Posted 10/20/2018 7:31 PM (GMT 0)
It has been two weeks since my last update. I have now completed 20 of my 28 IMRT treatments and both of my HDR brachytherapy treatments. I thought I would share some information on my HDR treatments since they are invasive and in my case what I had been most interested in reading about. The treatments were completed on Thursdays on consecutive weeks. In both cases I received no IMRT treatments on the day of the HDR procedure and the day after the HDR procedure (Friday). I would then resume IMRT on the following Monday. Here is the basics for my particular procedure. The prep involved no aspirin products for seven days prior to the procedure, no liquids/food after midnight and a fleet enema the morning of the procedure. I arrived at 7:00am and was taken to a prep room. The nurse checked my vitals and set up my IV. I then walked to the surgery room for placement of the 18 catheters. I sat on the edge of the surgery table and was given general anesthesia (last thing I remember) and a local numbing agent in the insertion area. The urologist and the RO worked together on placement of the catheters. After placement, a CT scan was used to see the exact placement in my prostate and complete any final adjustments to the catheters. I was then moved to a recovery room where they woke me up. I spent 45 minutes hanging out with my wife and the nurse as we waited for the RO and physicist to complete the radiation plan based on the CT scan. I was a little groggy but had no pain. Once the radiation plan was completed, they moved me to the radiation room and hooked me up to the after loader. The after loader is the equipment that moves the irradiated probe thru the catheters at a predetermined speed and dose rate to meet the radiation plan. The radiation treatment lasted about 20 minutes. I was awake and listening to music. They told me I would feel some pressure but no pain and some clicking sounds as the probe moved thru the catheters. Once the radiation was completed, I was moved to back to the recovery room where I was given general anesthesia for the removal of the catheters. I woke up with an ice bag on the insertion area and was given some time to recover. I was dressed and in the car heading home at noon. I was given four prescriptions to start after the procedure. I was given an antibiotic, steroid pack, Flomax and Tylenol. They also recommend that I purchase some over the counter AZO. The short term side effects from the procedure were tenderness in the insertion area and urinary issues (urgency and burning). The burning was by far the worst. I had heard it described as peeing razor blades or molten glass and that was a pretty good description. Luckily they resolved themselves by the end of the second day. I also had some issues with low blood pressure after starting with the Flomax. My blood pressure was as low as 90/60 and I had issues with fatigue. The RO suggested taking Flomax every other day and my blood pressure is now 105/70. I am 8 days out from my last HDR and feeling good. I have been able to continue my morning walk during the treatments but took two weeks off from tennis. I played tennis this morning for the first time and felt good. I am in the final stretch with IMRT. I will be done on October 31st. Overall, I have been happy with the process and still feeling good about my treatment decision. My RO told me in my follow up exam this week that the HDR procedures went very well. I asked him if he could define define "very well" or does he just tell everyone that the procedure went very well. He responded by saying based on my two decades of experience, I believe the radiation coverage of the areas we wanted to radiate was excellent without over radiating the areas we didn't want to radiate. Hearing his response start with "my two decades of experience" was very reassuring to me. When I started this journey in March my goal was to find a treatment plan that I was comfortable with and find a doctor with the experience to execute that treatment plan. I am content with my decisions and ready to accept whatever the future has in store for me. I hope sharing my experience will help those of you who are considering treatment options and those of you who have decided on HDR brachytherapy and are anxiously awaiting your treatment. regards MJ