has shrunk the little bugger,and to discuss date to start RT.What I would dearly love to know is how do they attack it? do I have to lie stark still in a certain position,if so how long? do they direct it at the prostate area alone or at whole body?do I have to undress (not a pretty sight) or am I fully clothed? am I in a room with other people or alone? Last question,is it true that RT can affect the eyesight? if so,is it temporary or could it be permanent?


 


Thanks in advance and nice to meet you all


 


Kind regards


 


Chris

User
Posted 05 Jul 2014 at 22:15
Chris

You will have a scan in preperation for RT. Prior to the scan they will want you to empty your bowels and fill your bladder.
Once they are satisfied with this they will do a small tattoo dot just below each hip and on your pubic line. They will use these to line you up at each session (using lasers). They will want you to empty the bowels and fill the bladder before each RT session, this is to minimise any side effects. They will discuss all this with you ie when to drink the water etc
You will go into the RT 'room' with the radiographers. Once on the bed you will be asked to drop your trousers and underwear so they can see the tattoos to line you up. They will put a paper towel over your privates to protect your modesty. Once lined up. The RT m/c will move around you zapping from five different positions above, below and sides of the pelvic area/prostate. It takes about 3-4 mins and is painless.
Once done you can go. You will probably need a wee to empty your bladder.
Some men do suffer with side effects but the oncologist will discuss this with you
All the best
Bri
User
Posted 06 Jul 2014 at 01:37
Hi Chris,

Once set up you will be left in the treatment room alone during treatment although I would expect you will be observed either through a window or via camera as I experienced. It is entirely painless, rather like having a dental X-ray with one of those machines that move round your head except it takes longer and the machine (a Linear accelerator or Linac), pauses at each one of it's positions - normally 5. You will need to remain still on the treatment table during this time as it helps the operator keep the beam on your prostate and specifically the tumour(s). Other nearby organs may receive a small dose but this is minimised as much as possible. I am not sure whether it is standard practice to have to remove your shirt and pants for treatment - I kept mine on but I was encased in a body cast which carried markings for alignment which is not the norm. I have never heard that RT of the pelvic area could affect your eyesight but do ask your radiologist about this if you have heard that it could do.



Barry
User
Posted 06 Jul 2014 at 05:28
They will give you enemas. But I had my RT early morning and fortunately I'm as regular as clockwork so didn't need them. If your bowel isn't empty at the scan they will ask you to empty your bowels.
Random scans are then done throughout RT to make sure the bowel and bladder situation is consistent. An enema is a small price to pay to avoid your bowel being zapped mate

Bri
User
Posted 06 Jul 2014 at 13:28
Chris,
you will not necessarily get the enema treatment.
My hospital (Southend) kept us on a mild laxative to keep things moving in an orderly fashion.
'Twas the good old milk of magnesia so not exactly rocket fuel.
Worked a treat. However some guys didn't even bother taking it as they were confident with performing on time :)

Hth

Kevin
User
Posted 06 Jul 2014 at 15:47
Chris,

The empty bowel/full bladder is required before each and every treatment. As Chilled says, not all hospitals recommend enemas. Mine recommended a laxative called magnesium hydroxide which is available over the counter from a pharmacist (I insisted on a prescription). It looks and tastes like Milk of Magnesia, but is much stronger. I found it all too effective at cleaning me out at the higher end of the recommended dosage and reduced dosage to a minimum.

I managed to arrange most of my treatment appointments for the same time each day which helped me get into a routine to manage the bowel/bladder regime. Things went well except when appointments ran late or were rescheduled. Unfortunately, this can happen quite often. Some people (didn't happen to me) have appointments cancelled which results in the treatment schedule being lengthened. I gave RT 100% prioirity and cleared my diary of everything else when necessary.

Many patients have side effects such as more frequent peeing and "urgency" as the medics call it when you're caught short. I always waited at the hospital for 10-20 mins after treatment to do an extra pee before driving home. This stood me in good stead for the 40 minute drive. I also sometimes had an "urgency" problem when lying on the treatment table. This I usually solved by "mind over matter", but on one or two occasions (literally) put up my hand to ask the radiographers to pause the treatments while I did a pee. If this happens don't worry: radiographers are well used to this. Some men who have bladder control problems end up being catherterised, which sorts the problem. Take a spare of underpants with you to deal with the consequences of any bladder problems.

I found that my urinary and bowel symptoms started about 2 - 3 weeks into the treatment and faded 2 -3 weeks after completion.

Oh, I should mention that a weekly blood test - full blood count and PSA - is normal during RT. This should give reassurance.

Hope all goes well!

Viv
User
Posted 07 Jul 2014 at 21:23
Great news Chris!

The RT will be a breeze, if was apprehensive before it started but when it finished I missed meeting the other guys each day for a chat...

