My SBRT journey begins today.

I forgot to add, I was told to expect blood in the urine, stool and semen for a time. I was told it was similar to what is experienced after the biopsy, but often times not as drastic and for not as long. I didn't have any major issues after my biopsy, although I did have blood in all three.
I will let you know how that goes as well. So far, I have urinated with VERY little blood noticeable compared to when I had my biopsy.

Mike,
The hardest part is behind you. ;-)
Will they be doing a fused MRI/CT for planning?
Ask to see the Dose Volume Histogram that the plan comes up with -- the way the dose drops off so quickly outside of the prostate is really quite amazing.
Also, please let us know about the machine. Is it CyberKnife M6? Does it have the IRIS? (I'm such a nerd!)
- Allen

Mike, good luck ahead for you. Will be looking for regular updates and see how you do with this treatment type.

david in sc

So my simulation has been schedualed for this coming Monday the 19th. I will have a cradle "custom made' for me, a long consult with my RO and signing release forms, an MRI and a CT scan. A "plan" for dosage, etc will then be developed and around a week to 10 days after that, I will begin the five treatments of radiation.
The prep will be a little "different" , as far as diet goes. The intent is to have empty bowels and a full bladder for the treatments and we will begin with that during the simulation next Monday. i will be required to take Milk of Magnesia and a Gas-X tablet each night, starting this Friday. I am also told to not eat any raw vegetables or fruit, no whole grains, beans, seeds, or salads. Basically nothing you would eat on the "healthy" diet we are all told to be on! It's called a "Low-Residue" diet. This will be very different from what I've been eating since the first of the year, but I get it.
I also need to empty my bladder two hours prior to treatment and then drink 24-32oz of non caffinated, non-alcoholic (darn!), liquid.
The point is to minimize exposure to my bladder and rectum during the radiation. They want my rectum and bladder to be full/empty at a consistant size each day, so the diet and medications will help with this. There will be a balloon inserted in my rectum for each of the treatments as well, so that's part of why they want me empty or at least a consistant size each day. Same with the bladder, the phrase "comfortably full" is used. No peeing until after the treatments.
I've never paid this much attention to how full my bladder or rectum has been in my life, but since doing so will minimize any possible radiation damage to either, I'm going to be all over it!
I'll let everyone know how the simulation went on Monday night next week, and will continue this thread throughout my SBRT sessions. I know it might sound like I'm complaining about things, but it's really been smooth so far with just minor inconvienances.
Mike

Hey Mike, thanks for the update - and please, keep them coming as again it will help those that may want to consider SBRT/CyberKnife as a treatment option.

What a great example of "Pay Forward" ! ! ! ! ! !    

Best of luck to you brother - you 'did good' with your research and decision - now it's time to kick some beast butt!

Mike,

Thanks for the gory details -- I love 'em!

I've talked online to several guys who've gone through CyberKnife or other SBRT treatment, and every center seems to have a slightly different protocol.

This is the first time I've heard about a balloon used for SBRT. I had no bowel prep or dietary restrictions at all. Just the water before each treatment. One man I spoke to had a catheter for the planning CT/MRI.

One question I asked before they did the plans is whether they can spare the seminal vesicles. In my case, the cancerous biopsy cores were too close to it, so they wanted to give them a full dose, and because of their proximity, some dose is unavoidable. A friend in FL had it done 3 months ago and they were able to spare them somewhat. Consequently, he is still able to ejaculate fully. I think they will spare the penile bulb completely, but it doesn't hurt to ask. It's more of a problem with IMRT.

- Allen

Simulation Day!
Had my simulation in prep for my SBRT treatments yesterday. All in all, not a bad day. I had to make sure my rectum was clear (low residue diet for three days, enema the morning of), and my bladder full (this was tough, as i drank too much water prior, and had to "reload" just before we started, in other words I really had to go when I got there!). I filled out a release form and talked to my RO, sort of a recap of things we had talked about before, SE's, what would happen, etc. then I filled out a lengthy questionarre to determine my base line for things like urinary function, bowel habits, sex life, etc. Then it was on to have my "cradle" made. I put on my "johnny" and laid down on a thick pad that sort of felt like a beanbag. I was told to settle in and get comfortable in it. No problem there, as it was thick and plush. Then I was tucked in and wrapped up with a sheet and some plastic. Then they basically draw out the air, and vacume seal you. Not at all uncomfortable. The pad then hardens some and comforms to your body. This will ensure you don't move when the radiation treatments begin. The thing is pretty comfortable.
Next step was on the get a CT done while in my cradle. A ballon was inserted into my rectum and then inflated. Not painful, not enjoyable, just kind of wierd. It does give you the feeling you need a bowel movement for about 30 seconds and then that passes and you just lay there. When the CT scan was done, the baloon was removed and i walked down to the room where my MRI would be done. I was placed in the cradle and the baloon was inserted again. Knowing what to expect this time, it was no big deal. The MRI was my first, and it's louder than I expected, but I was comfortable and given headphones to listen to sports radio (my choice) during the 30 minutes it took. The only thing that made it unenjoyable was the fact I had to pee again for the last 10 minutes. Nothing I couldn't control or deal with, but man, I had to go! I was also given an IV with the tracker fluid fluid, which was no big deal either, just a little cold as the dye went into my arm. When the MRI was done, the IV and balloon were removed, and I was allowed to go to the bathroom. Then I was done. The whole thing from waiting room to walking out the door was about 3 hours. My treatment will take about one hour each from undressing to leaving. I was told I would recieve 5 treatment total. they will be given every other day, with a weekend in between. The RO and her team will be developing my Plan and will contact me in about a week. I will begin the low residue dieat again three days prior to my first treatment and that will include taking Milk of Magnesia each night along with a Gas-X tablet. They request I do an enema each day of treatment as well, and come with a full bladder. I was given a prescription for Flomax that I will begin one day prior to the first treatment and continue for around six weeks afterward.
I will find out in a week, when I start. so far, this has been a piece of cake, but of course no radiation has begun. My team of ladies who made the cradle and will be with me when I start have been terrific. Being half naked, holding your junk while a ballon is inserted, etc could have been very uncomfortable and embarrasing, but these ladies were thoughtful and respectful and I enjoyed thier company considering the circumstances. They all gave me thier card and said to call if I had any questions, and no one pointed and laughed, which was a relief. :)

