Saturday, February 16, 2008

After 2 weeks of treatments

I have had 10 radiation treatments thus far. The treatments are very easy lasting only about 15 minutes each, with radiation being administered in 7 separate beams lasting 10-18 seconds each. No pain, discomfort or problem with the treatments. They each start with two X-rays to align the beams with the gold seeds in my prostate.

After the initial anxiety about what the process would do for me and the questions about whether I had chosen the right treatment I have adopted the attitude that this is a good choice, that the radiation is a positive to treat my cancer and that I will not second guess myself.

Side effects thus far are that urination is more frequent at night, especially early in the sleep as I wake every hour or two. This compares with the pre-treatment pattern of 1-2 times per night. Urination is painless but is slower and emptying the bladder is harder with the need to wait longer to complete. Bowel movements have become a little looser as well. I am told that orgasms will be "dry" as the prostate will no longer generate the fluids that they did before. So far they are feeling less complete than before, I assume due to the lessening of seminal fluids being produced.

Other than that I feel fine with no sense of fatigue thus far. I plan to ask the doctor about whether the urination frequency will change after the treatments are over.

Tuesday, February 5, 2008

First IMRT Treatment

I'm 60 years old having been diagnosed with prostate cancer a few months ago. My Gleason score was 6 (3 + 3), which is a low grade cancer so my doctors said all treatment options were available. I met with 4 doctors, a surgeon, two radiation oncologists and my urologists plus spent considerable time researching on the web various approaches including watchful waiting. My health is excellent with normal sexual function, using no meds and am 5' 10" 150 lbs.

My decision was to go with IMRT, a form of external beam radiation administered over 39 sessions, 5 times per week. The cure rates seemed comparable with prostatectomy, brachytherapy and other approaches with side effects, at least in the next 10 years or so somewhat less than alternatives. In preparation for the radiation treatments I had an MRI, Cat Scan and gold seeds implanted in my prostate, all for the purpose of improving targeting of the radiation. I had three very small black dot tatoos placed on both sides and center for the later treatments.

The first treatment session at Stanford Hospital lasted about 20 minutes, half of which was for set up. The technicians X-rayed me twice to locate the gold seeds, I assume, then laying on my back for about 10 minutes of on and off treatments from a rotating circular machine in a very large open room. Although the 3 technicians were quite friendly and seemed very competent, for a first session of a long treatment process I would have preferred a little more background info --- even 5 minutes more to describe what would happen, how the machines would work, asking if I had questions would have been appreciated. It wasn't a big thing but would have been comforting. When the treatment started I felt nothing at all and the technicians were quite nice and did answer my questions about dosage level, number of treatments (just in case I asked to make sure I was getting the right treatment).

After the treatment I met with a doctor who went over a consent form discussing possible side effects ranging from nausea to urinary problems (burning sensation most likely), fatigue, sexual function problems, possible long-term radiation induced cancer (10-20 years out) among others. Later that day I had several minor but noticeable affects including slight chills and more of an urge to urinate. My thoughts went to what was going to happen over the next two months of treatments, how bad might the side effects be, maybe I out to opt for surgery instead. It was not the best night of sleep that I've had wondering about how would my body be reacting over the cumulative effects of this treatment path. I found my mind ranging from normal to worst case scenarios, not something I'm used to in normal circumstances.