IMRT INTENSITY MODULATED RADIATION THERAPY

Jon2010

Does anyone have any experience with this type of radiation?

bdhilton

No but I am looking into
No but I am looking into having this done at a few cancer centers in the USA because my pathology report from my March 3 surgery showed Right Seminal Vesicle involvement and my surgeon and Urologist have suggested that I just get the radiation treatment 90-120 days out from surgery (even with 0 PSA readings). I have a consultation at MUSC Hollings Cancer Center (satellite facility at the Carolina Regional Cancer Center at Myrtle Beach, SC instead of their Charleston, SC campus)

I will also have a consultations at St Joseph Hospital in Atlanta, GA, Emory in Atlanta, GA , and Loma Linda in Loma Linda, CA..

I am sure it is a toss up at all of these facilities with the only difference I can see right now is with Loma Linda and they are big on diet as part of any treatments (and this is my biggest complaint with doctors and our western medicine in general is that very few give advise in diet and exercise)…

Anyway, I would look to one of the 64 recognized radiation facilities that are recognized by the National Cancer Society (that also give grants to these centers)…I am sure there are many good “center” out there but for us it becomes a “pig at a poke”…

I am sure I will post this part of my journey here as I go through it…

All the best-BDH

gkoper

IMRT
I had IMRT therapy after prostate removal surgery. It was to zap bad cells that escaped somehow during the surgical process since my doctor said the cancer was contained.

The IMRT process is painless and quite easy......in & out 20 minutes. However, it took about 40 trips (including prep, consultation,etc, to get it done. It did lower my psa from .7 to .3. Was told it could take up to 6 months to kill all bad cells.

The cost was comparable to the surgery$$$$$$$ Glad I have good ins.

And to him who said US doctors don't do enough to promote diet & exercise....you are so right.....even when I ask direct questions about the two they all sort of poo-poo it. Don't know why.........Anyway.good luck in your journey Jon2010.

George

bdhilton

gkoper said:

IMRT
I had IMRT therapy after prostate removal surgery. It was to zap bad cells that escaped somehow during the surgical process since my doctor said the cancer was contained.

The IMRT process is painless and quite easy......in & out 20 minutes. However, it took about 40 trips (including prep, consultation,etc, to get it done. It did lower my psa from .7 to .3. Was told it could take up to 6 months to kill all bad cells.

The cost was comparable to the surgery$$$$$$$ Glad I have good ins.

And to him who said US doctors don't do enough to promote diet & exercise....you are so right.....even when I ask direct questions about the two they all sort of poo-poo it. Don't know why.........Anyway.good luck in your journey Jon2010.

George

Hey George,
I was to email
Hey George,

I was to email and talk with you about this about a week ago… If you do not mind me asking how old are you, how long ago did you have this “clean” radiation treatment and how many CY’s did you have (I am being told to get 64cy)… I am stressing about this a bit with all of what I read on immediate side effects and long term…like major ED issues, secondary cancers but then again why worry…we all have no control so I guess I should just enjoy the ride …As yes most western doc for the most part suck when it comes to diet and exercise…. They seemed to be trained to treat problems not prevent…

Best to all

gkoper

bdhilton said:

Hey George,
I was to email
Hey George,

I was to email and talk with you about this about a week ago… If you do not mind me asking how old are you, how long ago did you have this “clean” radiation treatment and how many CY’s did you have (I am being told to get 64cy)… I am stressing about this a bit with all of what I read on immediate side effects and long term…like major ED issues, secondary cancers but then again why worry…we all have no control so I guess I should just enjoy the ride …As yes most western doc for the most part suck when it comes to diet and exercise…. They seemed to be trained to treat problems not prevent…

Best to all

Imrt
I just turned 66. I was told I was getting the 64 dose. I am 3 months post my last treatment. Only side effects were ( not now) increase in frequency & urgency of uination.
Can't say about long term effects. Right now I feel great...........I'm living large.....as we all know.....life could be over in the twinkling of an eye.
You sound like you are doing all the research & will arrive at the right decision for you.
Good luck,
George

bdhilton

gkoper said:

Imrt
I just turned 66. I was told I was getting the 64 dose. I am 3 months post my last treatment. Only side effects were ( not now) increase in frequency & urgency of uination.
Can't say about long term effects. Right now I feel great...........I'm living large.....as we all know.....life could be over in the twinkling of an eye.
You sound like you are doing all the research & will arrive at the right decision for you.
Good luck,
George

George...thanks and looking
George...thanks and looking forward to living large again after all of this surgery and radiation treatment stuff out of the way... and yes I am starting to believe luck is a part of this whole PCa thing....thanks again

erisian

bdhilton said:

Hey George,
I was to email
Hey George,

I was to email and talk with you about this about a week ago… If you do not mind me asking how old are you, how long ago did you have this “clean” radiation treatment and how many CY’s did you have (I am being told to get 64cy)… I am stressing about this a bit with all of what I read on immediate side effects and long term…like major ED issues, secondary cancers but then again why worry…we all have no control so I guess I should just enjoy the ride …As yes most western doc for the most part suck when it comes to diet and exercise…. They seemed to be trained to treat problems not prevent…

Best to all

Integrative Medicine
What a lot of us are looking for has a name- Integrative Medicine. I recently got a book called 'Integrative Oncology'. It covers just about every treatment, including various supplements, and even Homeopathy and "Energy Medicine". It's intended for health care professionals, so a lot of it is pretty technical and it's not light reading, but it is full of solid, unbiased information. I'm going to get what I can out of it and then give it to my oncologist. Apparently, it is up to us patients to educate our doctors about the subject.