..Mike, I have heard things about the cyber knife. Thanks for sharing your journey with us, looking forward to your updates and success..

.....Strength & Honor..........Appleseed...

Mike,
I'm glad to hear those women didn't laugh at your junk -- that would have been so de-moralizing! ;-)

I wonder if they will give you the mold to take home when you're finished. It would be comfortable to lie in while reading or watching TV.

Do ask your RO to take you through the plan -- I found it fascinating and encouraging.

I think that is such a great idea to give you the Flomax prophylactically. It's so much better to prevent any such problems than to fix them afterwards. I think that should be standard practice with any kind of radiation/brachy.

One thing I learned recently -- it's a great idea to visit a proctologist before the SBRT and have him inject any hemorrhoids inside with phenol to dry them up. The radiation aggravates them and may cause them to pop and bleed. Some of us are more prone to them than others.

- Allen

 Well, the "zapping" begins this coming Tuesday 9/3.  I have sessions on Tuesday, Thursday, the following Monday, Wednesday and Friday, then it's done until the follow up in a few months.  I have to go back on the fiber restrictive diet starting tomorrow along with the Milk of Magnesia and Gas-X.  I'll start on Flomax on Labor Day, with my first SBBRT session the next day.

Tuesday I'll go over the final plan with my RO, and then get my ballon placed and have the first session.  they said to plan on about an hour and a half, for the other four sessions, I was told to plan for an hour or so.

Although I'm obviously not happy to have PCa, I am ready to get on with my treatments. It seems like a long time since I was Dx'd in March.  I'm confident in my choice and ready for the next step to the "other" side.  I've seen a lot of new guys here in the past few months, and i want you to know that although this whole ordeal is scary, there does come a sense of peace once you've decided on your treatment, met your doctors, and begin the journey.  At least for me there is.

I'll keep everyone abreast of how things go (I know how much everyone loves to hear about my rectal baloon insertions ) and add any details in hopes it answers questions.

This site has been a God send, and thank you all for your support.

Mike

Day 1 of my SBRT treatments is in the books. I was given a steroid to help with any internal swelling, had my rectal balloon inserted and inflated, placed in my "cradle" and vacum sealed in to keep me from moving, and then the procedure started. Had a CT scan, was repositioned a little, and then another CT scan, and then the radiation began. The machine is open and not very noisey, so it's much better than a PET or MRI. the machine consists of a "ring" that revolves around you to get in the right position to shoot the beam, the table moves too. The whole thing took about an hour and 15 minutes, and was not uncomfortable at all. I go back Thursday (tomorrow) and then Monday, Wednesday, and Friday next week. I've been on Flomax since Monday with no SE's from that. I do have a headcold right now, so if I'm woozy from the Flomax, I don't realize it. I was told the steriod might keep me awake and make it hard to sleep, but I slept like a baby and only got up once to pee, which isn't unusual at all, in fact it was a good night as far as that goes. I know it's only my first treatment, but other than a feeling "something" happened down there (sorry I can't find the right words to explain it, but it's not bad or alarming at all) for about an hour, it's all a memory for right now.
The worst part of the whole thing might have been the music they played. I was asked what I'd like to hear and I said "classic rock", but I listen to 1980's power ballads by groups like Styx and Journey instead. LOL I was told I could bring in a CD of my choice next time, so I'll have to dig something else up.
Still on the low residue diet, taking milk of magnesia and gas-x each night. I'll be glad when that's over. I've found the best way for me to have my bladder "comfortably full" for the procedure is to drink a 20oz water in the parking lot when I get there. By the time the procedure is over I'm ready to pee, but not uncomfortable. Never paid this much attention to bowel and bladder in my life!
I'll let everyone know how it goes Thursday.
Mike

Hey Mike, thanks for the entry detailing the procedure. I'm following it closely. Of the 75 minutes on Day 1, how many minutes was the radiating part? Hang in there, bro.