RT?

User

Posted 24 Jun 2018 at 19:26

Finished the 37 RT sessions last week! Side effects have been slight - no tiredness and been out on my bike a lot and walking at weekends right through. Increased frequency of peeing, but specialist nurse advised paracetamol for that and it seemed to help: ended up getting up twice a night for a pee. Bowels have been a bit unreliable, with occasional diarrhoea, and lots of wind in the evenings, but nothing catastrophic. Consultant reckons things should get back to normal in a month or so. The RT just got very tedious towards the end - will be very good not to have to head up to the hospital at all this week.

PSA test in 8 weeks time and HT for another 2.5 years - the consultant thought nothing much will change till the HT stops and only then will it be possible to see the effect of the RT. Much looking forward to travel and holidays now.

The radiotherapists were really excellent - highly skilled and always cheerful and good humoured -they made the whole process bearable.

User

Posted 17 Aug 2018 at 11:37

Check-up this week, 8 weeks after the end of the RT. PSA now 0.2. Consultant very pleased with that and told me to go away and forget about it all for the next few years. 2.5 more years of HT, so things could change 12-18 months after that but for the moment everything looks fine.

Next PSA check in 4 months then, assuming that's OK, every 6 months - and results by phone so no need to see the hospital again for a long time, I hope. Seems like the RT has done its job - much relief.

User

Posted 17 Aug 2018 at 11:55

That's excellent news - delighted to hear that you're doing so well! Have all your RT symptoms subsided now?

Chris

User

Posted 17 Aug 2018 at 12:03

Excellent news.

Ian

Ido4

User

Posted 17 Aug 2018 at 12:43

Chris, yes - RT side-effects have all disappeared. In the couple of weeks after the RT, I got a few minor skin issues - athlete's foot, a wart and patches of irritated skin on my legs - probably as a result of the RT sending the immune system haywire. All cleared up now (had the wart frozen off).

Peter

User

Posted 06 Jan 2019 at 19:02

Update: 6 months post-RT check-up showed PSA to be ＜0.1 (hospital lab says it can't measure reliably below 0.1). Next check-up in 7 months, so looking good.

Started to get some breast soreness as a result of Zoladex (another 2 years of that to go). GP fairly useless in giving advice on that, but looks as if Tamoxifen might help? Any views most welcome.

User

Posted 06 Jan 2019 at 19:20

On the basis that you have been on HT for almost a year, it is too late to ask for radiotherapy to the breast buds. You could ask about trying tamoxifen but it doesn’t always work and not all CCGs will allow it to be prescribed.

Great news on the PSA :-)

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

User

Posted 06 Jan 2019 at 19:35

GP seemed to think that Tamoxifen was an option, so looks as if it can be prescribed. But he didn't want to do anything without the oncologist's OK, so now pursuing her for a discussion.

Incidentally, the oncologist was very annoyed that the urologists didn't re-check the PSA before starting HT. Nobody had told me that I shouldn't ride a bike or have sex for 48 hours before the PSA test so, shall we say, the initial PSA level was not necessarily accurate. Clearly it was elevated, but the actual level will have to remain a mystery.... Definitely worth making sure that the PSA is tested just before starting HT (and minus bike-riding and sex...)

User

Posted 07 Jan 2019 at 06:41

What determines whether you have 20 or 37 sessions?

User

Posted 07 Jan 2019 at 08:22

How up to date your onco is, and how healthy s/he thinks you are. It also depends on the hospital having a suitable capacity for delivering IGRT / IMRT.

37 fractions of 2Gy has been standard for many years. Recent research found that healthy men could take a higher dose than previously thought (up to 3.2Gy) without causing additional side effects.

RT is cumulative so 19 or 20 fractions at 3 or 3.2Gy (around 60Gy total) is as powerful as 37f x 2Gy (74Gy).

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

User

Posted 07 Jan 2019 at 08:28

Not sure. the NHS centre near me generally does 20 hypofractionated sessions, should have same effect as 37 sessions as i understand it.

With 20 sessions each treatment is of a higher dose, e.g. for salvage RT i had 2.75 Grays of radiation each day to give 55 Grays in total.

I think the men having RT as their primary treatment had 62.5 Grays over 20 sessions.

Interesting articles below explainig this.

https://www.redjournal.org/article/S0360-3016(16)33496-4/pdf

https://www.england.nhs.uk/wp-content/uploads/2017/10/clinical-policy-hypofractionated-external-beam-radiotherapy.pdf

Ido4

User

Posted 07 Jan 2019 at 08:28

Okay Lyn and Ian that's really helpful thanks.

Edited by member 07 Jan 2019 at 08:29 | Reason: Not specified

User

Posted 07 Jan 2019 at 17:51

I think that I am going to have 20 sessions, 6 days for 4 weeks, this should be confirmed tomorrow when ihave my appointment with the oncologist

Bob

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