I've had radiation, but for bone mets, not to the prostate. What does CY mean?

bdhilton

erisian said:

Integrative Medicine
What a lot of us are looking for has a name- Integrative Medicine. I recently got a book called 'Integrative Oncology'. It covers just about every treatment, including various supplements, and even Homeopathy and "Energy Medicine". It's intended for health care professionals, so a lot of it is pretty technical and it's not light reading, but it is full of solid, unbiased information. I'm going to get what I can out of it and then give it to my oncologist. Apparently, it is up to us patients to educate our doctors about the subject.

I've had radiation, but for bone mets, not to the prostate. What does CY mean?

CY is a measurement of
CY is a measurement of radiation. Apparently the dose I might be getting is less than what you woud get if you were having the "whole" prostate treated with radiation

erisian

bdhilton said:

CY is a measurement of
CY is a measurement of radiation. Apparently the dose I might be getting is less than what you woud get if you were having the "whole" prostate treated with radiation

centigray?
I'm guessing that's what it is. It is a metric unit of absorbed radiation. Centigray would be abbreviated as cGy. That's what they used when I got a bone met in my femur nuked last year. I overheard Dr. Nukem say; "If there's enough area, we can turn it all the way up to 800 and get it in one shot." Hmmm, do I smell something burning?

I asked him about it later. He said that the "800" was 800cGy. If they had done it in fractions, they would have done 10 fractions @ 200cGy each, for a total dose of 2000cGy. So the single-dose job reduced the total radiation exposure by 60%. That made me feel better about it. Of course,that was a nice clean target, with no sensitive tissues nearby, and they shot it from 5 or six different directions.

So based on that, 64cGy sounds about right for the total dose for a prostate. Maybe you can take some comfort in knowing that it is a relatively small dose.

Wikipedia page: http://en.wikipedia.org/wiki/Gray_(unit)

bdhilton

erisian said:

centigray?
I'm guessing that's what it is. It is a metric unit of absorbed radiation. Centigray would be abbreviated as cGy. That's what they used when I got a bone met in my femur nuked last year. I overheard Dr. Nukem say; "If there's enough area, we can turn it all the way up to 800 and get it in one shot." Hmmm, do I smell something burning?

I asked him about it later. He said that the "800" was 800cGy. If they had done it in fractions, they would have done 10 fractions @ 200cGy each, for a total dose of 2000cGy. So the single-dose job reduced the total radiation exposure by 60%. That made me feel better about it. Of course,that was a nice clean target, with no sensitive tissues nearby, and they shot it from 5 or six different directions.

So based on that, 64cGy sounds about right for the total dose for a prostate. Maybe you can take some comfort in knowing that it is a relatively small dose.

Wikipedia page: http://en.wikipedia.org/wiki/Gray_(unit)

Yes my surgeon and doc said
Yes my surgeon and doc said it was a relative low dose but I still believe any amount of radiation is not good…it is not like eating a steak or drink one to many single malt scotches …But everything is relative and compared to your does to the bone is sounds like a walk in the park…What I am finding with this PCa shite is that it could always be better and worse…so live large and be well…BD

Trew

bdhilton said:

No but I am looking into
No but I am looking into having this done at a few cancer centers in the USA because my pathology report from my March 3 surgery showed Right Seminal Vesicle involvement and my surgeon and Urologist have suggested that I just get the radiation treatment 90-120 days out from surgery (even with 0 PSA readings). I have a consultation at MUSC Hollings Cancer Center (satellite facility at the Carolina Regional Cancer Center at Myrtle Beach, SC instead of their Charleston, SC campus)

I will also have a consultations at St Joseph Hospital in Atlanta, GA, Emory in Atlanta, GA , and Loma Linda in Loma Linda, CA..

I am sure it is a toss up at all of these facilities with the only difference I can see right now is with Loma Linda and they are big on diet as part of any treatments (and this is my biggest complaint with doctors and our western medicine in general is that very few give advise in diet and exercise)…

Anyway, I would look to one of the 64 recognized radiation facilities that are recognized by the National Cancer Society (that also give grants to these centers)…I am sure there are many good “center” out there but for us it becomes a “pig at a poke”…

I am sure I will post this part of my journey here as I go through it…

All the best-BDH

Loma Linda
BD, sorry to hear of the complications. As a patient at LLU you also get access to the Dryson Fitness Center- a complete workout facility- pool, wieghts, bikes- everything. As long as you are a patient you get to use the center free!!

On staff nutritionist is also recommended- but you have to schedule an appointment with her and she will give you a diet to help minimize side effects.

