Ext. Radiation, Seeds and Urinary Problems

Ext. Radiation, Seeds and Urinary Problems - Plan B

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olfart - 28 Apr 2004 01:33 GMT

Hi Group;
When I went for Radiation today I ran into the Head Dr.(Rad Onc) and managed
to steer him into an empty exam room. When I told him about the urinary
problems I have been having and the fact that I have had swollen prostate
problems for several years which have never responded well to treatment, he
sent for my charts.
After checking my records out, he called my URO . After their "chat" he told
me - "you are not a good candidate for seeds as there would be alot of risk
involved on your part" . He said that he can get about the same result
without seeds by increasing the number of IMRT treatments from 25 to 48 and
by reajusting the computer program. If I should run into a "no pee"
situation during the course of the IMRT there would be no harm in stopping
for a few days (which I had to do last week) giving my URO time to get the
plumbing going again.
I'm alot more comfortable with this method knowing that I won't sustain a
permanant problem after seeding since "once they are in there" there isn't
much a URO can do improve things.
I haven't seen much on all the websites or in postings on the newsgroup that
deals with the success rate, etc of just having IMRT plus Lupron. So I would
appreciate any comments, suggestions or criticisms.
Thanks, George

Age - 69
8/12/02 - PSA 3.7
10/13/03 - PSA 4.69
11/11/03 - PSA 4.8
11/18/03 - Biopsy - 10 cores
one core-25% of core-Gleason 4+4=8
all other cores benign tissue
12/10/03 - Consult - Oncologist
12/16/03 - Consult - Radiation Oncologist
Treatment Plan - Northeast Ga Cancer Center
HT - started 12/17/03 - Eulixen & Lupron (2nd 4 mo Lupron-4/26)
2/10/04 - Started - Flowmax and Megastrol
Radiation - IMRT to begin 3/30/04 - 48 treatments

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Alan Meyer - 28 Apr 2004 20:17 GMT

> I haven't seen much on all the websites or in postings on the newsgroup that
> deals with the success rate, etc of just having IMRT plus Lupron. So I would
> appreciate any comments, suggestions or criticisms.
> Thanks, George

George,

The research I did indicated that external beam
radiation, when given in a sufficient dose (something
like 74 grays, I don't remember for sure) has the same
outcome as low dose external beam + seeds. Both
work equally well.

There are apparently some small tradeoffs in treatment
modality and side effects. With the 48 IMRT treatments
you have to keep going back for treatment for a much
longer period of time, but you don't have to go through
the anaesthesia and inpatient hospital stay for the seeds.

As far as side effects, I'm not sure. Irritated skin and
hemmorhoids may be more of a factor with more
EBRT. But maybe the dangers of urinary problems
are less.

In any case, from what I've read and been told by a
radiation oncologist, you have nothing to worry about
as far as treatment outcomes are concerned.
IMRT will do the job.

You can see this too on the Sloan-Kettering
nomogram program at:

http://www.mskcc.org/mskcc/html/10088.cfm

The Lupron treatment that you had is good preparation
for both EBRT and seeds, so that will still stand you
in good stead even if you switch to all IMRT.

Alan

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olfart - 28 Apr 2004 20:48 GMT

> > I haven't seen much on all the websites or in postings on the
> newsgroup that
[quoted text clipped - 37 lines]
>
> Alan

Thanks for the link Alan. The Dr said the out come should be about the same
either way. Side effects with the 48 IMRT might be a little more severe
(skin discoloraton and rectal soreness and possible bleeding,etc) but wiil
susside after rea is complete. In my case he feels that the seeding might
give me prostate swelling and hardening which could be difficult to correct
with my present condition.

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