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  • SBRT - Side Effects Timing

    I have completed two SBRT treatments (Tuesday & Thursday) [no hormone therapy]. I will have the next three treatments this week (Monday, Wednesday & Friday). I have heard about some of the side effects (urinary and bowel problems, erectile dysfunction, etc) and tiredness. It seems these side effects tend to get worse over AFTER radiation is completed. For those of you getting the five treatment SBRT, when have you experienced these side effects, specifically tiredness? Should I expect to be tired this week (treatments 3 - 5)?






    55 year old with unfavorable-intermediate risk prostate cancer, cT 1c N0M0, Gleason score 4+ 3 = 7, <50% positive cores, pPSA 3.9, Grade group 3.

    Biopsy in 10/2021 which showed GG1 disease and patient went on AS. Repeat biopsy in 3/2022 which demonstrated Gleason score 4+ 3 = 7, <50% positive cores. MRI of the prostate showed no ECE, no SV involvement, and no pelvic lymph node adenopathy. Bone scan is negative for metastatic disease.
    Last edited by CruzeDon; 07-31-2022, 03:41 PM.

  • #2
    Hi CruzeDon....welcome to the forum....I will tell you what I know....

    I had HIFU treatment and psa prior to was 10.6.....now 3.5 I'm looking into SBRT pending next psa or unusual rise. There is a clinic in Seattle, Wa at the Swedish Radiosugery Center that does Cyberknife/SBRT.

    I talked to a friend of mine whom had SBRT at Seattle clinic and asked him your concerns: This is what he said, I was minimally tired after treatments 3-5 but it didn't interfere with me playing golf. Most guys who are in reasonably good shape don't notice much. Now if a person is in their 70's and don't take care of themselves are are out of shape they might experienced severe tiredness.

    My take on this:

    1.) Clinic should have gone over all of this with you....They mapped out a plan of action to target problem areas.
    2.) 5 days of high radiation is going to make you tired...guaranteed...I wouldn't stress/sweat over that.
    3.) Don't overdue anything. Drink lots water...go for mild walks...
    4.) Tiredness might occur up to a month after treatment...if it is longer consult with clinic whom did your SBRT or your consult with uro.

    Take care & I hope all goes good with you!
    Keep us informed!
    YOB: 1953

    Pathology report July28/2020

    Right apex anterior x4 prostatic adenocarcionoma, gleason score 6/10 (3+3), Grade group 1, 2/4 cores involved, 20% &< than 5%
    Left mid lateral : prostatic adenocarcinoma, gleason score 7/10 (3+4), grade group 2. 4% pattern : 15%. Tumor involves 40% core.
    Left mid peripheral zone x4: prostatic adenocarcinoma, gleason score 7/10 (4 + 3), grade group 3. 4% pattern: 85%; cribriform pattern. 2/4 cores involved (fragmented), 75% of overall tissue
    Left apex: prostatic ad enocarcinoma, gleason score 7/10 (4+3), grade group 3, tumor involves 5%
    HIFU treatment, Toronto Canada on Nov.22/2020....Volume prostate prior to HIFU 43cc

    PSA History:


    Aug/2011 2.42, Oct/2012 3.1, Feb/2016 5.1; Apr/2017 6.0; Sep/2018 6.7
    Oct/2019.. 8.5; Nov/2020 10.6 HIFU treatment Nov22/2020 Feb/2021 2.9
    Jul/2021 3.2; Nov/2021 3.0 Next...Feb.23/2022 3.5

    MRI Aug/2021 & Volume 30cc
    Ablation defect on left posterior. Low signal extending from left peripheral zone from base to apex. Left peripheral reduced in size. No discrete high signals present on right/left peripheral. No suspicious lesions.

    Comment


    • #3
      Forgot to mention....Gleason score 4+3=7 & grade group 3 is serious aggressive cancer. IMO...A bone scan will not show everything. I'm surprised facility that is doing your treatment did not perform a Pet Scan. In the last month, I have had both bone scan & PET Scan.
      YOB: 1953

      Pathology report July28/2020

      Right apex anterior x4 prostatic adenocarcionoma, gleason score 6/10 (3+3), Grade group 1, 2/4 cores involved, 20% &< than 5%
      Left mid lateral : prostatic adenocarcinoma, gleason score 7/10 (3+4), grade group 2. 4% pattern : 15%. Tumor involves 40% core.
      Left mid peripheral zone x4: prostatic adenocarcinoma, gleason score 7/10 (4 + 3), grade group 3. 4% pattern: 85%; cribriform pattern. 2/4 cores involved (fragmented), 75% of overall tissue
      Left apex: prostatic ad enocarcinoma, gleason score 7/10 (4+3), grade group 3, tumor involves 5%
      HIFU treatment, Toronto Canada on Nov.22/2020....Volume prostate prior to HIFU 43cc

