Final Decision, CyberKnife SBRT

Hello Brothers, Sisters,Today I made the final decision of primary therapy.By my signature ,an intermediate risk,I choose CyberKnife,SBRT.The team I chose was Dr.Arica Hirsch,Advocate Lutheran general Hospital,IL. I had the visit today and it was really good.My Wife has been on all 6 previous visits,plus 5 phone consuls with me to LDB,HDB,IMRT,RP,all great Drs.,and you just know when the chemistry is right. We both felt good about it. Great organization.

Dr.Hirsch was referred to me by Dr.Debra Freeman,out of Tampa,CyberKnife,a great SBRT DR. in her own right.Out of 6 visits with other ROs ,in my area for all of the radiation options , I have decided that her team and the CyberKnife SBRT was the best choice for me.My Wife and I thought very highly of her and her staff.Yes its a path that we must all walk down and believe me it aint easy.Armed with the knowledge from this forum I know I made the correct decision in one of the most important decision in my life.

Fidicuals soon, (4) Dr.Hirsch does 5 sessions,every other day.So thats M_W_F---M_W total 5. Just 2 weeks.Yes it will be intra-fractional tracking.It will be trans-perineal for the fiducials.not sedated,doped up ,I like that. I brought the Tall Allen STICKY questions and we went thru them all.Dr. Hirsch even said that I was prepared and I mentioned our Forum to her.Thank You Forum.Thank You Tall Allen. So the Wife and me just came back from dinner and had a few beers to celebrate that we have a plan.We were actually relieved that this part is over.Im shure you guys agree. I wil pay forward. One last thing,Dr.Arica Hirsch,a very intelligent Dr. and a very pretty Dr,asked me if she could do a DRE on me. I declined.I told her I already had 6 DREs ,and they were all good.And I point blank told her she was too darn pretty to invade me.She laughed,blushed, said she will do it soon enough.GEEZ . Thank You, Forum,SemperFi

I will add on more info as I go thru this . Again,Thank You Ladies and Gentleman for making my life so much easier.SemperFi

0311 said...
... So the Wife and me just came back from dinner and had a few beers to celebrate that we have a plan.We were actually relieved that this part is over.Im shure you guys agree....

For sure that is a good feeling, it is a relief to see the conclusion of your due diligence and have a plan of action. Be sure and keep us updated with your progress.

JNF said...
Exemplary job of research and process driven decision making. Wouldn't it be great if all men did so well.

Exactly! And an great choice. Good luck to you; I'm sure everything will go great.

Jim

"And I point blank told her she was too darn pretty to invade me."

"I agree that she should at least buy you candy if she wants to stick her finger in. "

Seriously boys ?

0311-Oh I am so-o happy for you. The choice is made. Wonderful! I wish you a very easy and stress free journey...the end is in sight. HURRAH!!

Congrats 0311 on your decision for treatment modality! Glad to see you are celebrating already to boot! Let us know when you have some dates so we can keep you in our collective thoughts and prayers.

Did the doctor tell you, and you should ask, about discomfort? I just finished Cyberknife. It's high intensity and it's not easy and not fun with regard to side effects. The doctor said it was my fault, that I didn't follow the diet. My brother had IMRT last year with no side effects.

Pain varies by situation. I had SBRT, no pain during and no adverse side effects 15 months later.

Mharn,

The doctor should have told you to expect these kinds of acute symptoms. Everyone is different and has different sensitivity to radiation. They are all the result of inflammation, and they should pass as the inflammation subsides.

1. This is caused by inflammation of the urethra. Those tissues are tender and swollen. There is an over-the-counter medication called Pyridium that is especially good at soothing those tissues. Don't wear white underwear with it - it stains everything orange.

2. That symptom is called "tenesmus." The nerve endings in the rectum sense inflammation (radiation proctitis) as something pressing on them, so you feel like something is in there even when there isn't. The main danger is that you will strain on the toilet in an attempt to get "it" out. That can lead to hemorrhoids and bleeding. I think just knowing that can help a lot. It too will pass as the inflammation subsides. If it continues to be bothersome, you can get an Rx for Anusol with hydrocortisone or for mesalamine.

3. The bland diet to eliminate gas was only during the treatment. They sometimes ask patients to do that because passing gas during treatment can move the prostate around. I was treated on a very fast machine, so it was unnecessary. At this point, it's a good idea to bring soluble fiber (oatmeal, Metamucil) back into your diet. You may want to take Colace, a stool softener, as well, because hard stool might be painful to pass. Avoid laxatives and opiates. For the next couple of weeks, never trust a fart.

You might want to take daily ED meds to prevent radiation damage to blood vessels. They have the extra benefit of helping you pee better.

I think those symptoms began for me about a week after the end of treatment, and lasted for me for about 2 weeks. I hope they are very brief for you too.

I forgot to mention a disclaimer regarding pain management. It wasn't until the fourth treatment that I took Advil which helped a lot.

And the symptoms of discomfort went way down after two weeks.

I was a little disappointed regarding the ED issue but will discuss at the follow up what you said, Tall Allen.

I think the tenesmus was the main issue and the Advil helped so I could have been more proactive regarding that. Lol.

Aren't you glad you asked, 0311?
Mark

Post Edited (Mharn) : 2/7/2016 10:07:42 AM (GMT-7)

Mharn,Yes Im glad I asked.Even though Im 1 week away from fiducials ,Im mentally prepared . Your post was needed to get issues out there so that the FNGs like me can make an good decision about what to expect in a given primary therapy.I knew of the SEs from the education this forum has given me.And its good to hear everyones SEs from all modalities.Thats why those forms we fill out at Drs. offices track this stuff. Hope your doing well. SemperFi

Mharm,

Your doctor did not mention ANY of these common side effects and potential treatments? Where was your SBRT done? Cyberknife?

I asked because in more or less casual conversation with my GI doctor during my colonoscopy I asked what they knew about rectal toxicities with SBRT and IMRT and they mentioned everything regarding tenesumus anusol, stool softeners etc..and they aren't even radiaton guys.. I half expected them to say" ask the ROs." I did do that at our little jerkwater hospital, no center of excellence, and not Strum's optimal care I wouldn' t imagine, they mentioned all of it too..and they don't even do SBRT for prostate cancer, just their best guesses given what they do know about it. I guess you have to press some docs for answers more than others.