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Posted 5/3/2017 7:28 PM (GMT -5)
After months of testing, diagnosing and researching, I finally had my first fraction of SBRT today.
I'm so glad that this hurdle will be behind me soon, although I realize that possibly a lifelong monitoring of PSA lies ahead.

Nevertheless, I couldn't be happier at the moment.
Posted 5/3/2017 7:36 PM (GMT -5)
Congratulations! I hope it is clear sailing for you.
Posted 5/3/2017 7:39 PM (GMT -5)
Thank you Allen.

I read with much interest your commentary on SBRT dose escalation.
FYI, dr. King is now using 40Gy.
Posted 5/3/2017 7:49 PM (GMT -5)
Yes, I know -- I was treated with 40 Gy by him 6 years ago.
Posted 5/4/2017 1:34 AM (GMT -5)
Congrats on getting the first one done! One down four to go... (At least I presume you have four to go...)
Posted 5/4/2017 6:31 AM (GMT -5)
Good news. We look forward to your progress. And don't worry too much about that life-long PSA thing. It will get to be like all of the other routine tests during your physical.

Jim
Posted 5/4/2017 7:01 AM (GMT -5)
Congratulations! Soon you will join the rest of us Post Toasties!
Posted 5/4/2017 8:23 AM (GMT -5)
Congrats and good luck from another post toastie
Perry
Posted 5/4/2017 4:49 PM (GMT -5)
Could you please describe the pre treatment procedures?

Thx
Posted 5/4/2017 11:38 PM (GMT -5)
Hi Akai,

about one week prior to your first radiation treatment you will get three golden fiducial markers (each about the size of a grain of rice) placed in your prostate. These will be left forever in your body, but don't hurt it in any way. You will be on your back with your legs in stirrups. An ultrasound probe will be placed in the rectum. The markers will be inserted via the perineum. Local anesthetic (lidocaine) will be used to numb the perineum and the prostate. This is uncomfortable, but after that you won't feel the placement of the markers at all. They will give you a one time dose of 500mg Cipro to avoid infections. Following the placement of the markers, you will get a CT scan to get a 3D image of the prostate wth the markers in position, after which the treatment plan can be made.

Hope this helps.

Hans
Posted 5/5/2017 7:42 AM (GMT -5)
Akai - Hans (searching) has described the pre-treatment procedures well. That is about all there is. The only difference between his and my pre-treatment stuff is that I had 4 gold markers implanted. Mine were of the "threaded" variety, meaning that the doc actually only had to insert the needle twice, each time he inserted a string of two markers.

I describe this procedure as "annoying" in that it is uncomfortable. My teeth were clenched the whole time the needle was in me, but I was still cracking jokes with the doc. As soon as the needle was withdrawn, all pain ended and I was good to go back to my daily life.

Some clinics will want to insert the markers trans-rectally, similar to the way most biopsies are done. My RO preferred to use the trans-perineal approach as it offers the doc better visualization of the prostate to get the markers where doc wants them, and it has a lower possibility of post-procedure infection.

The other procedure, the CT scan of the prostate is "interesting." This is typically done both with and without a dye solution. The dye is introduced into the bladder and urethra via a catheter inserted into the penis - basically a Foley catheter without the bag. The entire procedure takes only minutes, but you may experience some pain upon urination for a day or so after - that dye is nasty.

I was a bit apprehensive about these procedures, but I convinced myself that these were the price I had to pay to get the treatment (SBRT/CyberKnife) that I wanted. Now, they are just memories.
Posted 5/6/2017 11:10 PM (GMT -5)
Thanks Hans and Paxton.
Posted 5/7/2017 9:35 AM (GMT -5)
akai,welcome to a great site,I was sedated for my biopsy,with my Uro.But I wished I was sedated for the markers implant..Paxton and I had the same RO,Dr.Hirsch,same crew and they were great.But too much pain for the implants.A friend of mine was sedated = no pain.
Posted 5/7/2017 5:04 PM (GMT -5)
0311 - It is true that sedation would equal no pain, but at least for me, the loss of the afternoon and evening due to balloon-head (from sedation) would negate the pain control. For me, the pain was real, but was manageable. I just breathed slowly, cursed the doc under my breath, and let them finish. After that - no more pain. I was able to enjoy the rest of the day, knowing that I was all ready to commence my treatments.

None of us enjoyed the implant procedure, but AFAIK none of us have died from it, either. . .

BTW - I STILL need to turn on the light when I pee at night. My urine stream never did begin to glow in the dark like the others tried to tell me it would. smile
Posted 5/7/2017 5:43 PM (GMT -5)

Paxton said...
BTW - I STILL need to turn on the light when I pee at night. My urine stream never did begin to glow in the dark like the others tried to tell me it would. smile

I was promised x-ray vision. Still hasn't happened.

Andrew
Posted 5/8/2017 7:19 AM (GMT -5)
Heck, I can SEE the bowl, I'm just lucky when I hit it. . .
Posted 5/8/2017 11:00 AM (GMT -5)
Didn't realize it would be painful. I just had a biopsy (my 4th) in which 18 cores were taken, a little bit of pain and got better the next day.
Posted 5/8/2017 8:26 PM (GMT -5)
Pax,its a personal choice of to sedate or not.Im retired,dont care of balloon head as you say,lasts all day.or take a day off from work.If I had to do markers over again it will definetely be,Balloon Head time.
Posted 5/8/2017 10:18 PM (GMT -5)
It hurt but only for a brief moment until the lidocaine kicks in.
Posted 5/9/2017 7:06 AM (GMT -5)
No matter whether it hurt a bit or not. . . it is history!

I am not complaining about a bit of pain. I am only describing my experience so that others will not be surprised should they have a similar experience. I would not let the thought of the implants deter me from choosing SBRT. . . not for one second.
Posted 5/10/2017 4:24 PM (GMT -5)
I was sedated for the placement of the fiducials (Georgetown U Hospital). Got six of them, but didn't pay extra AFAIK. Had to be driven home by someone else because of the prior sedation. All in all, the procedure was painless.
No rectal balloon or spacer for the actual SBRT.
Posted 5/10/2017 6:23 PM (GMT -5)
SrSailor: That was an option that I was offered as well. But I wanted to drive straight to work from the procedure, so I elected to forego the sedation.

Paxton: Me neither, I just wanted to give a perspective to akai since he used the term 'painful'. Sounds worse than it was.
Posted 5/11/2017 7:07 AM (GMT -5)

searchinginla said...
Sounds worse than it was.

Agreed - Same here.
Posted 5/28/2017 11:28 AM (GMT -5)
Coming to two weeks after SBRT, I'm happy to share that the flare up of bowel discomfort, that I experienced one week after the last treatment, has subsided and I'm almost back to normal. It was a rough weekend last week, but all is good now.
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