Radiotherapy questions

Forgot to add...PSA 3+4. Staging T2N0. Not spread outside the prostate so far.

I literally change my mind every day about best way forward...radiotherapy or prostatectomy. Also offered cryotherapy as part of a clinical trial but from what I’ve read more difficult to treat things down the line with that latter one if the cancer comes back or cryotherapy not successful first time. 

So I think for me so far it’s prostatectomy vs radiotherapy but very afraid about ED and incontinence consequences of having an operation. 

Benefits over surgery,   no major op. No catheter, Less likely to have ED  and continence issues.

I didn't have a special diet but just ate sensibly.

Sore rectum , yes , mainly due to severe constipation, creams provided. Starts midway thru treatment and tails off a few weeks after treatment finishes.

Once RT finishes side effects stop after a few weeks.

Bear in mind I had RT without HT so there could be additional side effects for longer if on HT as well.

If u r really worried about ED and continence  consider RT .

Steve

I had Robotic surgery 8 years ago. No problems at all. Penis a bit smaller. PSA less than 0.02 ever since and i still have RT as an option. Ask consultants for latest figures on both procedures. 

Unknown said:

(2) ... daily treatment with your bladder full & bowels empty. 

Bowels, bladder and prostate are only loosely fixed; if one is full, the others will shift to accommodate to some extent. Imagine one day your bladder is full, next day it's empty, but your bowels are full. As a result, your prostate gland will likely be pushed forward on the second day.

This would risk the radiation intended for the prostate actually hitting the wall of the rectum, 2.5cm away. So, to ensure that everything is in the same place for each treatment, the radiographers will

(1) Lay you in the same position each day, often using tiny tattoos to match up the exact position of your hips, etc.

(2) In some cases, they insert gold markers into the prostate, so they can see exactly where it is to line up the angles correctly and 

(3) They get you to regulate bowels / bladder to make their job much, much easier.

How they do this varies from place to place. When I had my RT, I had to empty my bladder a while before, then drink exactly 500ml over 20 minutes. Different centres do it different ways: they will advise you. It is important.

As for bowels, if you settle on a dietary routine, and empty bowels daily, you'll be OK. If you tend to constipation, tell them and ask for advice.

I had 2.5 weeks of radiotherapy followed by brachytherapy, so no side effects from RT. The worst bit of RT was the pain of having a full bladder and having then to dash to the loo immediately after only to find it occupied! Have they told you about brachytherapy where radioactive seeds are injected into the prostate to kill the cancer cells?

The worst part of the treatment is the hormone therapy which knocks out testosterone production...and goes on for two years. That causes erectile dysfunction and loss of libido and other emotions, with no end date for recovery.

Will

I found the dietary advice very important. There were some in the waiting area who ignored the 'dont drink alcohol ' so I thought what harm can a couple of glasses of wine do - as it was Christmas. 

Well that coupled with sprouts was one big mistake! 

So make sure you get a diet sheet and stick to it religiously!

Hope all goes well.