Long term effects of salvage or adjuvant radiation

Compatriots:

Looking like I'm in for radiation, either now or later.

I'm pretty up to speed on possible short term effects.

But what about long term? My oncologist and my surgery guy seem to differ here.

My surgery guy filled me with really dire stories about patients five or ten years after salvage radiation having severe difficulty urinating, blood in the stool or urine, severe hemorrhoids, etc.

My oncologist downplayed that.

Anybody have any useful stats on that?

Aachen,

Of course, your surgeon and your radiation oncologist could both be quite right from their point of view. I believe the side effects of modern external beam radiation are usually fairly mild but there are occasional patients who do have problems. My RO estimated something like 15 percent would have some sort of lingering problems to deal with. Assuming that is right then the men who go to their urologist to talk about their problems will be those 15 percent. The other 85 percent never think to make an appointment with their urologist to tell them that since their radiation everything is just peachy. The only guys who talk to a urologist (surgeon) about radiation are the ones who have something bleeding or something leaking. It's not a fair sample but it is an honest assessment.

I am four months out of my adjuvant radiation and, for the most part, I am not having any obvious after-effects. I was pretty fatigued for six weeks after the radiation but I didn't miss any work and it seems to have passed. I do leak more than most guys (I never got dry after surgery) but it's hard to decide whether to blame my surgeon, or my radiation oncologist, or my fate.

There are undoubtedly people who suffer long term effects of SRT or ART. As you are finding out, that includes some men on this forum.

A study from Mayo ( www.ncbi.nlm.nih.gov/pubmed/19766337 with more on that here written in plain English: www.sciencedaily.com/releases/2009/09/090928131212.htm# found that most people are fine. I'm one of those. At this point I have no lingering side effects that I can attribute to my salvage radiation. A recent colonoscopy, screening for cancer at my mid-century mark, showed no visible radiation damage, as well. As a bonus, my PSA became undetectable and stayed there (knock wood).

I did have a short-term side effect, but it was just that.

You may want to look at my thread I started yesterday. It is similar to yours, but inquires more about fatigue that comes with radiation and hormone deprivation.

I only have two sessions left so on Wednesday I will have completed all 38 sessions. The first 28 dealt with the pelvic region and blasting all the lymph nodes that could be problematic down the road.

The first two weeks, you shouldn't experience anything. After that, the loose stools begin, so have Immodium always on you. As stated by both moderators, there may be blood in your stowels (I never checked for that and probably never will unless it is obvious).

Today, I just noticed some drops of blood after I have urinated and will watch that to see if it continues. I also started to feel like I had a sun burn internally after about four weeks of radiation and it still feels that way today..

After the first 28 sessions that caused loose stools since they blasted the pelvic region. However, around Session 31 I finally had a normal BM and I was excited.

Fatigue finally caught up to me beginning around Session 25. I was use to the fatigue from the hormone deprivation, but I really noticed the increase due to the radiation.

Since I haven't even completed the IMRT, the future remains to determine what I will be blessed with. All these procedures are a major trade-off. Since I am high-risk for recurrence, the IMRT should add a few years to my longevity, the trade-offs is feeling yucky during the last half of IMRT, fatigue for heavens only knows in the future.

I hope your cancer center is as careful as mine has been to make sure you are perfectly aligned on the carbon fiber table with the tattoes you will receive on your first CT scan and ultra-sound that they will plan for how they will deliver the radiation, the daily CT scan to compare to the original and then the adjustments that they make on a daily basis to account for changes in your bladder, intestines, etc so they don't damage anything they didn't intend of doing. It was very impressive to me the safe guards they have in place to prevent unnecessary damage.

Good luck and best wishes as you embark down the radiation path.

I'm almost 2 years post SRT. I noticed a bit of radiation proctitis at about the one year mark but it may actually be healing a bit. I plan on my regular doc taking a gander up that direction this year so I'll find out what he learns then.