My Journey through HT and RT

Mentally tough as well as a physical one  never a day goes by when I don't worry about it all 2 years in after r/t and h/t psa has been steady at 0.01 but every twinge   bruise swelling ect you worry but have to realize we can't control it and we are getting older along the way good luck with your treatment and stay as positive as possible gaz 👍

Hi Malcolm

Sounds very like my RT experience at St Lukes, Guildford June 22. I liked driving down there after the mini enema and 400 ml water. Free parking for onco patients. Good banter in the waiting area, hoping your session was on time after all that water! 

Yes, I had fiducial gold markers plus tattoos to ensure a good aim with new, advanced linac. Being manhandled by pretty radiographers was pleasant but the zoladex rather spoilled things. It was great to Ring the Bell 3 times after my last session and wave goodbye (I hope!).

Stopped zolly 6 mo ago but side effects still with me, fatigue and aches and pains. Psa still  below detection limit but so is testosterone which may account for the side effects.

Only downside is some radiation proctitis which will be treated shortly.

My journey started about a year ago diagnosed T3b n0m0 G9 so a bit worried . Progress so far is good and as I am 79 I have stopped worrying.

Good luck to all of us.

Peternigel

On the up side, the 37 sessions was rather sprung on you last year as an alternative treatment option on a belt & braces approach rather than because your diagnostics showed that it was necessary; initially, you were expecting 20 sessions aimed at the prostate. So the issue is that plan B, which was dangled before you, now appears too risky and you revert to plan A. Frustrating for you but maybe in a few months you will look back and be pleased that the choice was taken out of your hands.

Hey Decho 

hope you are feeling okay

i was convinced from your plan that I was destined for 37 fractions and pleased that the Oncologist said only 20 was needed. I do have several lit up lymph nodes in the pelvis. he explained that the additional number of fractions did not change the outcome as the cumulative dosage was the same and there was no evidence to suggest extra fractions improved the outcome. I think I read on here how the greys are calculated but can’t remember where. I think it is just they give a little more each time.

N

Edited by member 20 Jan 2023 at 20:47  | Reason: Not specified

N, you will drive yourself round the bend! You seem to be imagining RT as a linear thing - limited PCa with no lymph involvement = 20 fractions, PCa with lymph nodes zapped = 37 fractions. That is just not how it works - if it was like that, we would see men with very small tumours having 10 fractions and a man with a really big prostate having 50! Weirdly, the opposite can be true - a man with advanced PCa may have 1 or 2 sessions just to reduce some bone pain and a man with a T3 / T4 having 5 or 6 fractions at 6Gy! 

Some oncos will use 20 fractions at 3Gy / 3.2Gy for all radical RT - some will only use it for men with T1 / T2 but perhaps at a lower dose than 3Gy - some will only use it for adjuvant or salvage RT. 

Some oncos will use 37 fractions (or even 39 in Decho's onco's case) at 2Gy for all men - some will use 37 fractions only for men with pelvic node involvement - some don't do 37 fractions at all now (for example, because of changes to procedures since Covid and the drive to reduce the number of visits each patient makes to the hospital) 

Some oncos will run 30+ fractions for a man with local spread - 20 or 25 fractions delivered as normal and then a few additional fractions aimed just at the nodes or just at the heaviest load in the prostate.  

You are trying to rationalise the random ... oncos have different preferences and NHS trusts may also have developed different approaches. The fact is that 37 x 2Gy (74Gy) delivers more or less the same amount of killer rays as 20 x 3.2Gy or 6 x 6Gy and a personalised computer programme determines how much killer dose is delivered to which bits of the pelvis. Your onco and Decho's onco can therefore both be right!   

PS

i am basically a problem  solver 

in industry and last 10 years in gov work and I struggle with this.   I understand I really do but doesn’t stop me being frustrated as I can not solve this. Just have to suck it up I guess