Cheers
Kevin
User
Posted 07 Jul 2014 at 22:25
Hello Chris,
I'm into my third week of rt and everything so far is going well. Someone has already suggested to take a spare pair of underpants with you. I've gone a little further...packed two pair, a towel and I also asked one of the radiologists if she could get me a couple of bottles for peeing in. If on my way home I do get caught short then I can pull into a layby and use a bottle with the towel over my lap...seemed to make sense.
Up to now, I've not needed to. Like others have said, always empty out after the rt is over and before setting off for home.
Best of luck

David

Edited by member 07 Jul 2014 at 22:27  | Reason: Not specified

User
Posted 08 Jul 2014 at 09:19
"Bang Goes the Theory" gave a nice layman-level description (and a fab example using a paintnball gun) which my wife found useful in understanding how Radiotherapy works. Its available on youtube : https://www.youtube.com/watch?v=Go3ZfWJCYLA
User
Posted 13 Jul 2014 at 22:51

Hi everyone I am new on here, seems such a good idea this site.  Solid practical advice from the contributors.


It may be Chris is now well into his treatment but here's some additional notes;


all I can add is that the motorised bench you lay on to be zapped is the hardest carbon fibre I've ever encountered.  I got 6 treatments over 6 weeks; some less sturdy folk get smaller doses every day for 6 weeks, quite a burden.  But the bench has a head pillow & foot braces so for ten minutes you can reasonably keep dead still, except for breathing of course.


I was enlisted into the "Stampede" clinical study, as a result I was chosen into group "H" to receive X-Ray treatment in addition to the hormones I was already on.


The operators are very kind and careful to line up your laser dots - which were established from a tunnel scan, you look like a 'crash test dummy'! - they heave you into position expertly.  In my case an operating gown was given to travel from the changing room to the X-Rayzapper.  The machines have nice restful names like "Laurel".  On the ceiling is a calming Nature picture, I found it helpful to study it so as not to move but don't shift your head to still see it when the electron head swivels over you.


I've kept a graph of PSA count since diagnosis last May (2013) and it plummeted from then due to the hormones, and again down a fraction after the X-Rays.  It stayed under the alert target of 4 for a time, but is now (June 2014) creeping up a fraction - this bounce after 18 months is not unusual.


It helps to keep notes of all the dates from the original diagnosis onwards - so many kind specialists I'd never recall the names and PSA scores otherwise.  Goes without saying, the best of luck.

User
Posted 20 Jul 2014 at 19:40
Hi, Chris,
Having gone through through RT here in the states, it sounds like the same regimen, with the exception of the "emptying bowels" part. I was never required to do that. As was mentioned earlier, the treatment becomes your routine for the designated period of treatment. Mine was 4:00 PM, Monday through Friday for 6 weeks. You become familiar with those on similarly scheduled treatments. My RT was after my RP by three years; the PSA started to rise. I had a problem related to the RT I haven't seen mentioned. Two years after RT, I developed benign tumors in my bladder. A consequence, I was told, of the RT. 1st symptom was blood in my urine stream, a phenomenon that will immediately catch one's attention! No surgery is fun, but the recovery from the tumor removal was quite fast. It's just that one doesn't look forward to any procedure which begins with, "transurethral". I have no idea if mine was a common problem, so we'll assume you won't have to deal with that further down the road.
All the best,
Lawrence
"I am not young enough to know everything."
Oscar Wilde
Show Most Thanked Posts
User
Posted 05 Jul 2014 at 22:15
Chris

You will have a scan in preperation for RT. Prior to the scan they will want you to empty your bowels and fill your bladder.
Once they are satisfied with this they will do a small tattoo dot just below each hip and on your pubic line. They will use these to line you up at each session (using lasers). They will want you to empty the bowels and fill the bladder before each RT session, this is to minimise any side effects. They will discuss all this with you ie when to drink the water etc
You will go into the RT 'room' with the radiographers. Once on the bed you will be asked to drop your trousers and underwear so they can see the tattoos to line you up. They will put a paper towel over your privates to protect your modesty. Once lined up. The RT m/c will move around you zapping from five different positions above, below and sides of the pelvic area/prostate. It takes about 3-4 mins and is painless.
Once done you can go. You will probably need a wee to empty your bladder.
Some men do suffer with side effects but the oncologist will discuss this with you
All the best
Bri
User
Posted 06 Jul 2014 at 01:37
Hi Chris,

Once set up you will be left in the treatment room alone during treatment although I would expect you will be observed either through a window or via camera as I experienced. It is entirely painless, rather like having a dental X-ray with one of those machines that move round your head except it takes longer and the machine (a Linear accelerator or Linac), pauses at each one of it's positions - normally 5. You will need to remain still on the treatment table during this time as it helps the operator keep the beam on your prostate and specifically the tumour(s). Other nearby organs may receive a small dose but this is minimised as much as possible. I am not sure whether it is standard practice to have to remove your shirt and pants for treatment - I kept mine on but I was encased in a body cast which carried markings for alignment which is not the norm. I have never heard that RT of the pelvic area could affect your eyesight but do ask your radiologist about this if you have heard that it could do.



