SRT after RALP - Centering CTscan execution

asic025

Good morning, I just had a centering CT scan because I have to undergo SRT (I had a robotic radical prostatectomy in 2019, and the PSA slowly rose to values ​​around 0.200-0.250). The preparation for the centering CT scan included a full bladder and an empty rectum. Everything was OK for the rectum, but, probably having drunk too much water, I showed up for the CT scan with a very full bladder. The technician called the doctor who decided to proceed with the tracking anyway. So first of all I wonder if a very full bladder can lead to problems with imperfect centering of the actual radiotherapy applications. The technician then stressed to me that according to him, the Doctor, given the very full bladder, will probably proceed to a contouring whose edge will perhaps be a little more "inside" the bladder itself, but I wonder if all this could lead to irradiations that are not well centered (too wide or too narrow) compared to the optimal. Thank you.

Old Salt

Hard to read. Can you reformat, please?

asic025

Good morning, I just had a centering CT scan because I have to undergo SRT 
(I had a robotic radical prostatectomy in 2019, and the PSA slowly rose to 
values ​​around 0.200-0.250). The preparation for the centering CT scan included 
a full bladder and an empty rectum. Everything was OK for the rectum, but, 
probably having drunk too much water, I showed up for the CT scan with a 
very full bladder. The technician called the doctor who decided to proceed 
with the tracking anyway. So first of all I wonder if a very full bladder 
can lead to problems with imperfect centering of the actual radiotherapy 
applications. The technician then stressed to me that according to him, the 
Doctor, given the very full bladder, will probably proceed to a contouring 
whose edge will perhaps be a little more "inside" the bladder itself, but 
I wonder if all this could lead to irradiations that are not well centered 
(too wide or too narrow) compared to the optimal. Thank you.

Clevelandguy

Hi,

That would be a question for your Oncologist or get a second opinion from another doctor team.

Dave 3+4

swl1956

I wondered about this too. Seems a full bladder can be a bit arbitrary. I've been having difficulty holding my bladder. I'm currently enduring daily IMRT which everyday they align my body via lasers and tattoos on my belly and hips. Then the machine does a CT scan of which they can visualize my bladder and rectum to make sure they're full and empty respectively. Then they make some final adjustments. I can feel the machine position before treatment starts. Hopefully they know what they're doing? Last Friday the machine I was on blew a circuit breaker and quit during my treatment. Doesn't exactly instill confidence. Lols! Turned out a cooling pump failed. It was replaced and Monday's treatment went as planned. I figure even the best of equipment fails from time to time.

asic025

Hi swl1956, I'm sorry for what happened to you. However, the contribution of a single session, even if
it is interrupted, I don't think is so decisive for the functioning of the entire therapy.
I have already started the treatment for two days, and as far as filling the bladder is concerned,
in one way or another I have identified times and quantities of water to present myself with a fairly
ready bladder.
But I have already realized that preparing the rectum is a more complex task!
So: they told me: if you empty yourself naturally in the morning, you don't have to do anything, but
if you don't go spontaneously, then you have to empty the rectum with an enema.
And here the problems begin, because, for example, this morning I had no urge to evacuate, and so I
did the enema (with a rectal solution called "Clisma Fleet", even if I used half of it).
Well, I realized later, while evacuating, that the rectum was already practically empty!
But the enema causes irritation, so much so that in the afternoon I had a stomachache!
So I'm a little worried about the possibility of having to do this enema every day for 36 sessions!
How do I get to the end? With a totally inflamed rectum? As if the radiotherapy alone wasn't enough....
In short: I still don't know exactly how to behave for the rectum....

swl1956

Perhaps I'm just lucky with regular bowel movements, but I believe timing and consistency of diet is a big factor. My RT sessions are at 1pm. Every morning around 9am I have some OJ with three or four prunes, then I eat a bowl of oatmeal with strawberries, blueberries, and raspberries Then a small portion of lean protein (white meat or fish) and finish with a fruit and nut breakfast bar with coffee or tea. I think fiber is the key. It's keeping me pretty regular with a bowel movements right around 11 am which is one hour before I leave the house. Maybe try to experiment with your diet a bit for regularity. I know there are other over the counter medications like citrucel, mirolax, milk of magnesia, etc. I think these approaches will be much gentler on your rectum. I too would not want to do enemas everyday or any day for that matter if I didn't have to. Hang in there! You'll likely get into a routine that works for you. I'm still struggling with holding my urine both on arrival and making it back home afterwards. Tomorrow, I'm going to hang at the radiation center for another half hour and pee a second time before leaving. This morning by the time I got home I was in desperation mode. Jumped out of my vehicle motor still running and pissed right in the driveway. Couldn't care less if anybody saw me. Lols!

Old Salt

https://csn.cancer.org/discussion/comment/1721920#Comment_1721920

I believe that asic025 underwent a simulation scan; typically done prior to the actual SRT.