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  • Approaching 1 year post radiation

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    Old 10-11-2021, 03:05 PM   #1
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    Approaching 1 year post radiation 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?

    PSA results: 9/16-12.73;11/16-13.26; 7/17-14.97; 1/18-14.08; 4/18-13.94; 7/18-17.61; 10/18-16.29; 2/19-17.09; 4/19-17.84; 6/19-17.81; 10/19-16.24; 1/20-23.14;3/20-19.41; 5/20-17.66; 7/20-20.86; 12/2-0.1
    Biopsy results: 10/17-Gleason 3+3=6- Group 1; 11/18-Gleason 3+3=6- Group 1; 11/19-Gleason 3+3=6- Group 1 Increases in PSA even with no change in biopsy results indicated the need to begin treatment. Decided on IMRT.
    Lupron injection #1: 7/20; Markers and spacer placed 8/20; Lupron injection #2 10/20
    Radiation treatment began 9/15 and ended 11/06: 39 sessions at 200cGY per session
    Side effects of radiation general fatigue and painful frequent urination treated successfully with Flomax. Stopped using Flomax after 2 months due to it causing a severe dry cough. A cough is a listed side effect. Switched to saw palmetto with no decrease in effectiveness. All in all not a bad marathon to run.

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    Old 10-12-2021, 05:25 PM   #2
    Terry G
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    Location: Butler PA
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    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
    Rising PSA:
    11/13 1.95; 9/15 3.28; 10/16 5.94
    TRUS 1/17
    Bx: Three of twelve cores adenocarcinoma Gleason 6 (3+3) all on left side, no pni.
    DOB 7/21/47; good health; age 69 @ Dx
    Treated 6/17 SBRT @ Cleveland Clinic by Dr. Tendulkar
    Reduced ejaculate only side effect; everything works
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    PSA’s post.SBRT 1.1, 1.1, .9, 1.8, 2.7, 1.0, 0.3, 0.6, 0.8, 0.4

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    Old 10-19-2021, 04:44 PM   #3
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    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.


    - - - - - - - - - - - - - - - - - - - - - - - -
    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.

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