CSN Login
Members Online: 8

You are here

Post External Beam Radiation Urinary Stricture Questions

maallyn
Posts: 13
Joined: Aug 2017

Folks:

 

I just completed external beam radiation (using Varian Truebeam IMRT) on Wednesday, April 18, 2018). Total number of EB sessions was 43 over 8 weeks.

Being a long-time active exerciser (used to commute by bicycle 30 miles per day before retirement, but continuing bicycling now in retirement), I never had any fateague problems as others had. I rode bike to each radiation session with no problem and continuted to work out in gym. So, no weakness effect. Only effect is stricture (inability to pee easily and needing catheters), which is what I want to address.

Along with EB, I get hormone shots (luprin, I think they call it) every 3 months. This started two weeks before EB started. 

Treatment is for PSA 25 / 12 out of 12 samples of TRUS Biopsy positive / Gleason 7. Some cancer found by MRI in prostate area, but CAT/Bone Scans were negative.

Had moderate stricture (having to pee several times per day/night and some trouble getting started. Was put on Tamsulosin HCL  .4 MG (2 capsules per day)  and Ibuprofen 200mg (2 capsules per day).

Stricture gets worse during treatment (as predicted by both the urologist and the radiation oncologist. By about week 4 (treatment 20 or so), started on self catheterization 5 times per day; using disposable catheters. Not Foley catheter.

Now that the treatment is over, Urologist wants a sever week wait and watch post EB treatment before deciding what course of action to take if any on the stricture.

 

Here are my questions . . .

What has your experience been regarding stricture (inability to pee easily) immediately after EB treatment? How long did it take for things to get back to normal/near norman?

What about dietary changes or suppliments to help with the stricture? Currently, I am on strong veg and freuit and grain diet with almost all processed stuff (including bread) removed. No red meat but occasional white meat. I am not currently taking any suppliments.

Any suggestions on suppliments or changes in diet to address the stricture issue?

 

Thank you

Mark Allyn

Bellingham, Washington

hopeful and opt...
Posts: 2226
Joined: Apr 2009

Mark

My friend had SBRT, a form of radiation. He had an inability to pee after treatment and had to have a catheter. His prostate size was large going in. Apperently the prostate swells after treatment, then atropies over time, so now he is doing fine. At the time he also received a medication to help him pee. I think that it might have been rapaflo (I am not sure of the drug name).

I cannot comment on what diet is appropriate for stricture, however your diet is both heart healthy and prostate cancer friendly.

 

Old Salt
Posts: 720
Joined: Aug 2014

My Rad Oncologist recommended alfuzosin to help with urinary flow problems during and after radiation therapy.

VascodaGama's picture
VascodaGama
Posts: 3041
Joined: Nov 2010

It may take two months for improvements on radiation proctitis/cystitis after RT of the prostate. This may be the reason behind your doctor's suggestion. You need to give up bicycling to allow healing of the area too. In fact, the previous high PSA (25 ng/ml) could have origins in your cycling life style along the years, which may also have placed into jeopardy the muscle tissues of regional organs (bladder, prostate, colon penis, testis, etc). I am not so sure but I think that avoiding medicines that thinner the blood (Ibuprofen, aspirin, etc) is better for faster natural healing at inner wounds.

 Please note that we are not doctors. You better get a second opinion from a radiologist instead of an urologist.

Welcome to the board.

Best wishes for fast recovery.

VG

 

 

 

maallyn
Posts: 13
Joined: Aug 2017

VG: Thanks for the feedback. I am interested in your note about bicycling. My radiation oncologist knows that I bike a lot and has encouraged me to continue to do so since exercise helps to stav off the fatege that some encouter (I had no fatege at all during my treatment). I hope that he would have said something about my bicycling if there was any issue. In fact, I rode my bicycle the two mile to and from each of the 43 treatment sessions. 

Now I wonder if all of this is wrong?

VascodaGama's picture
VascodaGama
Posts: 3041
Joined: Nov 2010

Physical exercise in moderation is recommended for fast healing of affected tissues. It also may relieve stress which is behind the fatigue in tissues. Exercising provides much needed oxygen to the inflammation. However, exercise in excess can work the other way and be damaging. Cycling involves much massaging of pelvic muscles creating inflammation. Surely too much cycling could have a negative effect on tissues already under inflamation by radiation. I would think that your doctor's recommendation was to do it moderately, but what does moderation mean in a guy that have bicycle all his life.

There have been studies on this theme that links cycling to problems in the pelvis, most particular to the initiation of testicle and prostate cancer. It all relates to too much massage of local inner muscles (the prostate shell) creating inflammation. Please read this advice at a famous Cycling magazine;

"... Prostatic inflammation: Repetitive compression and trauma to the perineum, leading to recurrent inflammation of the prostate, has been reported to be higher in cyclists. Chronic inflammation is known to be a risk factor for malignancy."

Here is the full story:

http://www.cyclingweekly.com/fitness/essential-guide-to-prostate-health-for-cyclists-234445

Other news on the matter;

https://www.nhs.uk/news/cancer/cycling-linked-to-prostate-cancer-but-not-infertility/

https://www.telegraph.co.uk/news/health/news/9110824/Cycling-increases-warning-signs-of-prostate-cancer.html

I am sorry if my comments made you worry or let down your enjoyment in bicycling as described in your first post "... used to commute by bicycle 30 miles per day before retirement, but continuing bicycling now in retirement ...". I am not a doctor so that you need to get the opinion from experts in regards to continuing cycling while in recovery. In your shoes I would exchange cycling with another physical exercise till full recovery.

Best wishes,

VGama

that have if such a nflamation of muscle tissues affaect  

Grinder
Posts: 442
Joined: Mar 2017

Had no idea cycling coorelates with prostate issues! Checked out the article VdG quotes, it even mentions resorting to a comfortable seat, leading me to believe the action and mechanics against a racing seat could well be responsible for prostate irritation and inflammation, and since the prostate is nearly void of sensation, a cyclist would never know it.

Wish I had known this 10 years ago.

Maallyn... besides moderating your cycling, you may want to turn in your racing seat for one of those bucket style touring seats.

I have been a bit suspicious of racing seats, and they do push right into the prostate area without distribution of weight to a general area like a touring seat does.

The pressure of a racing seat would also inhibit circulation to the prostate, as well as produce PSA from the pressure and mechanical actvity. Weird to think about.

Grinder
Posts: 442
Joined: Mar 2017

racing seat

Grinder
Posts: 442
Joined: Mar 2017

touring saddle

 

maallyn
Posts: 13
Joined: Aug 2017

Grindr: Thank you. I have just ordered that seat and should be getting it any day.

By the way, the biking I do now is in the order of 5 to 10 miles per day if that. It's flat. It's no where near what I was doing for work two years ago. When I rode to and from the EB appointments, it was about 1 mile each way.

Subscribe to Comments for "Post External Beam Radiation Urinary Stricture Questions"