Barry
User
Posted 06 Jul 2014 at 02:15

Thank you very much for your very helpful replies,good idea to make sure I empty my bowels before I leave home then? we all get days when we don't go so please don't tell me enema http://community.prostatecanceruk.org/editors/tiny_mce/plugins/emoticons/img/smiley-surprised.gifhttp://community.prostatecanceruk.org/editors/tiny_mce/plugins/emoticons/img/smiley-surprised.gif


Chris

User
Posted 06 Jul 2014 at 05:28
They will give you enemas. But I had my RT early morning and fortunately I'm as regular as clockwork so didn't need them. If your bowel isn't empty at the scan they will ask you to empty your bowels.
Random scans are then done throughout RT to make sure the bowel and bladder situation is consistent. An enema is a small price to pay to avoid your bowel being zapped mate

Bri
User
Posted 06 Jul 2014 at 12:19

Thanks Bri,I agree it's a small price to pay and I'm happy and willing to do all that is asked of me by the RT team.I have to ask though,is this emptying of the bowel thing just for the tattooing or every RT session? for example,if I were like some people who only empty their bowels 3 to 4 times a week, I would have to have an enema prior to every RT session that I don't empty my bowels? I feel I am not making much sense with the questions I am asking,sorry for that but although since being diagnosed, I feel I am handling my situation pretty well all things considered,ie: having undergone two heart attacks and two heart bypasses over the years and COPD on top of that.So if my questions seem a bit banal I apologise .Thanks again for your comments.


 


Kind regards


 


Chris

User
Posted 06 Jul 2014 at 13:28
Chris,
you will not necessarily get the enema treatment.
My hospital (Southend) kept us on a mild laxative to keep things moving in an orderly fashion.
'Twas the good old milk of magnesia so not exactly rocket fuel.
Worked a treat. However some guys didn't even bother taking it as they were confident with performing on time :)

Hth

Kevin
User
Posted 06 Jul 2014 at 15:47
Chris,

The empty bowel/full bladder is required before each and every treatment. As Chilled says, not all hospitals recommend enemas. Mine recommended a laxative called magnesium hydroxide which is available over the counter from a pharmacist (I insisted on a prescription). It looks and tastes like Milk of Magnesia, but is much stronger. I found it all too effective at cleaning me out at the higher end of the recommended dosage and reduced dosage to a minimum.

I managed to arrange most of my treatment appointments for the same time each day which helped me get into a routine to manage the bowel/bladder regime. Things went well except when appointments ran late or were rescheduled. Unfortunately, this can happen quite often. Some people (didn't happen to me) have appointments cancelled which results in the treatment schedule being lengthened. I gave RT 100% prioirity and cleared my diary of everything else when necessary.

Many patients have side effects such as more frequent peeing and "urgency" as the medics call it when you're caught short. I always waited at the hospital for 10-20 mins after treatment to do an extra pee before driving home. This stood me in good stead for the 40 minute drive. I also sometimes had an "urgency" problem when lying on the treatment table. This I usually solved by "mind over matter", but on one or two occasions (literally) put up my hand to ask the radiographers to pause the treatments while I did a pee. If this happens don't worry: radiographers are well used to this. Some men who have bladder control problems end up being catherterised, which sorts the problem. Take a spare of underpants with you to deal with the consequences of any bladder problems.

I found that my urinary and bowel symptoms started about 2 - 3 weeks into the treatment and faded 2 -3 weeks after completion.

Oh, I should mention that a weekly blood test - full blood count and PSA - is normal during RT. This should give reassurance.

Hope all goes well!

Viv
User
Posted 06 Jul 2014 at 16:44

Thank you to each and every one of you for the excellent info,I am more prepared and ready now because of you guys.Thanks again.


Kind regrds


 


Chris

User
Posted 07 Jul 2014 at 19:32

Just an update,went to Colchester hospital today and the doctor said very good news,my PSA has gone from 20 down to 0.5 and is almost undetectable,you can imagine me and my wife's relief.Told I will be starting RT mid August.


Regards


Chris

Edited by member 07 Jul 2014 at 20:20  | Reason: Not specified

User
Posted 07 Jul 2014 at 21:23
Great news Chris!

The RT will be a breeze, if was apprehensive before it started but when it finished I missed meeting the other guys each day for a chat...

