The semen is re-adsorbed. The semeninal vesicles are gone and some of the
tubing leading to them, the semen are probably dumped into the abdominal
cavity. The symptoms you mention about cover it- I didn't experience any of
them, however.

Hi Gareth,
I had five weeks of EBRT followed by 110 PD-103 seeds implanted into the
prostate.
My side-affects in a nutshell:
Immediately following, difficulty peeing - not unbearable, just had to work
at it. Wife's reaction, "try not to groan so much" :-) Flomax helped
immensely. Change in bowel movements. Tiny and frequent.
Some days I get very tired and have to rest but it passes quickly. I
exercise at health clubs and that is very important. Do what you can to keep
your energy up. Soy supplements may help with the night sweats.

Stay positive and don't let this thing get you down!

Good luck,
Larry

also tiredness

See http://prostate-cancer.org/index.html and click on "PCRI
Papers." Searching the page that results will provide access to
information on every conceivable treatment modality.

There are dozens of links to be found at PCRI's "Resources" page.

As for side effects: Gareth does not tell us which modality of
radiotherapy he is to undergo. Brachytherapy (seed implants), 3D
Conformal, IMRT, other? It would be helpful to know, as more
detailed info could then be provided. Also: what are Gareth's
age, PSA, TNM stage, and Gleason? Other medical conditions?

Possible side effects could include: fatigue, skin reactions at
the treated area (this would be applicable -- if at all -- to
EBRT (External Beam Radiation Therapy) not brachytherapy, nausea,
diarrhea, rectal irritation or bleeding. Also possible is
impotence, maybe permanent, up to two years post-treatment. (Also
see below)

But every man is different. I concluded 38 IMRT (Intensity
Modulated Radiation Therapy) treatments a couple of weeks ago. My
side effects were quite mild. Some minor diarrhea when urinating,
inconvenient but manageable as I'm not working every day. I took
a half-caplet of Imodium twice a day, which worked well for me.
But bowel malfunction might be permanent, depending upon the
radiation method and, of course, the individual.

Some minor incontinence/urgency, again easily managed so long as
I was, er, prompt.

Minor rectal bleeding/spotting which may or may not have resulted
from the RT, as I also have internal hæmorrhoids that
occasionally do the same.

I developed a very minor rash at the site, which was taken care
of with one application of ointment supplied by my oncolgist.

At this point, almost three weeks post completion of IMRT, the
effects are are nearly gone.

EBRT would probably include a trip to the clinic every weekday
for 35 - 40 sessions.

I believe that the primary reason for my relatively minor side
effects was the employment of IMRT, the very latest modality.
Because it's so accurate, higher energy levels can be employed
and tailored to the characteristics of the organ and tumor(s),
while at the same time decreasing exposure of healthy tissue to
radiation.

Beginning ADT prior to radiation is called "neoadjuvant hormone
therapy" and I understand it to have good results.

I, too, am on Zoladex. I complained about the pain of the
implantation procedure, requested Emla cream/patch (lidocaine),
will switch to Lupron late next month. It's still an implant, but
is done in the gluteus maximus (sp?) and is maybe less uncomfortable.

The night sweats are "hot flashes," exactly the same as suffered
by menopausal women. Gareth is probably having the same during
the day, but doesn't notice. There are treatments, including,
believe it or not, Paxil (paroxitine) or Effexor (venlafaxine)
both of which are antidepressants. One of their side effects is
suppression of hot flashes. Also in use is Megace (megestrol
acetate). This is a man-made form of the female hormone
progesterone. It has been administered with Zoladex and Lupron,
and found to reduce hot flashes by some 90%. I'm presently trying
800 IU of vitamin E, at the suggestion of my onc's assistant.
After one week, no result. I'll give it another while before
raising the issue again.

I expect to be on ADT for several months, maybe a year before
stopping to see what my PSA does. Reason is that my tumor is a
Gleason 8, high risk of metastasis.

Let us know how it goes.

Regards,

Steve J
__
"Never give in--never, never, never, never, in nothing great or
small, large or petty, never give in except to convictions of
honour and good sense. Never yield to force; never yield to the
apparently overwhelming might of the enemy.''
--Sir Winston Leonard Spencer Churchill

BTW, is Gareth aware that Sir Winston was awarded honorary US
citizenship? It was done posthumously; maybe they were afraid
he'd stand for election, here ;-)

His mother was a US citizen.

Difficulty urinating is not uncommon; I believe my doc said about 1 in
4 patients. I was prescribed Flomax about half-way through the
treatments, continuing until the treatments ended.  After the
treatments stopped, all urination and bowel issues went away.  

It has been 18 months since treatments ended.  The effects on
sexuality gradually become more apparent.  The amount of ejaculate has
slowly decreased to a dribble.  With that, libido has decreased:  I
don't get spontaneous erections and I don't feel very horny anymore.
Erectile function has decreased to about 90% or so of before,
sometimes less.  So far, no need for viagra or other pill, but I
assume my time will come as the radiation damage continues to
manifest.  I hear it takes a few years.

Good luck.
--dt

Semen gets absorbed into the body.  Just like if you were vasectomized.

I drank lots of water, walked 3-5 miles 3-5 times a week and slept one extra
hour every night.

I had some diarrhea but not nearly a problem.  I had some urinary tract
burning in the very last week.  and, my wife told me I seemed tired, but I
didn't notice it.

One side effect I had that no one mentioned yet is blood
in the semen.  For me, that started during radiation and
continued for a month or so afterward.

I had a combination of 3DCRT, HDR brachytherapy,
and Lupron.

   Alan

_______

Hi Gareth and good luck.  It sounds like you have a pretty good handle
on what to expect, although EBRT doesn't necessarily mean a lot of
trouble.

I had 45 external beam radiation treatments that ended on August 10,
and I really suffered very little in the way of side effects.  Mainly,
it was a problem peeing, but two Flomax capsules a day did (and are
still doing) wonders in that department.

Toward the end of the treatments, diarrhea was an annoyance, but I'm
now pretty much back to normal.

Also, the fatigue would have been a serious problem if I wasn't 68
years old and retired.  In my case, I just took a lot of naps.  But
there were days when the walk down the drive to the mailbox was a
major trudge.

I, too, have been on Zoladex, and I blame it for very nearly
everything that is wrong in America.  Well ... not really, but I do
think the hormone suppression has far reaching effects, beyond the
infernal hot flashes (that continue but are diminishing as I approach
the nine-month mark!)  

I gather that I will be on the three-month time-release Zoladex shots
(in the stomach) for two years.  One of my radiation oncologists (a
woman) noted that the shots really knock down a man's hemoglobin,
accounting for tiredness and the occasional feeling that you need more
oxygen from your lungs.

And she agreed that the cost -- $1,950 per shot -- was criminal.

Happily, my medical plan pays for it, but I'm still outraged.  Anyway,
I think you should NOT greatly fear the EBRT.  Side effects will vary,
but my example shows that you can be lucky indeed!

All the best,
Marshall

Gareth:

I have just about finished half of my IMRT treatments (20 0f 45
treatments). I'm not taking any androgen deprivation drugs. I have
very mild urination slowing, some bowel differences (more movements
with less feces per movement) and some fatigue. I'm not yet taking any
meds for these things. It might get worse later, but the IMRT has
been, so far, no problem.

Jim Thomas