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.

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