Cheers
Kevin
User
Posted 07 Jul 2014 at 22:25
Hello Chris,
I'm into my third week of rt and everything so far is going well. Someone has already suggested to take a spare pair of underpants with you. I've gone a little further...packed two pair, a towel and I also asked one of the radiologists if she could get me a couple of bottles for peeing in. If on my way home I do get caught short then I can pull into a layby and use a bottle with the towel over my lap...seemed to make sense.
Up to now, I've not needed to. Like others have said, always empty out after the rt is over and before setting off for home.
Best of luck

David

Edited by member 07 Jul 2014 at 22:27  | Reason: Not specified

User
Posted 08 Jul 2014 at 01:13
What a great idea David,cheers mate
User
Posted 08 Jul 2014 at 09:19
"Bang Goes the Theory" gave a nice layman-level description (and a fab example using a paintnball gun) which my wife found useful in understanding how Radiotherapy works. Its available on youtube : https://www.youtube.com/watch?v=Go3ZfWJCYLA
User
Posted 13 Jul 2014 at 22:51

Hi everyone I am new on here, seems such a good idea this site.  Solid practical advice from the contributors.


It may be Chris is now well into his treatment but here's some additional notes;


all I can add is that the motorised bench you lay on to be zapped is the hardest carbon fibre I've ever encountered.  I got 6 treatments over 6 weeks; some less sturdy folk get smaller doses every day for 6 weeks, quite a burden.  But the bench has a head pillow & foot braces so for ten minutes you can reasonably keep dead still, except for breathing of course.


I was enlisted into the "Stampede" clinical study, as a result I was chosen into group "H" to receive X-Ray treatment in addition to the hormones I was already on.


The operators are very kind and careful to line up your laser dots - which were established from a tunnel scan, you look like a 'crash test dummy'! - they heave you into position expertly.  In my case an operating gown was given to travel from the changing room to the X-Rayzapper.  The machines have nice restful names like "Laurel".  On the ceiling is a calming Nature picture, I found it helpful to study it so as not to move but don't shift your head to still see it when the electron head swivels over you.


I've kept a graph of PSA count since diagnosis last May (2013) and it plummeted from then due to the hormones, and again down a fraction after the X-Rays.  It stayed under the alert target of 4 for a time, but is now (June 2014) creeping up a fraction - this bounce after 18 months is not unusual.


It helps to keep notes of all the dates from the original diagnosis onwards - so many kind specialists I'd never recall the names and PSA scores otherwise.  Goes without saying, the best of luck.

User
Posted 20 Jul 2014 at 14:29

Thanks rabdhu45


All info from everyone is gratefully received.Went to my first appointment at the new Radiotherapy Unit at Colchester Hospital last Friday 18th.I have to say I was so impressed with the place and the waiting areas and gardens,it was easy to imagine what private health care would be like.


I was asked by the receptionist for my parking ticket and exchanged it for a free ticket,great result.I was then seen by a radiologist (I think)lovely person,and the next half hour was mostly info,I was able to ask questions which helped greatly.One of my concerns was finding a parking space for the future 37 appointments and it turns out that there is a dedicated car park for RT patients and it's free,what a result.


My next appointment is Friday 25th July for a scan and tattoos I believe,then I start treatment proper on18th August.


I know Colchester Hospital has had a lot of bad press over the past year,but I have to say that I have had nothing but the best care and attention by everyone that has been dealing with me since I was first diagnosed in January this year.When the doom-sayers in the media say the NHS is on it's knees,then all I can say is Colchester Hospital are doing a brilliant job in covering it up.


I won't be making long posts like this very often,I thought that if there are people reading this are going to use the same hospital,then I hope I have reassured them of the professionalism of ALL the staff that work there.


Thanks again for your comments and advice.


Kind regards


Chris


 


 


 


 


 


 

User
Posted 20 Jul 2014 at 19:40
Hi, Chris,
Having gone through through RT here in the states, it sounds like the same regimen, with the exception of the "emptying bowels" part. I was never required to do that. As was mentioned earlier, the treatment becomes your routine for the designated period of treatment. Mine was 4:00 PM, Monday through Friday for 6 weeks. You become familiar with those on similarly scheduled treatments. My RT was after my RP by three years; the PSA started to rise. I had a problem related to the RT I haven't seen mentioned. Two years after RT, I developed benign tumors in my bladder. A consequence, I was told, of the RT. 1st symptom was blood in my urine stream, a phenomenon that will immediately catch one's attention! No surgery is fun, but the recovery from the tumor removal was quite fast. It's just that one doesn't look forward to any procedure which begins with, "transurethral". I have no idea if mine was a common problem, so we'll assume you won't have to deal with that further down the road.
All the best,
Lawrence
"I am not young enough to know everything."
Oscar Wilde
User
Posted 21 Jul 2014 at 15:03

Thanks Lawrence

Edited by member 21 Jul 2014 at 23:47  | Reason: Not specified

 
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