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TURP and IMRT

tonybuxton
Posts: 76
Joined: May 2012

I recently posted how my oncologist did not answer any of my questions but simply "brushed me off"
So I am posting them here.
Why did I not receive a higher dose of radiation i.e 84 gy instead of 69gy when the higher dose is supposed to produce better long term results. I had the latest Novalis shaped beam IMRT which can deliver a higher dose. My daily dose was 2.3gy (30 factions)

I believe that a large portion of my prostate was removed (30 grms)by prior TURP. Therefor would this mean that the balance prostate left behind received much more radiation because there was less to radiate and would that be the reason I received only 69gy.

I also wanted to ask him about my expected disease free survival prospects. Not getting much response from him, my parting remark was "I guess I will live a couple of more years or so". And all the response I got from him was "you will live a lot longer that that".

I also wanted to ask him about my PSA results and the influence of HT but this has been kindly answered by some of you on the forum . I have learned a lot about Pca on this forum and it is very reassuring.
Tony

VascodaGama's picture
VascodaGama
Posts: 1511
Joined: Nov 2010

Hi Tony

I do not know much to help you with answers but I know that age matters in the decision of the doctors. The therapy goal will try to deliver sufficient radiation to cancerous tissues while avoiding or minimizing damage to close organs and healthy tissue. Some doctors aim more at the quality of life of the patient than cure.

In that sense radiation protocols differ a lot and only your team of radiologists (in particular the radiation oncologist) can give you a satisfactory answer for their choices in your case.
Gray doses are also decided on the tissue that will absorb the radiation. And that defines the isodose planning. Dense tissues require larger doses to deliver ionizing levels to the target. Fractions can be shorter in time (less Gy) or longer (higher Gy, hyperfractionate).
Maybe 2.3Gy is enough in TURP patients. Similarly in salvage treatments of the prostate bed the fractional doses tend to be smaller.

Sending the best to you and family.
VG

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