Hi Bob;
I had 43 IMRT - finished in early June. The last 10 treatments which I
understand were more concentrated than the others caused the side effects to
increase in intensity - frequent bowel movements, anal burning and
hemmeroids which never bothered me before. I had alot of gas, stomach
bloating and my stomach always felt full-so I couldn't eat much without
discomfort. The Rad Onc said it would go away and gave me several
prescriptions, which were very expensive and didn't do much good. I finally
went to my Urologist who has been in the Prostate Cancer business for ma
ny years. He gave me 2 prescriptions - Celebrex and Librax and within 2
weeks things were just about back to normal.
After almost 6 months I still have frewuent bowel movements - from 3 to 5 or
6 a day. The stools are normal and there is no discomfort-only
inconvenience. My Uro said I will probably always have this condition-some
of the Radiation got where it wasn't supposed to go. A recent CT scan shows
no abnomalities - so I live with it.
In addition I have been on Hormone therapy - Lupron and now Viadur and have
the expected side effects of that - fatigue and low energy being the main
problem.
The rectal burning was a real pain the the a--  and the prescriptions I got
didn't help much. I found that by keeping the area clean - use the moistened
Baby wipes each time and liberal amounts of the following really helped.
Olfart's Butt Salve -
Mix equal parts of Hydrocortisone 1% cream and Triple Antibiotic Ointment.
You can get these for a few bucks at the drug store and work much better
that the $ 63.00 foam that the Rad Onc precribed. I mix mine in an old
plastic film canister.
The maybe this-maybe that answer form Rad Oncs is pretty standard. The side
effects, their intensity and how long they last seems to vary from peron to
person.
Good Luck on your outcome.

Hi Bill.  I was a surgical case, so I don't have anything to offer on
IMRT except to point out that there are lots of posts on it in the
archive, which you can access via Google Groups (I hope you can do that
on webtv).

The IMRT folks here will probably be along shortly.

jimhoney

Bob,

I had a combination of 23 external beam treatments and two
HDR brachytherapy procedures, plus hormone therapy.

Side effects included hemmorhoids, blood in the semen and
swelling of the prostate around the urethra that made urination
difficult and very frequent.  At its worst, I got up seven times
a night to urinate.  There was also a small amount of sunburn
like effects on the skin around the area, and some of the pubic
hair was burned away.

To mitigate the side effects, I used Preparation H (lots of it),
skin lotions, and Flowmax, a prescription drug that made
urination easier.

None of the side effects were severe or debilitating and all
seem to have completely cleared up by about three months
after the end of treatment.  Even the hair came back.

Potency was down a lot during treatment, but I was on hormone
therapy that affected that too.  It has come back pretty close
to baseline afterwards.  The amount and nature of the
semen is now very different from what it was but, for me at
least, sex is as good as ever.

    Alan

I completed a course 38 IMRT treatments in mid-October. I'm also on
adjuvant ADT, Lupron, for an indefinite time. Reason: Gleason 8 tumor
with relatively low PSA (3.6), which is a marker for hormone-refractory
PCa.

Also, this was "salvage" IMRT because I have a history of failed
cryosurgery on a Gleason 9 tumor a year ago.

The dosage was 76 Gy, plus 45 to the pelvic lymph nodes and 55 Gy to the
seminal vesicles.

Presently, I have minor bowel movements when urinating in the morning.
Urination is fairly frequent, but IMO not unusual in view of the fact
that I'm drinking coffee. There have been a few mornings when for some
reason I did not drink coffee, and the urinary frequency declines. No
surprise there. Mostly, the stream is nearly normal, but that could be
the Flomax 0.4 mg qd I'm taking.

The BMs decline as the day progresses.

As for nights, I have recently found that frequency has declined to
twice, maybe three times. Might also have a small BM. This is a vast
improvement from six weeks ago, when it was hourly.

No anal complications.

I expect to wean myself off of the Flomax in about a month.

Still some fatigue, which I must address via exercise.

I expect that, two steps forward one back, things will settle down in
the next couple of months. But it is necessary to bear in mind that the
effects of RT do not end with the treatment sessions.

As for the ADT, my SE's are pretty much what one can expect.

