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Hiker2020 10-11-2021 04:05 PM

Approaching 1 year post radiation
 
So..one year post radiation and PSA remains below 0.1 and recovery from the effects of radiation and ADT is complete. However, the past few weeks I have noticed that my urine stream has become weaker (especially at night and early morning) and intermittent. No pain or other issues. Not taking Flomax. I vaguely recall reading on this board or somewhere else that this 'one year out syndrome' occurs frequently. Can anyone educate me on this and if it is real did you do anything to rectify it?

Thanks

Terry G 10-12-2021 06:25 PM

Re: Approaching 1 year post radiation
 
Hiker, I’m four years post RT and don’t recall hearing or reading anything about the one year syndrome. My ride has been a very easy one with only very mild and temporary urinary issues that lasted maybe ten days. I elected very early treatment. All systems function the same as prior to treatment except ejaculate is minimal. My urologist was ready to schedule removal on our first sit down to discuss treatment options. In hindsight what a huge mistake that could have been.

Although I had a script for Flomax during RT my issues were minor; but, I did try an over the counter medication called AZO that my wife recommended. It does make your urine a strange color and I think it may have helped. Might be worth a try. Terry

IADT3since2000 10-19-2021 05:44 PM

Re: Approaching 1 year post radiation
 
Hi Hiker2020m,

I too, like Terry, have not experienced such problems after radiation. In fact, possibly because some of the cancer was in the central one of the prostate, urination has been better than it was, including at night (though this is not a common or typical experience).

That said, scar tissue can develop after radiation and slowly cause such issues for some of us. Usually it takes several more years to develop, but depending on where the dosing had to be laid down to beat the cancer, it might be affecting you earlier.

There is an abundance of health care providers with expertise in dealing with post surgery urinary issues because such issue are common. Fortunately, uringary side effects are infrequent with radiation patients, but, unfortunately, that means it can be hard to find doctors who are expert in treating those side effects from a post-radiation standpoint. There are some such doctors, but my layman's hunch is that a urologist expert in post-surgery side effects would also likely be able to treat similar side effects caused by radiation.

Also, radiation is not completely a bed of roses side-effect wise. Rectal side effects, though usually mild, are fairly common with radiation, at least for those of us treated before the wide use of SpaceOAR technology. It's usually not a big deal - smaller size, increased frequency, some increased urgency, but it bothers some patients. Overall, such side effects are remarkably uncommon long-term, especially these days with superb modern imaging and SpaceOAR. That is an enormous improvement over the picture a couple of decades or more ago, a time when radiation often resulted in a number of highly burdensome side effects.

Good luck.

….Jim
[SIZE="1"]
- - - - - - - - - - - - - - - - - - - - - - - -
21 years as a survivor. Doing well. Diagnosis Dec 1999 PSA 113.6 (first ever), age 56
Gleason 4+3=7 (J. Epstein, JHU), all cores +, most 100%; "rock hard" prostate with ECE - stage 3, PNI, PSADT determined later 3-4 months; technetium bone scan and CT scan negative; prognosis 5 years.
Later ProstaScint scan negative except for one suspicious small area in an unlikely location. ADT Lupron as first therapy, in Dec 1999, then + Casodex in March 2000, then + Proscar and Fosamax in Sep 2000. Rejected for surgery January 2000; offered radiation but told success odds were low; switched to ADT only vice radiation in May 2000, betting on holding the fort for improved technology; PSA gradual decline to <0.01 May 2002. Commenced intermittent ADT3 (IADT3) with first vacation from Lupron & Casodex. Negative advanced scans in 2011 (NaF18 PET/CT for bone) and 2012 (Feraheme USPIO for nodes and soft tissue). With improved technology, tried TomoTherapy RT, 39 sessions, in early 2013, plus ADT 3 in support for 18 months (fourth round of IADT3), ended April 2014. Continuing with Avodart as anti-recurrence shield. Current PSA, for some reason based on a less sensitive test on 7/20/2021 was <0.05, still apparently cured in my ninth year since radiation (PSA as of 12/2/2020 was <0.01). (T 93 as of 12/2/2020.) Supportive diet/nutrition, exercise, supportive medications during this journey, as well as switches in antiandrogen, 5-ARI, and bone drugs. Barely noticeable side effects from radiation; continuing low T, likely do to long use of ADT, but good energy and adequate strength. I have a lot of School of Hard Knocks knowledge, and have followed research, which has made me an empowered and savvy patient, but I have had no enrolled medical education. I have also had 225 undergraduate classroom hours just in statistics and experimental design, plus more in graduate school, which dwarfs what most doctors have, and that has made my “hard knocks” experience more meaningful. What I experienced is not a guarantee for all but shows what is possible.[/SIZE]

Hiker2020 10-30-2021 05:45 PM

Re: Approaching 1 year post radiation
 
I have an appointment coming up with my Urologist in December and will address the issue. I started taking saw palmetto and I think it is helping. Overall it is not a huge issue. I did go with the SpaceOAR. Two months post radiation I had my 5-year colonoscopy and asked the doc doing the procedure to see if she could detect any damage. She could tell I had radiation but that the damage was minimal and healing up. Hopefully that will remain true for the long term. It is a good idea to have them check when having a colonoscopy.

Prostatefree 10-31-2021 06:36 AM

Re: Approaching 1 year post radiation
 
Drink more water. Measure and record the amount you drink a day and keep a diary. Some of us will drink less water to try to manage incontinence. Not a good idea. Chronic dehydration is a serious side effect of many aging related conditions causing incontinence including; weak pelvis floor muscles; obesity; constipation; among other more serious conditions.

The long term side effects from the radiation are going to take longer than a year to show up.

Urine the color of apple juice or darker is dehydration. Urine the color of lemonade is normal. With low output, use a sample cup to test urine color. A small amount of urine will dissipate quickly in a toilet bowl and not be a true color.

PS after reading Djin: I didn't think this needed to be said. Radiation does not cure BPH. TURP is the most common treatment for serious BPH. The bonus with a RP is no more BPH.

DjinTonic 10-31-2021 09:55 AM

Re: Approaching 1 year post radiation
 
Do you have a history of BPH? You mentioned you had stopped Flomax that you tried for urinary symptoms. An enlarged prostate seems like a good suspect.

Excess growth causing problems doesn't always result from a very large overall size, but can be caused by the tissue growing [i]inward[/i], impinging the urethra.

Djin

skipper3 11-02-2021 05:38 PM

Re: Approaching 1 year post radiation
 
I had a 1 year setback. I am now 18 months out. (Haven't been on the board since my 4/2020 Cyberknife treatment.) At my "1 year out" I had to go back onto Flomax. Also has become hard to orgasm, and when I do my ejaculation is nil. Also my PSA just jumped from 1.4 in April, to 2.4 last week. Going to recheck in 6 weeks. Fingers crossed


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