      PSA History:


      Aug/2011 2.42, Oct/2012 3.1, Feb/2016 5.1; Apr/2017 6.0; Sep/2018 6.7
      Oct/2019.. 8.5; Nov/2020 10.6 HIFU treatment Nov22/2020 Feb/2021 2.9
      Jul/2021 3.2; Nov/2021 3.0 Next...Feb.23/2022 3.5

      MRI Aug/2021 & Volume 30cc
      Ablation defect on left posterior. Low signal extending from left peripheral zone from base to apex. Left peripheral reduced in size. No discrete high signals present on right/left peripheral. No suspicious lesions.

      Comment


      • #4
        Friend just texted me and said, he experienced decreased urine flow & they gave him flowmax to relax muscles in prostate and bladder.

        Cheers, & good luck to you!
        YOB: 1953

        Pathology report July28/2020

        Right apex anterior x4 prostatic adenocarcionoma, gleason score 6/10 (3+3), Grade group 1, 2/4 cores involved, 20% &< than 5%
        Left mid lateral : prostatic adenocarcinoma, gleason score 7/10 (3+4), grade group 2. 4% pattern : 15%. Tumor involves 40% core.
        Left mid peripheral zone x4: prostatic adenocarcinoma, gleason score 7/10 (4 + 3), grade group 3. 4% pattern: 85%; cribriform pattern. 2/4 cores involved (fragmented), 75% of overall tissue
        Left apex: prostatic ad enocarcinoma, gleason score 7/10 (4+3), grade group 3, tumor involves 5%
        HIFU treatment, Toronto Canada on Nov.22/2020....Volume prostate prior to HIFU 43cc

        PSA History:


        Aug/2011 2.42, Oct/2012 3.1, Feb/2016 5.1; Apr/2017 6.0; Sep/2018 6.7
        Oct/2019.. 8.5; Nov/2020 10.6 HIFU treatment Nov22/2020 Feb/2021 2.9
        Jul/2021 3.2; Nov/2021 3.0 Next...Feb.23/2022 3.5

        MRI Aug/2021 & Volume 30cc
        Ablation defect on left posterior. Low signal extending from left peripheral zone from base to apex. Left peripheral reduced in size. No discrete high signals present on right/left peripheral. No suspicious lesions.

        Comment


        • #5
          CruzeDon.

          You have a history similar to mine, Active Surveillance for one year, repeat biopsy showing G 4+3. My treatment was in 2011-2012, before a track record for SBRT. But excellent record for IMRT/LD brachtherapy which I finished in December 2012. I no longer have the records for the Rad dose and may not be all that that comparable to SBRT side effects. I know that the treatment centers provide you with extensive information about side effects which I am sure you have studied. My side effects were as follows:

          GI-I had no side effects that I can recall, did not follow any specific diet other than I was a vegetarian. DId not use any rectal protective barrier.

          ED-To my surprise I developed ED about two months after the Brachytherapy, totally improved with low dose Viagara. Resolved with in 6 months. I am now 72 and get by with 100-200 mg Viagara.

          Fatigue-almost none. Two months after treatment I was backcountry skiing 12 miles at 6000 feet elevation.

          Urinary-this was the big problem. I developed a large post void residual volume, over 200cc. Mostly a problem at night, nocturia x5. That was a different kind of fatigue from lack of sleep. Fluid restriction after 6-8 PM was somewhat helpful. I used doxazosin which was very helpful and compared to the Flomax which I tried it worked better and I could adjust the dose. Back then Flomax was a single dose as I recall. I still take 5mg of Terazosin at H.S. to this day, not a big deal.

          My information from reading other forums is that these side effects seem to be different for each individual and your results may vary. No guarantees!!

          A quick comment on the opinion that you should have had a PET scan. My urologist offered both a bone scan and CT back in 2011 but also said they would likely be normal. After a quick survey of the information available back then I decided not to have the scans. The algorithms I use today do not recommend bone scan/ PET scan for Group 3 with your level of PSA. I would go along with what your treatment team has recommended.

          Comment

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