All in all, I will not know whether the RT achieved its purpose for at
least five years. Yes, five. At least that much relapse-free time must
pass before I'll be able to say with any confidence at all that I'm
cured. And there will always be some degree of doubt, even beyond five
years.

Caveat: everyone is different, so Bill's experience may -- or probably
-- will not be the same as others'. On the whole, I consider it all to
be tolerable. YMMV.

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 L. S. Churchill

That's because there will be much variation according to the patient's
age, overall health, etc.

I'm 53 (54 in January) and 20 months post treatment, and by now the
only side effect is ED.  I remember fatigue, difficulty urinating,
frequent bowel movements, blood in the stool.  That all eventually
went by the wayside as time went on, and now it's all a memory.
That's the good news.  That and all 6 mo. PSA checks showing PSA still
falling, and incontinence has never been even a slight factor.

The bad news is that ED and sexual dysfunction slowly take effect.  I
noticed nothing in THAT department during treatment and for months
afterward.  However, be aware that as time goes on, the volume of
ejaculate continues to decrease to a tiny discharge (though I don't
think it ever goes completely dry with IMRT), and the stiffness of the
erection starts to go south.  The orgasm sensation is much less
intense - at least it is for me -  with the small fluid discharge.

Back to good news.  I resisted Viagra and the other drugs until very
recently, stubbornly refusing to admit the effects of the radiation.
At my last check up in November I had the doc prescribe both  Viagra
and Levitra to experiment.  Let me tell you that these drugs work just
great for IMRT patients. They don't fix the sensation issue, but they
do make wood.  Big time.

Back to bad news.  My wife and I found out that despite a
representation in our health insurance prospectus, these "life style"
drugs are not covered.  And they are not cheap.  So our once a week
"night on the town" is pricey when you factor in dinner, wine, and the
pill.  But worth it.

I had EBRT, but I suspect the SEs are the same.  I had very minor bowel
problems, lesser fatigue problems and even lesser urinary tract problem at
the very end.

I walked 3-5 miles a day, 3-5 days a week, slept 1 more hour each night, and
drank gallons of water to stave off SEs.

TTT

________

I'm 68, almost 69, and was diagnosed just slightly more than a year
ago, with PSA of 18.  All encapsulated, we think.  Had 45 sessions of
IMRT, ending in August, combined with Zoladex hormone deprivation
therapy.  Hate that!!

But the radiation was a piece of cake, happily with few of the
to-be-expected side effects.  I did have problems peeing, a result of
a swollen prostate, but Flomax has taken care of that.  And I
developed an intense case of athlete's foot and, later, jock itch.  

I don't know that anyone will attribute those maladies to the
radiation, but it seems to me that they might well be side effects
that attacked me simply because my resistance was down.

Since shortly after the DX, I have been on Zoladex and that will last
for two years, I believe.  The side effects of that are horrendous!
Hot flashes are a pain, of course, and there is the sexual
dysfunction, but the memory loss is REALLY annoying.

I was clicking around the TV dial the other night, for instance, and
came upon Larry King.  And realized that I could not dredge up his
name!  My mind was just a total blank.  

I have mentioned the memory loss thing here before, and I would be
seriously concerned, except that it is a *known* SE of hormone
meddling.  

Ah well.  My wife had a minor stroke about 10 years ago, and she still
sometimes has to search for a word or a name.  Now we are a nice match
once again.  And we think we will be quite comical when we truly get
into our dotage.

Marshall

Hi Bob:

I finished my IMRT ten days ago (45 treatments, 81 Gys). My SE's were
limited to some loose bowels, some difficulty in urinary speed and
completeness (fixed by taking Daypro), and mild to moderate fatigue
(fixed by getting plenty of sleep and limiting hard physical activity).
The bowels and fatigue are already feeling good, and I plan to stop the
Daypro when the bottle runs out (in a few days). There's been no
problem with impotence (although, at 65, I wasn't Sam Stud to begin
with). I've been very pleased with the treatment and SEs; of course,
whether it nailed the PCa won't be known for many months.

I think your oncologist ought to be able to give you answers that are
"probably this" and "probably not that", rather than just "maybe". Most
of the posts and information elsewhere I've seen indicate that most
men's SEs are similar to mine.

Jim Thomas