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Posted 9/26/2015 3:23 AM (GMT 0)
I will be starting IMRT soon, with fiducial markers. My Oncologist told me that it didn't matter if I had a empty or full bladder as long as it was the same for each session. This seems contrary to what I've read. My understanding was that the full bladder helped define the organs on their computer, it stabilizes the bladder and surrounding organs, and helps to move the prostate away from the bladder floor. She said it didn't matter. Her recommendation, also, was a 5 week course at 2.5 Gy, rather than 8 week at 2.0. Now I'm not even sure about that.

Age 68
PSA 7
5 cores at 3+3
1 at 4+3
Posted 9/26/2015 3:54 AM (GMT 0)
Same is important. The fiducial markers line up the machine. Some think that a fuller bladder reduces damage to the bladder. My RO recommended having just one bottle of water about an hour before the daily treatment. I did 6 weeks and have done just fine.

Andrew
Posted 9/26/2015 4:55 AM (GMT 0)
I would insist on a full bladder.

Long story short. I went through 39 SRT treatments with an empty bladder, RO's choice, and it ended up burning and destroying my bladder and bladder neck. Resulted in needing major bladder by-pass surgery, and I am with an Urostomy the rest of my life, and the radiation damage has left me 100% disabled for life due to extensive nerve damage, mostly everything from the hips down.

I would insist on a full bladder, if nothing else, to be on the safe side.
Posted 9/26/2015 6:23 AM (GMT 0)
Think of the bladder as a big floppy balloon. When it's empty, it wraps around the prostate which is underneath it, and any radiation to the prostate necessarily has to go through it as well. When it's full, it lifts away, and doesn't get hit with as much toxic radiation. When full, it also holds the prostate steadier, which helps limit the number of beams that miss their target.

You meant 5 weeks (actually about 27 treatments) at 2.5 Gy, which is radiologically equivalent to to 40-44 treatments at 1.8 Gy- 2.0 Gy. It's certainly a step in the right direction, but only if the imaging equipment is very good.
Posted 9/26/2015 6:31 AM (GMT 0)
Can only share my experience. I had IMRT, 40 sessions to prostate bed and lymph nodes, total 72 GY, in early 2012. My RO was Dr. M. Zelefsky of MSK NY. I had 8 ounces of water before every session and the team was very careful about that. No complications or side effects since then.
Posted 9/26/2015 9:36 AM (GMT 0)
On my earlier sessions..if the bladder is not at least 80% full, they found out from the scan, the radiation therapist team will send me to top up with another glass of water, wait for another 25-30mins to get back for radiation. By this time controlling the bladder from pee-ing is tough
As the others had mentioned, I also support full bladder before going under the beam.
Posted 9/26/2015 11:30 AM (GMT 0)
When I began Proton treatments last November, I was told to drink 16 ounces of water 30 minutes before treatment. The 16 ounces was based on a CT scan taken a few weeks before treatment to determine what I needed to drink to achieve a full bladder. We are told to empty our bladder when we first arrive and then to drink our individual recommended water intake during the 30 minutes preceding our scheduled treatment.
time.

Many things can affect hydration. How much coffee one drinks, exercise, outside temperatures, etc. Some times during my treatment I did not feel that I had a full bladder after drinking the 16 ounces. Other times I couldn't wait to get off the table and head to the bathroom. Sometimes I would drink an extra 8 ounces just to be sure I was full. I mentioned this to my nurse one day and she said the patients fret over the full bladder thing too much. She described it exactly the same way Tall Allen did and explained that even though I might not feel completely full, 16 ounces would lift the bladder away from the prostate sufficient to avoid excess radiation. I hope she was right.
Posted 9/26/2015 11:57 AM (GMT 0)
I had IMRT to my prostate and pelvic nodes in the fall, I did not have markers, my treatment was mapped out using CT scans prior to starting. I always had to have a full bladder and empty bowels or I was pulled off the table. They were always very careful about this, I have not had any issues from treatment despite receiving the maximum dose over 40 or so sessions. When in doubt ask a lot of questions of your doctor.

