IMRT: How many ?

Alot of variables in IMRT, dosemetrics- the level of exposures in grey scale, mapping area decided upon, type of machinery and its delivery systems, there are even threshold limits of how much is considered 'safe' radiation and some patients opt if they know of such for heavier duty program and you can sign off as getting such, I did but I also got a way different radiation method combined which is very rare as you need a Cyclotron to do that only 2-3 of these in the USA from what I know, also Neutron ray is most potent ray available and is used sparing and hopefully by highly qualified rad-doc so I got the Neutron(10sessions) & Photon(25 sessions) using 2 machines). Went well and I have no complaints, and I am 7+ years since doing this radiation, 8 yrs. since diagnosis. This along with ADT3 was my primary treatment...I was not a reasonable candidate for curative surgery.

Usually IMRT is around 35-37+ sessions from other patients chiming in. Should go very well and not often do we see people with horrible side effects, alot of variables including the equipment maintenance and whom is at the helm and doing the planning and work. Around 30-40 yrs. ago technology was bad on radiation and burn and issues were common then (called Box radiation and some other names).

Why rush into radiation, let the gland issues heal the best they can sounds very reasonable. It is not as scary to get radiation as you may first perceive, this is why you get all these mini sessions and weekends to build up your system, while doing this. Other guys can mention how it went for them or their doseage levels and details, all worth learning about.

Post Edited (zufus) : 2/27/2010 11:57:59 AM (GMT-7)

My Salvage IMRT ended after Thanksgiving day. I had 39 treatments for a total of 72 gys, which is quite a load for a secondary treatment. There are just so many factors for your radiation oncologist to consider when they come up with a person's "plan". So you will see quite a range of sessions numbers and gys. Where I had mine done, the longest possible regiment is 45 days.

David in SC

J B I'm starting adjunct radiation on April 13 which is about 11 weeks after surgery.I'm getting 68 gys over 38 days, my onocologest said he could do it over a little shorter period of time if I wanted but I told him I didn't mind the extra days for the recomended protocol.The way I understand it, its the accumulated Grays that count.I hope its not cast in stone that your bladder control will not improve after radation starts.I'm leaking most of the day now ,6 pads a day so hopefully it will improve over the next 6 weeks DICK

You began your journey riding the Lupron train. Lupron will knock your psa readings right down to zero, and halt the advance of PCa. With a gleason score of 4+4=8, I totally understand your starting out on the HT path. Don't know enough to understand why you couldn't get a post-op gleason score (due to therapy effects?) In any case, the PCa is not going anywhere, so rest up and heal for as long as you can before starting RT. How about you asking for a psa test right now so you can confirm a zero? I was supposed to begin my RT on December 20, but the Rad Oco said that with my zero psa I could wait an extra month until after the holidays to begin. AND, he does NOT think I will have any long term continency problems. I wear a pad, for security, but probably could go without if I were brave enough.
All the best.
Roger

Opa N -- I am interested in your treatment history, from your signature -- relatively low pre-op psa; Gleason 3+3 from path report, good post op psa, and post-RP treated with adjuvant LHRH agonist and IMRT without waiting for post op psa rise. Seems an agressive (though perhaps very prudent) course. Was this based solely on the existence of postitive margins? How long do they plan to keep you on the adjuvant hormone treatment? Past the end of IMRT? Just asking as part of my effort to learn more. Thanks.

Medved - We are veering slightly off-thread here, but I want to answer your inquiry. I was stupid and allowed 10 years to pass between psa tests (and annual physicals too for that matter.) I was seeing a cardiologist all that time, and believed that doing so was all I needed to look out for my health. Very wrong assumption. So, when I finally had a physical, the family doc drew blood for a psa, then did a DRE, then when the psa result came back slightly out of normal range, he passed me on the the Uro. If I had caught this PCa earlier, then I might not have had positive margins to the extent I did have (all over the place), nor seminal vesicle invasion. The path stage of T3b triggered the Uro to refer me out to both the Rad Onco and the Med Onco. I wrestled mightily over the HT part of all this; at first I objected strenuously to it, but eventually came around to realize that both HT and RT gave me the best shot of beating this thing. I have outlived all other males in my family by at least 5 years (they all died mostly of heart problems, by age 63), so I figured I was on "gain" time, and needed to make the most of it. All the docs considered me to be at high risk for spread/recurrence, EVEN THOUGH my psa tests were coming back undetectable. So there was the decision process. My treatment coursecalls for one more Lupron injection (30 mg, 4 mos), which I do tomorrow. Theoretically it will wear off starting in July, and we will be testing psa regularly after that. With God's help, it will be all I need. I have to give thanks out to TC-Las Vegas, Doting Daughter, and Zufus, all of whom offered great advice to me while I was wrestling with my decision. Agressive? Yes. Prudent? I believe so.
All the best.
Roger

Looks like probably you got the zoladex it is usually cheaper and is given in the stomach area as opposed to Lupron usually in the rump-end area. With zoladex you have a nice black n blue mark that lasts a while and eventually goes away. They basically work the about the same, both are LHRH type drugs. Back when I got it the Lupron, was about $500-600 more in cost over zoladex (2002-2003-2004). Taking these would mask any natural or real psa number you might actually have, so when you go off these and months go by one should get psa tests to know where you are in the psa world.

Best to you in the journey.