First appointment with radiotherapy nurse

2 minute read time.

Up at the crack of 7.00 am, on February 25th, to travel UCLH in Euston Square, for my first pre RT appointment. It was timed at 10.00am and I was seen almost immediately by Nurse Beata (I think). Had I been told the potential side effects such as diarrhoea? Yes, but I should pay close attention as she was going to explain how to minimise the risks. Did I know how to self-administer an enema? Well, she was going to tell me.

 

She showed me a Micolette, which is a micro enema. It consists of a plastic tube with a long neck, and the tip made to break off easily to access the contents. Instructions are to break off the tip, insert into the rectum (back passage) and squeeze out the contents. Wait 10 minutes for it to take effect. This had to be done daily from March 1 to March 5 and I should record the results, whether substance or merely gas. This would help ‘train’ my rectum’ and was quite independent of whether I had already been to the toilet that day. She then gave me a prescription for 24 micro enemas, to start with, further supplies to be provided as required. I should bring them with me on every visit, including the planning scan, on March 6th. Once we came to the actual radiotherapy, starting on March 24th, I should also bring one, or two, with me to the hospital but wait for the radiologist to tell me when to use it.

 

The next point we discussed was bladder control. During radiotherapy, the bladder has to be full to keep it, as far as possible, out of line of the radio waves. This minimises the risk of bladder damage and subsequent urinary incontinence. To ‘train’ the bladder, I should first empty it, and then drink 500 mls (about three cups) in one go. Then I should record how long I can hold it before I have to pee. This is where my daily pelvic floor exercises come in. The aim is to hold it for a minimum of 30 minutes. Curiously, if I was able to hold it for longer than 45 minutes, I should try again with 650 mls of water. I think this is what is known as ‘testing to breaking point’. This routine will be for 5 days and my records would be reviewed at the meeting on March 6, ‘Scan Day’.

 

Any questions? Well, yes. My PSA readings had been pretty low, maximum of 0.58, before the course of bicalumatide hormone tablets, and the previous radioactive scan (Choline PET scan) had shown nothing, so why did I need the radiotherapy? In her words, the cancer cells are so small that they don’t necessarily show up on the scan. It is really to be sure that no cancer remains. I have accepted this as I saw my brother die, as previously blogged, of untreated prostate cancer, except for pain killers.

 

Anonymous