Ed
Posted 9/26/2015 12:32 PM (GMT 0)
I had Cyberknife ART in 2012, 3 months after DaVinci RP. 3 tattooed dots sighted with lasers, fibreglas lower body mold. Took a pee before I hit the table every time. Lots of green lasers, then the scan located me correctly for treatments. Some residual colonic side effects still, bladder is fine. Prostate bed and inner pelvic nodes.
Posted 9/26/2015 3:07 PM (GMT 0)
Monday I have #30 session of 39. SRT. DV in May '12. Margins were not clear, but no detectable PSA for 3 yrs. then a slight tick up... sooo.. As to full bladder.. I had trouble at first...mostly too much h2o...very uncomfortable on table for 20 min.
Now, as I close to the bell week, I cut fluids three hrs before, empty bladder one hr before, drink 20oz h20 as I drive to hospital (15min) That is working for me FWIW. Had DV at 70. The Surgeon usually does not cut on the 65+, but he did me...I am in excellent health, otherwise.
Still have coffee, beer. Have stayed away from spicy stuff. No side effects ..so far. View myself as a statistic, in that there are longevity studies, etc. just a day at a time...as mentioned elsewhere ..no looking back..no second guessing ... Good luck and God Bless...

Post Edited (Garby) : 9/27/2015 5:23:30 AM (GMT-6)

Posted 9/26/2015 4:10 PM (GMT 0)
If my bladder was not full, they made me get up off the machine and go drink water until it was full. Reason for full bladder was to move it up out of the way.
Posted 9/26/2015 8:43 PM (GMT 0)
42 treatments ful bladder fried bladder have had many surgeries to try repair! nono
Posted 9/26/2015 11:33 PM (GMT 0)
Having a full bladder makes sense from reading the prior messages. Yet (!) no such precautions were part of the IMRT protocol at Georgetown U Hospital (August-September 2013).
Confusing?
Posted 9/27/2015 12:49 AM (GMT 0)
I am currently undergoing IMRT. I was instructed to drink 8 ounces of water 60 minutes and 30 minutes prior to treatment for a total of 16 ounces. They recommended these amounts as a starting point. They said they want me to come to the treatment with a comfortably filled bladder. They DON"T want me straining on the table to hold in my urine. Straining the pelvic muscles in this way can throw off the alignment of the beam during treatment. They monitor the fullness of my bladder by the CT scan they do prior to each treatment. It has worked out well. My bladder has always been filled enough for the treatment and I haven't felt like hopping around with the need to pee.
Posted 9/27/2015 1:49 AM (GMT 0)
24 ounces of water before my treatments, done two weeks ago, no side effects as yet....
Posted 9/27/2015 1:52 AM (GMT 0)
Stabilizes the region so surrounding "parts" don't move around. Dattoli has it as part of his protocol. He's been at it a since the late 80's.

and John R, your fried bladder(sorry to heat that") has nothing to with having had a full bladder, it's a benefit. see above. You were probably overdosed and/or improperly aligned
Posted 9/27/2015 2:57 AM (GMT 0)
To clarify, to those newer here, to what happened to me. Due to endless and unfixable stricture issues post surgery, I underwent radiation treatments with a Suprapubic catheter in place (they exit through the skin, below and to the left of your navel, not through the penis).

In order to have a full bladder, all they had to do with clamp off the catheter, and have me drink water, thus filling my bladder while I was being zapped. Or, pumping water up the irrigation side of the cath, while I was being zapped. My RO did neither, so all of mine were done with a completely empty bladder, and I mean zip, my urine, if any, was instantly being drained via the cath into a bag.

Huge mistake. I began to feel burning on my 4th treatment, yet the RO dismissed it as "my imagination" and it continued to worsen over the days and weeks ahead.

Yes, I filed a medical malpractice lawsuit, but got no where, as here in SC, due to very unfair (to patients) tort laws, unless one dies, its virtually impossible to win. I finally ran out of statute of limitation time and walked away with no justice, and no money.

