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Brachy plus IMRT Side Effects

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Posted 4/4/2024 3:14 PM (GMT 0)
Hi all. I’ve recently transferred my care from local team to MSK. At the end of the day (besides their reputation) I switched because they think adding brachy with IMRT would be best. Local does not offer brachy.

Diagnosed back in January, two weeks before my 49th birthday. I’m at the locally (or regionally?) advanced stage IVA T3b N1 M0. Biopsy results - six of 12 cores all on the left side 3+3 6, 4+4 8, 4+3 7, 4+3 7, 4+5 9 and 4+3 7. Have been on Eligard for three months now and Abiraterone for about a month. Last PSA (taken last week) was 0.9.

I’m curious as to anyone else’s experience with side effects of the brachy plus IMRT. The hormone therapy side effects have been shockingly light.

Thanks!
Jim
Posted 4/4/2024 3:37 PM (GMT 0)
JP, I had combined IMRT and brachy a little more than 13 years ago along with ADT. As for the radiation side effects, they started about 10 days into the daily radiation and persisted until about two weeks after the daily radiation stopped. They were limited to some increased urinary frequency and urgency and softer looser bowel movements. Very minor.

With the brachy I was tender for a few days and avoided sitting on hard chairs. Brachy induces a little internal bleeding and aided by gravity the blood pools and shows as bruising to the scrotum and penis. No problem just looked weird for a week or so.

The main dietary changes I made was to eliminate caffeinated and carbonated drinks and anything acidic. These are all tough on the urinary tract. I drank a lot of water and green tea. I was eating a high fiber diet and my docs said to continue it and keep very hydrated.

My RO said to expect some bowel issues and to go with any urge, not try to hold anything. He also said to keep plenty of immodian D close at hand. I did, but never needed it.

As I mentioned the very minor side effects left quickly after the daily radiation stopped. Since then I have had absolutely no negative treatment induced side effects. All plumbing works just fine. I have had three colonosocopies and the GI doc says everything looks fine with no radiation damage.

You have chosen a very effective treatment combination and will do very well. There are a few other combination radiation men on the forum that have long term experience similar to mine.
Posted 4/4/2024 4:14 PM (GMT 0)
Until reading JNF's description, I had forgotten that sitting was a bit difficult following my brachytherapy. But it only lasted a few days. In general, the only long-term issue I have is I don't pee quite as well, but it's easily handled with an occasional dose of generic Rapaflo.

Glad to hear your ADT side effects have been so mild. For me, ADT was more difficult than any of the short-term radiation issues.
Posted 4/4/2024 4:28 PM (GMT 0)
"I have had three colostomies and the GI doc says everything looks fine with no radiation damage."

JNF -- i sure hope you mean colonoscopies smile.

like michael said ADT was the hardest for me. i had SEs from both radiations and lupron but the two SEs i've never had is untreatable ED and incontinence
Posted 4/5/2024 10:33 AM (GMT 0)
Thanks for the catch, Ed. One would have been bad enough, but three? Sheesh.
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