What to expect ie side affects from Radiation treatment

RR, I haven't gone through radiation yet. But from reading the forums, i would say most guys experience various levels of urinary symptoms, (burning, frequency, etc), bowel symptoms (diarhea, frequency, constipation) and fatigue, although i think a lot of that comes from the Hormone therapy that most SRT guys are on. For the most part these side effects are manageable and transient.
Others with more "hands on" experience will show up here and comment. But in the meantime...2 suggestions....

1. click on My Profile, at the top of the page, and enter a signature that will appear with your posts. (make sure to check the box "include my signature". Include vitals of your pathology, like Gleason score, PSA before surgery and since, margin status, seminal vesicle status, epe status, etc. More data will help others

2. read the thread "ADT and SRT Journey" its actually 4 different threads, as it got so long that we had to start new threads to continue the conversation, 3 times. Here is a link to part 1 /www.healingwell.com/community/default.aspx?f=35&m=3952177

Good luck, stick with us, lots of guys here have gone through it and almost all of them are very supportive, and knowledgeable.

I was almost fully continent right after surgery and radiation hasn't changed my continence, maybe i'm just lucky.

Radiation will definitely put a halt to your continence recovery. The radiation damages all tissues, but the healthy tissues recover and the cancerous cells die off. The process takes months. Additionally, you will need to be continent enough to hold a full bladder every day during radiation in order to protect your bladder and rectum from the radiation. That is why it is so important to be nearly fully continent before starting adjuvant radiation. I had to get a urinary implant so that I could get RT underway within the first year following RP. You may be faced with a similar situation, as your positive node will need to be treated before it spreads any further. Like yours, my RO started me on Lupron to hold the cancer at bay until the implant surgery could heal. Your actual prognosis depends on a number of factors.

These researchers suggest at least 7 months of pre-SRT ADT to allow for continence and erectile function to come back:

/www.sciencedirect.com/science/article/pii/S0302283816002670

For men with positive pelvic lymph nodes, treatment with SRT+ADT decreased 10-yr mortality by 59% compared to observation only in a recent retrospective study:

/pcnrv.blogspot.com/2017/12/salvage-whole-pelvic-radiation-after.html

RR said...
...I think my doctor is trying to do everything he can to hurry the process. He told me that whatever my continence level is around 3-4 months will be about as good as it is going to get and that's when we should start radiation.

Telling you not to expect significant further recovery of continence more than 3-4 months post-RP seems calculated to hurry the process. I'm pretty sure the evidence is that many men who still use pads at 3-4 months will continue to make significant progress toward continence and be pad-free by 12 months. That's not to say you shouldn't go ahead with adjuvant/salvage RT at 3 or 4 months if you're still incontinent. You would have to balance the risk of long-term incontinence from early RT against the risk of cancer spread if you delay RT. The question seems to be whether you can count on Lupron to keep the PCa in check for a few more months while you continue your recovery from surgery.
If you're continent by 3-4 months, certainly go for RT right away.
Hopefully TA or someone else who tracks studies better than I do will be able to supply some evidence to help you out with your decision.

I had surgery, and had just recovered full continence ten months later when my psa started up again. So I went in for radiation. I had almost no side effects during the treatment, but a few months after I was done with the treatments I started to leak again. Now, a year later, I'm almost continent again, but I still leak a bit some evenings.

about the same here DJBear... Several of the common ones and a few of the uncommon ones. RO simply said some bowel disruption is to be expected. Most improved a month or so after ART ended. What lingered since has been easy to live with.

Did you ever see The Man with Xray Eyes? Seemed like he didn't handle it too well..

Well, I was hoping for a mild case, and not like Ray Milland's

Andrew

Hey RR;

I had surgery last 8/24/17, and started radiation on 3/14/18 - so just about six months to recover from surgery. I was mostly continent fairly quickly at about 3 months post surgery, just a little occasional stress incontinence. I continued to improve prior to the radiation. As others mentioned, have a full bladder is mandatory for each treatment to protect the rectum as much as possible.

Like you I was node positive, but I also had positive surgical margins, extensive EPE, and SVI. So immediately post surgery, it was likely that I would need radiation. They irradiate the nodes at the same time they start the prostate bed. Basically they start with a wider radiation field to get the proper dose to the pelvic lymph nodes as well as the prostate bed, and then in later treatments "cone down" to only treat the prostate bed (where it used to be). All that was accomplished in 39 treatments.

I finished radiation 5/7/18, and have been recovering from the bowel side effects - radiation proctitis for me (YAY?). In early July I noticed some stress incontinence had returned, but that has slowly been getting better as well.

Keep us informed of what is going on with you. There is a pretty big bunch of guys on here who went through the same thing in the past year or so.

Rob