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SBRT PCa Treatment Progress and SE

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Posted 12/26/2017 1:00 AM (GMT 0)
Hi Everyone,
Since it is the night of Christmas I sure hope all have had a great Christmas.

I am writing to ask about Side Effect (SE) experiences during the SBRT treatment sessions. I have read quite a bit of the past posts on SBRT SE but hope to get some comments relative to my specific questions.

I go for my 3rd of 5 treatments tomorrow. After my first treatment Dec 19 I experienced no SE. On Dec 22 I had my second treatment and I have been experiencing some urinary urgency and burning pain that seems to be from the urethra in my penis while urinating. Also some relatively minor pain/pressure in the rectum if I am making or passing gas. I am taking FLOWMAX is all.

My questions -

1) Should I expect after each subsequent SBRT treatment the SE to worsen; or not necessarily or is it just a variable?

2) Is there a typical cause for the burning pain while urinating - is it clumps of dead cells exiting with the urine or is it simply due to radiation damage?

I do meet tomorrow after my 3rd session with the RO and will be discussing items with him too.

Thanks for any comments.
Posted 12/26/2017 1:15 AM (GMT 0)
You just got a sunburn where the sun don't shine. All your symptoms come from that. Just as with sunburn, there's a delay in when the symptoms arise. I didn't feel anything for about 10 days - everyone reacts differently. Take your daily Aleve, Flomax and Cialis.

It's not clumps of dead cells. it's "sunburn" pain. You can get pyridium over the counter - it is very soothing to the inflamed urethra - but be careful - it stains everything.
Posted 12/26/2017 1:44 AM (GMT 0)
Tall Allen,

Thanks for your answers and advice. I will try some Aleve. And hope the SE's do not worsen significantly with the remaining treatments.
Posted 12/26/2017 3:33 AM (GMT 0)
As TA says....Take the Aleve and flowmax. I just went through SBRT, last week, Take the Aleve and Flowmax.......Take the Aleve and Flowmax. You will be well.

Roger
Posted 12/27/2017 12:18 PM (GMT 0)
Hey Busman,

I didn't have that treatment but my brother did. Like you, he had similar symptoms after the second treatment and he was freaked out that they would get cumulatively worse as treatment progressed and he wouldn't make it through.

They never progressed past the initial minor symptoms which ibuprofin, pyridium and tamulosin reduced significantly.

A month out, he has no symptoms and is now worried the radiation wasn't strong enough.

Everyone reacts differently
Posted 12/27/2017 2:18 PM (GMT 0)
Hi Fauntleroy,
Thanks especially for your comments that tell me your bothers symptoms to the radiation treatments did not get progressively worse with the additional treatments - that gives me some good hope that mine will not get noticeably worse. Also, I hope it turns out your brother's treatment proves successful.

On Tuesday morning (Dec 26) prior to my third treatment my pain during urination went away and the urgency was gone too. I had my third treatment and the urination pain and urgency is back about the same as before. Much of the urgency to urinate seems to be driven by when I am making and passing gas - I tend to eat foods that make gas and I now realize I need to cut back on those foods. I did speak to the RO and he wanted me to double the FLOWMAX (tamsulosin) dose and recommended the pyridium. He ordered a urine sample test and said that most patients do not experience these symptoms till after the fourth or fifth treatment and even though I was early did not necessarily mean they would get worse.

I am getting 5 treatments of 9 Gy each for a total of 45 Gy which is more than most institiutions do the 36 - 40 Gy range. My RO at UTSW indicated to me they had settled on the higher 45 Gy treatment as standard because based on their experiences it has a better success rate with no worse SE. (Of course that is debated with different data from different RO's at different treatment centers). In my case I have been thinking that if the SE do worsen significantly I would just cut off the treatments but hope that does not happen. I think at UTSW they have a protocol that if a patient exhibits grade 3 SE during treatment then they stop the treatments.
Posted 12/27/2017 6:47 PM (GMT 0)
Busman - I had all of those side effects, but mine didn't show up beyond "annoyance" level until about 3 weeks after treatment. Then, they got somewhat worse, with urinary discomfort peaking at about 5 weeks out, then gradually subsiding. The tenesmus (feeling that you need to have a bowel movement, but maybe don't) then kicked in and stayed with me for a month or so. I also had/have some intestinal issues (never trust a fart!) which continue to come and go, just over a year out.

Have faith, brother. We are all different, so my side effects may be lots worse than yours. I did have IBS (irritable bowel syndrome) for years prior to treatment, which exacerbated my symptoms.

Even with the side effects I have, I still find that it is mainly discomfort, nowhere near the level that would impact my lifestyle. I still do everything I did before, I just have to adjust diet sometimes.

Hang in there. Even if it does get worse, it is only bad for a little while. Then it settles down and you just adjust to your new normal.
Posted 12/28/2017 2:06 AM (GMT 0)
Paxton,
Thanks a lot for commenting and telling me your SE experiences. It helps me knowing some others have these experiences even during the treatments. Seems like most though simply go thru with the treatments with no SE or none that are enough to mention.

Hope your SE simply go totally away in the near future.

I surely do hope I make it through all 5 treatments with no worse SE than I already have which seemed to have improved after my third treatment partly due to increasing FLOWMAX and partly due to eating foods that make less gas in my digestive system and I also started taking Aleve today which maybe helping.

I was able to due my normal excercize routine today of 30 minutes running and 30 minutes weightlifting which helped take my mind off the radiation treatment.
Posted 12/28/2017 6:32 AM (GMT 0)
Hey Busman..... My sbrt was completed this past July and part of the required protocol was a low residue, low fiber diet especially in the 12 hours or so preceding each treatment. I also walked three miles every day. My side effects were quite mild during and after treatment and continue to be no issue to this day. Some tenesmus during and right after treatment and a very mild burning sensation sometimes when peeing. I had Flowmax on hand during treatment but never needed it so when I had a little discomfort I just took a couple Ibuprophen. As Paxton said, there is a new normal that you will adjust to but in my case it is very subtle. I wish you the best. You are almost at the finish line.

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