I would still insist on having a full bladder, even if the doctor says it doesn't matter. It won't hurt you to have a full bladder, and you will be on the "safe" side. You have to be your own best advocate, a lesson I learned the hard and bitter way.
Posted 9/27/2015 3:43 AM (GMT 0)
My RO drew me a picture. When empty the bladder sags down and gets in the way of the radiation beam. If the CT scan showed that my bladder was not full they made me drink moe water before starting radiation. I believe this was a contributing factor in my having no side effects from treatment.
The ride home was uncomfortable so I had a bottle in the car and would pee at a red light.
Posted 9/27/2015 3:53 PM (GMT 0)
One more thing, the full bladder is just one of many things that contribute to a successful treatment. I was also on meds, one to add blood flow to the region and another to help protect the rectum, probably off label uses, but based on decades of experience from the RO I chose.

If they don't think it makes any difference you may want to seek other professional opinions from an RO who specializes in prostate treatment, not a generalist. My first RO consult, they did not specialize in treating the prostate and there were significant differences it what was offered in the treatment plan

I think most of the failed radiation treatments are from a combination of things, inexperience, improper planning, dosing, lack of protocols that safeguard your outcome, machines that are not calibrated correctly, etc...

You want to get it right the first time.

Post Edited (Fauntleroy) : 9/27/2015 10:03:05 AM (GMT-6)

Posted 9/27/2015 5:27 PM (GMT 0)
Another vote for full bladder. Purgatory ' s tale alone should be convincing enough. I had 44 sessions of IGRT and practiced beforehand to figure out my timing for a comfortably full bladder at treatment time. Every time. Also, regulated so could have my colon empty. Not easy, but we only get one shot at doing this right. I'm now just over two years out, and blessedly have no side effects from radiation.

Do the full bladder, don't mess around. Consistency is just as important.

All the best to you!
Posted 9/27/2015 5:37 PM (GMT 0)
Ditto what many are saying about maintaining a full bladder while doing IMRT.

I was an IMRT-as-primary-treatment guy, and my techs always totally insisted on it whenever I was on the machine.

It really is simple. Just get the treatments on a full bladder anyway. If it's necessary, you're covered. If it isn't, all that's happened is you had to hold it in for a little while.

Better safe now than sorry later.
Posted 9/27/2015 7:05 PM (GMT 0)

81GyGuy said...
Ditto what many are saying about maintaining a full bladder while doing IMRT.

I was an IMRT-as-primary-treatment guy, and my techs always totally insisted on it whenever I was on the machine.

It really is simple. Just get the treatments on a full bladder anyway. If it's necessary, you're covered. If it isn't, all that's happened is you had to hold it in for a little while.

Better safe now than sorry later.

I think the simulation needs to be done with bladder full.
Posted 9/27/2015 9:42 PM (GMT 0)
Had 40 treatments as primary. Techs wanted me to have a comfortably filled bladder. To full and you will squirm on the table an ruin their aim. Takes some practice the first week to find the right amount to drink before hand. Be sure the restroom is close as you will need it when finished with the session. I have had no bladder or bowel side effects. Been a year since I finished treatment

Good Luck you will do well

Carl
Posted 9/28/2015 6:06 PM (GMT 0)
It's not as easy as it sounds. I seem to have under performing kidneys (mild stage 2 kidney disease) and getting a full bladder takes a bit of effort. I need to start drinking liquid ( as much as two quarts) at least 4 hours before treatment. That means I make the daily, difficult (heavy traffic) 45 minute drive with a full bladder. It is often quite uncomfortable. Any suggestions?
Posted 9/28/2015 11:53 PM (GMT 0)
lifeguyd, oh and it gets more fun when there's a delay in the treatment room! I practiced trying to let out a certain amount, and then stopping. I was never really successful with that, but some say they could do it. If I'm really full, and the flow starts, it's really hard to stop it fully.

Good times....
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