And perhaps LLU may be able to treat you totally with protons- that would be good.

bdhilton

Trew said:

Loma Linda
BD, sorry to hear of the complications. As a patient at LLU you also get access to the Dryson Fitness Center- a complete workout facility- pool, wieghts, bikes- everything. As long as you are a patient you get to use the center free!!

On staff nutritionist is also recommended- but you have to schedule an appointment with her and she will give you a diet to help minimize side effects.

And perhaps LLU may be able to treat you totally with protons- that would be good.

Thanks trew
Probaly no Proton from LLU (we will see) but from what I am reading it seems that the IMRT process I am looking into is very controlled with regards to any “healthy” tissue damage that was a problem a few years backed…

Do not get me wrong in that I think radiation really sucks but apparently my dose of 64cy is fairly low when you compare it to other radiation treatments…yes lots of long term things you can choice to worry about but I am starting to believe in the “school of living large” and just enjoying life as much as I can each day or go crasy…btw the weather in Atlanta today and yesterday have been absolutely beautiful and warm…everything is in blooming…

I hope your doc change works out for the best…his practice really sounded bad…

WHW

Been There and Done That
Thought I might chime in on this discussion. Haven't been on the forum for a while but posted very heavily from my diagnosis in June 09 through my surgery in September and then on to my radiation treatment in December and January 10.

My PSA never really gave me a break after the surgery. My stats are posted below in my signature. When I had tests of .4, .53 and .6 after surgery I decided to go ahead and do radiation.

I had IG/IMRT (Image Guided IMRT) on the Tomo Machine. It took about 15 minutes per session and I did 35 for a total of 70 Grays. I suffered very little in the way of side effects until the last week or so. Then I was beset with a real case of the urgencies. This cleared about 2-3 weeks after the end of the rad. Other than that it was painless and tolerated very well.

However, as luck would have it, at least for now, it may not have worked either. My post rad PSA at 6 weeks was 1.0 and then another test 30 days later was 1.5.

So me and the RO are done with each other and on April 12th I have a meeting with the head of the Medial Oncology Department at MD Anderson, Orlando. Well see what the future holds at that point.

For what it's worth in the way of info,

Sonny

60 years old when diagnosed
PSA 11/07 3.0
PSA 5/09 6.4
Diagnosis confirmed July 9, 2009
12 Needle Biopsy = 9 clear , 3 postive
Gleason Score (3+4) 7 in all positive cores
da Vinci 9/17/09
Post Surgery Pathology: GS 4+3=7
Stage: T3a
Tumor Volume 12.5%
positive margin, extra-prostatic extension
30 day PSA 0.4, 50 day psa 0.53, 64 day psa 0.6
IMRT completed 1/15/10 35 treatments- 70Gy

2/24/10 FIRST POST RAD PSA 1.1---CARRRP --waiting for the next test. Test results 30 days later on 3/24/10 - 1.5

gkoper

WHW said:

Been There and Done That
Thought I might chime in on this discussion. Haven't been on the forum for a while but posted very heavily from my diagnosis in June 09 through my surgery in September and then on to my radiation treatment in December and January 10.

My PSA never really gave me a break after the surgery. My stats are posted below in my signature. When I had tests of .4, .53 and .6 after surgery I decided to go ahead and do radiation.

I had IG/IMRT (Image Guided IMRT) on the Tomo Machine. It took about 15 minutes per session and I did 35 for a total of 70 Grays. I suffered very little in the way of side effects until the last week or so. Then I was beset with a real case of the urgencies. This cleared about 2-3 weeks after the end of the rad. Other than that it was painless and tolerated very well.

However, as luck would have it, at least for now, it may not have worked either. My post rad PSA at 6 weeks was 1.0 and then another test 30 days later was 1.5.

So me and the RO are done with each other and on April 12th I have a meeting with the head of the Medial Oncology Department at MD Anderson, Orlando. Well see what the future holds at that point.

For what it's worth in the way of info,

Sonny

60 years old when diagnosed
PSA 11/07 3.0
PSA 5/09 6.4
Diagnosis confirmed July 9, 2009
12 Needle Biopsy = 9 clear , 3 postive
Gleason Score (3+4) 7 in all positive cores
da Vinci 9/17/09
Post Surgery Pathology: GS 4+3=7
Stage: T3a
Tumor Volume 12.5%
positive margin, extra-prostatic extension
30 day PSA 0.4, 50 day psa 0.53, 64 day psa 0.6
IMRT completed 1/15/10 35 treatments- 70Gy

2/24/10 FIRST POST RAD PSA 1.1---CARRRP --waiting for the next test. Test results 30 days later on 3/24/10 - 1.5

IMRT
You and I have been on a similar path on our journey to eradicate the beast.
I came out of my Davinci with a .3 that went to .7 in just over 4 months. I finished IMRT just before Christmas & got back to .3 with my 6 wk. check. Dr Anderson @ the Bossoneault institute in Ocala said it might take up to 6 months for PSA to go to the coveted zero. My next check is due. I am apprehensive as I know its hormone therapy if it goes up. Not a pleasant thought. Anyway, best of luck to you & keep us posted on your strategy.
George