Radiation and Treatment Advice (SInus)

So I am in a new world. As you may know, I had mets to the bone structure in my sinus cavity. Spent time in the hospital due to the situation. I was on taxotere at the time, and it did not work.

I have started cabazitaxel and the initial results as reported are excellent.

My MO (Mark Pormrantz at DFCI in Boston) and my treatment team have recommended radiation to attempt to kill any remaining mets in the sinus and around my skull. I have been prescribed memantine to help with memory loss.
While I want to be aggressive as possible, having my skull fried is a little frightening. (LOL)

The treatment will consist of radiation for 10 minutes or so for 10 days. The RO and my Onc team believe it will get the PC in my head and prevent a re-occurrence of the situation.

Has anyone had similar treatments, and what advice can you give me.

Your brother in battle.

Mike (aka kmclark1)

“Do you want to know who you are? Don't ask. Act! Action will delineate and define you.”
― Thomas Jefferson

Hopefully someone will know. I sure don't. Best to you Mike.

JNF - Do you know the type of radiation? I would want a pretty well controlled beam, seems better for proton or Cyberknife,

Thanks, I had heard that Cyberknife had a little more precision capability than IMRT machines due to the its ability to use the arm to get to better positions/angles and focus the beam. I know how the Varian machines operate so it makes some sense for certain situations to me. Proton has a reputation for brain tumors, etc.

Sorry Mike, I can't help on sinus radiation although I had sinus surgery years ago and it was not the worst thing I ever went through, just annoying and uncomfortable for a short while.

JNF - Pardon my casual use of terms, we could interject IGRT also I suppose. I understand the concepts pretty well but if you look at the Cyberknife equipment vs. Varian type, the application mechanics are different which would lead to different plus and minuses for some situations I would think.

Mumbo, IGRT is a merely subset of IMRT. It means Image Guided Radiation Therapy and simply uses a few gold fiducial markers inserted in the target (prostate, for example). Then a scan is made to help guide the beam from the IMRT (Intensity Modulated Radiation Therapy) LINAC machine.

Actually, IGRT is being used less as newer generations of the IMRT machines are using more sensitive scanning. They have gone from standard X-ray, to CT and now Elekta ( the machine I was radiated on) integrating a small MRI into the machine to “see” the target better. With these advancements, the insertion of the gold fiducials is less common. It would only be used by those clinics that have not upgraded their machines, but many of them do not use the fiducials. Plus, IGRT was never proven to be any better and some of the very best radiation oncologists and clinics never used the fiducials for PCa.

You have metastasis in your skull and the radiation scares you more than that?

Duck

No crape. Just went through two months of hell recovering from the sinus surgery. I am being as aggressive as possible with the radiation. Want to kill any PCA in the head. However, anybody that's not a little concerned about having their head nuked (all in fun) and the side effects is not being realistic.

Good to hear you went ahead with treatment, Mike! I was going to post that you carefully weigh the consequences of leaving it untreated.

All the best!

Djin

Hello, KMCLARK1 ~~~

I have been mindful you, as you embarked upon your treatments.

I am thankful you got through this series of treatments.

You have all of us standing alongside you --- the power of the fellowship here, beyond all words.

I will watch for future posts from you --- hope your side effects are lessening, with each passing day.

Keep forging ahead --- stay determined --- remain vigilant.

Thankful for your loyal sense of brotherhood here, KMCLARK1.

May your courage remain undaunted ----
CYCLONE ---- # Iowa State University