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Prostatic artery embolization after IMRT?

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Posted 7/21/2021 10:48 PM (GMT 0)
Just (7/19/21)completed four weeks/20 fractions of IMRT and am 2 months into ADT hormone therapy and frequency, weakness of stream and painful urination have intensified over the past two weeks. Tamulosin and finasteride have not been helpful, Azo didn't work. Saw palmetto, nope. Oxycodone alone and with ibuprofen helped a bit but surprisingly little. Wondering if anyone else has had a similar experience? Did you find relief? Some approaches to my symptoms seem to presuppose 'benign' hyperplasia, which, given the fact I have prostate cancer, is not my situation. I'm also wondering to what degree my symptoms are more a lingering side effect of the radiation vs. normative BPH. All existed to some degree prior to the IMRT though back then the pain was minor and transitory. TURP is not as advisable after radiation as before and I'm wondering which of the alternatives (Rezum, HoTep, Urolift, PAE etc.), if any, might be viable going forward. I'm wearing out the piece of leather I chew on to negotiate the pain. smile Thanks in advance for any feedback. PlatoK
Posted 7/22/2021 1:37 AM (GMT 0)
If you trust your medical team... now would be good time to talk to them...we are not doctors...nor do we claim to be...tho there are few members who are decent researchers...out of my pay grade and arguably most of the other members
Posted 7/22/2021 2:17 AM (GMT 0)
Good advice. Of course, I have talked to my medical team--they are the ones who recommended/prescribed the various pills and potions named above. My doctors can't tell me if any of you have had similar experiences though. In any case, thank you for your response.
PlatoK
Posted 7/22/2021 3:32 AM (GMT 0)

Each case is different, and you deserve the very best, PlatoK ...

My treatment history is shown below my signature, and I have not experienced the symptoms or side effects you are experiencing.

Make a specific list of problems, based on your post on this this thread, and ask to be seen by an expert from your medical team.

Most doctors save an appointment slot for emergencies ---- and you deserve to be seen without delay.

Push come to shove ---- show up in the emergency department --- be your own advocate ---- and tell them of your discomfort.

I would INSIST that you be seen pronto ---- you are experiencing major discomfort, on a variety of levels. A receptionist saying, "We can see you in September" isn't acceptable.

State that you need to be seen now --- not down the road.

Looking out for you ---- wanting all the best for you ~~~
CYCLONE - # Iowa State University
Posted 7/24/2021 8:22 PM (GMT 0)
You seem to say that because you have prostate cancer, you couldn't have an enlarged prostate, not related to cancer, it is quite common.
I started out with a 65cc prostate and it shrunk to 29cc after 6 weeks external beam radiation and ADT. With the that much shrinkage, I still had a problem due to an odd shaped "nub" that extended into the urethra. The RO thought the initial treatment would reduce that, it didn't, not enough for the upcoming Brachytherapy.
So I was referred to Uro to have green light laser prior to the seeds 4-6 weeks after the external radiation. This was not uncommon for this Ro's office to do this.
So it is possible, if needed, depending on what is causing your symptoms, maybe its something similar. The RO had their own color doppler and CT scans to see what was causing my issues.
It's also somewhat expected after the radiation, I was on high dose ibuprofin and trental, which was supposed to increase blood flow to the radiated area.
Your diet and liquid choices and very important to reduce inflammation.
Hope things settle down as time goes by
Posted 7/25/2021 12:39 AM (GMT 0)
I had some burning urination after my brachytherapy, but it was relatively short-lived, as in a couple of weeks. Following my brachy, I had IMRT and other than being a bit leaky for a while, everything was relatively normal. Longer-term I've had a weaker stream from my radiation, but it's handled with an occasional Rapaflo.

I hope you get some relief from this...doesn't sound like fun. But I think there's a good chance things will get better as your body calms down from the radiation.
Posted 7/31/2021 11:55 PM (GMT 0)
Thanks to all for your responses. The pain is no longer excruciating, merely discomforting. I am hopeful the worst is passed and though my urination is still frequent and uncomfortable, I can tolerate this. I'm grateful it isn't worse! Otherwise feeling fine though whether from diet or treatment, I seem to have lost twenty + pounds, down from 187 to 165 since April dx. At six feet I think I want to put 10-15 lbs back on. Thanks again all, for taking the time to share your thoughts and experience!
Posted 8/1/2021 3:08 AM (GMT 0)
Thanks for reporting back in. I'm glad there's an improvement--I was a bit cross about the burning that I had and it was only 2 weeks or so. I can imagine what it would be like to be longer. I hope the worst is behind you!
Posted 8/1/2021 3:19 AM (GMT 0)

Hello, PlatoK ---

I am thankful for the news of the improvements you are experiencing.

I hope, hope, HOPE --- that each day will bring more relief and healing.

We are here to support you --- keep us updated!

Handshake, encouragement, well wishes ---
CYCLONE - # Iowa State University
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