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Posted 5/14/2009 7:25 PM (GMT 0)
I already had a consultation last month with the Rad Doc prior to my high PSA .18. (See my other post). Can anyone out there who has completed IMRT tell me what the sequence of events are and the timeline before the actual treatment begins?   
Posted 5/14/2009 7:42 PM (GMT 0)

Hey Boot,

They will bring you in for a trial run to begin with where they will take a bunch of pictures that they will use to line you up on each of your subsequent visits.  I went five days a week for I believe 42 treatments after that initial visit;  that equated to I believe 72gy to the prostate bed and I am not sure how many grays went to lymph nodes.  The process itself is pretty simple, you lay on the table and they line you up using the images they took and the machine will whirl around you for about 5-10 minutes each visit.  The only side effect I experienced was mild fatigue and a little bit of rectal soreness which went away pretty quickly after the treatments stopped.

As far as the timeline it will probably depend on how flexible you are and how busy they are.  Being first everyday is probably a good idea if you can do it.

I think you are making the right call and I bet you are going to be fine, hang in there.

Posted 5/14/2009 10:36 PM (GMT 0)
It didn't take long for me to get started. I remember a 3D CT of the pelvis, getting three very small tattoos (about the size of freckles), having some x-rays taken while in place on the treatment table, and a dry run for practice, then we got started. From the first meeting with the radiation oncologist to starting treatment I think it was about 3 weeks, maybe less. It all happened pretty quickly. Looking back at my blog, it went something like this:

Meet with rad oncologist
Following week: CT planning scan and tattoos
Week after that: dry run followed the next day by the first treatment.

I also had a bone scan done, but that was just because a medical oncologist wanted one. It was done right after treatments began and was clear, otherwise we would have stopped at that point. Here's a link to my blog during those days: http://tinyurl.com/rdvopo
Posted 5/14/2009 11:14 PM (GMT 0)
First we debated it, but once we made up our mind, oK once I made up my mind to proceed, we scheduled some imaging tests.

We did CT Scans and t took about an hour. The iodine cause metallic mouth, and the banana drink sucked, but if anyone asks about flavors ask for banana the others really suck.
We did Xrays and they took about a half an hour.
Then we did an MRI it took about an hour also.
After about 5 days they called me back in for another CT. During this visit two things were accomplished ~ first we were casted. A cast template was made to lock my leg positions to be the same every time I laid on the table. This took about 15 minutes. Then I was run under the CT scan again and mapped for the dots. Three dots were tattooed on my body. I still have them.

Once I was casted and marked my first treatment went like all of them except the Friday ones. The IMRT radiation device rotated around me and stopped at 7 positions. At each position the intensity modulation was shaped sevral times and radiation was delivered after each one. Each day took about 15 minutes.

On Fridays, we did a routine dose of radiation but before we started, xRays were taken of the pelvic region. Every Monday we also consulted the radiation oncologist.

I was told to drink a 16oz bottle of water before coming in for treatment. Do not urinate until after treatment. After treatment I walked 3 miles. After treatment 28 (I had 38) I was told it would be less intense. I still didn't feel a thing. Two week after treatment I noticed I had more energy. surprisingly, I realized I had fatigue and didn't even know it. I recovered very well.


I was fascinated about the radiation technology and actually spent quite a bit of time with my RO. One evening we were together until 9pm and I could tell he was very into his work. I liked that about him. Even today I could stop in on him and ask him what's new? I am an electronics engineer by trade (since in management and sales) and really wanted to see the screens and the programs. My RO really like showing them. It was an interesting experience for me.

I hope this helps.
Posted 5/14/2009 11:53 PM (GMT 0)
Thanks Tony for such a complete narrative on your treatment with IMRT. It really helps to understand the procedure. We will be flying to Vegas after the treatments are done for some R&R. Might just look in on you and yours if you have the time. Thanks for the help. You are a real inspiration to all of us here at HW. I admire your courage.
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