Bladder control after radiation therapy (scaring/fibrosis?)

I would really appreciate some feedback from members of this group
specially any who have undergone radiation therapy after a radical
prostatectomy, or from any radiologists who may frequent this group.

My Dad underwent a radical prostatectomy last summer and is now
getting ready for external beam radiation therapy. He has been doing
the Kegel exercises and has shown continued improvement in bladder
control (he is dry through the night but has not regained full control
while standing or walking).

My Dad had preliminary visits with two radiologists. The first
radiologist said that radiation would cause scaring and fibrosis of
the pelvic muscle and his bladder control would _NOT_ improve further
once radiation starts. The second radiologist said that radiation
would _NOT_ cause scaring and/or fibrosis of the pelvic muscle.

QUESTION #1: What is the opinion of this group regarding scaring and
fibrosis of the pelvic muscle during radiation?

QUESTION #2: Those who have undergone radical prostatectomy followed
by radiation therapy, did your bladder control continue improving
after the radiation treatment?

Thanks very much for your replies!

Welcome to the group, CapnWhit.

I'm sorry to hear that your Dad needs EBRT, especially so soon after
surgery! Does "last summer" mean summer of 2006, or summer of 2007?

I'm assuming your Dad is facing salvage radiation therapy because the
surgery was not successful in removing the cancer, as probably
indicated by rising PSA. Correct?

My experience:

I think we who have had SRT recognize that the "common" dose of
radiation used in salvage therapy causes scarring, fibrosis, whatever,
of every bit of tissue in that area - lower part of the colon, rectum,
etc. - whatever is in the area of focus of the radiation.

I had salvage radiation therapy five years after surgery. My bladder
control had stabilized (and was good) so I wasn't concerned about
continued improvement. And, I noticed no significant difference in
bladder control after RT.

Best wishes for your Dad and all of his family.

Burney

On Sun, 11 Nov 2007 15:06:06 -0000, capnwhit@yahoo.com wrote:

>I would really appreciate some feedback from members of this group
>specially any who have undergone radiation therapy after a radical
>prostatectomy, or from any radiologists who may frequent this group.
>
>My Dad underwent a radical prostatectomy last summer and is now
>getting ready for external beam radiation therapy. He has been doing
>the Kegel exercises and has shown continued improvement in bladder
>control (he is dry through the night but has not regained full control
>while standing or walking).
>
>My Dad had preliminary visits with two radiologists. The first
>radiologist said that radiation would cause scaring and fibrosis of
>the pelvic muscle and his bladder control would _NOT_ improve further
>once radiation starts. The second radiologist said that radiation
>would _NOT_ cause scaring and/or fibrosis of the pelvic muscle.
>
>QUESTION #1: What is the opinion of this group regarding scaring and
>fibrosis of the pelvic muscle during radiation?
>
>QUESTION #2: Those who have undergone radical prostatectomy followed
>by radiation therapy, did your bladder control continue improving
>after the radiation treatment?
>
>Thanks very much for your replies!
RP in 1995 (age 52)
RT in 2000
ADT (Casodex) 10/06 - 8/07

burney dot huff at mindspring dot com

My husband went through radiation therapy 3 years after his prostatectomy.
He had no problems with bladder control when radiation started. With
radiation, he has more frequency and much more urgency (radiation ended 2
1/2 months ago). It is getting better though and hopefully will continue
to improve. I know this is different than your dad's case - but thought
it might help some. Good luck with your dad's treatment!
Regards, Debbie

Allen
Currently 53 years old
Suffers from Crohns disease (been controlled for many years)
Prostate Surgery 8/2004, 3+4=7, [capsular penetration, clear margins???]
Undetectable PSA until:
12/06 0.1
4/07 0.26
5/07 0.30
Started radiation on 7/11/2007.
Completed radiation 8/29/2007, PSA taken on last day of radiation 0.09
PSA 11/07 0.09

<capnwhit@yahoo.com> wrote in message
news:1194793566.629330.103610@d55g2000hsg.googlegr oups.com...

>I would really appreciate some feedback from members of this group
> specially any who have undergone radiation therapy after a radical
> prostatectomy, or from any radiologists who may frequent this group.

I had a radical prostatectomy December 2000 and had to undergo EBRT May
2002.

I recovered after RRP to nearly full continence, but regressed to stress
incontinence after the EBRT. I sometimes have to remind myself that it
would not be so irksome if I were dead and that usually brings me around.




--
PSA 16 10/17/2000 @ 46
Biopsy 11/01/2000 G7 (3+4), T2c
RRP 12/15/2000 G7 (3+4), T3cN0M0 Neg margins
PSA <.1 <.1 <.1 .27 .37 .75 PSAD 0.19 years
EBRT 05-07/2002 @ 47
PSA .34 .22 .15 .21 .32 PSAD .056 years
Lupron 07/03 (1 mo) 8/03 and every 4 months there after
PSA .07 .05 .06 .09 .08 .132 .145 PSAD 1.4 years
Casodex added daily 07/06
PSA <0.04, <0.05, <0.04, <0.04 10/11/07
Non Illegitimi Carborundum

"Debbie13331" <nospam@family.net> wrote in message
news:24c496dd64b6e4ddaab1144feed10361@localhost.ta lkaboutsupport.com...


> PSA 11/07 0.09
>
>

That is remarkable, Debbie. I'm sure you an Allen are pleased.


--
PSA 16 10/17/2000 @ 46
Biopsy 11/01/2000 G7 (3+4), T2c
RRP 12/15/2000 G7 (3+4), T3cN0M0 Neg margins
PSA <.1 <.1 <.1 .27 .37 .75 PSAD 0.19 years
EBRT 05-07/2002 @ 47
PSA .34 .22 .15 .21 .32 PSAD .056 years
Lupron 07/03 (1 mo) 8/03 and every 4 months there after
PSA .07 .05 .06 .09 .08 .132 .145 PSAD 1.4 years
Casodex added daily 07/06
PSA <0.04, <0.05, <0.04, <0.04 10/11/07
Non Illegitimi Carborundum

On 11 Nov 2007, you wrote in alt.support.cancer.prostate:

> QUESTION #1: What is the opinion of this group regarding scaring and
> fibrosis of the pelvic muscle during radiation?
>
> QUESTION #2: Those who have undergone radical prostatectomy followed
> by radiation therapy, did your bladder control continue improving
> after the radiation treatment?
>
> Thanks very much for your replies!

Hi cap!

I had a prostatectomy in Dec 05 and failed my first PSA test in Mar 06. I
was referred to the radiation oncologistand saw him in May. I later had
radiation therapy in June/July 06 - 36 treatments of salvage EBRT - 64 Gy.

1) Although the RP was in 05, by May I was not quite totally continent yet.
My rad onc refused to do the radiation then until I had better control. By
early June I was padless and only had 'stress incontinence' of a few drops
so the radiation started the following week. He had stated that the
continence would not get any better on its own than it was when I started
the radiation. I had to sign a paper that stated that he thought I would be
totally impotent after the treatments and that there was at least a 50%
chance that I could lose that continence in a few years. Now almost a year
and a half out from the radiation, I still have only the 'stress
continence' I had before I started. I leak a few drops when I 'belly
laugh',or cough harshly. I am not a doctor, only a patient, but, based upon
my experience and what my rad onc said, I would try not to start any
radiation until almost fully continent.

2) At my annual physical this year, my family physician did a DRE or rectal
exam. He said that he could feel the fibrose tissue ( he called it the scar
tissue) but he did NOT say whether this was from the RP or the radiation. I
am guessing, but I somewhat feel that it probably was from both. Perhaps a
urologist or oncologist that reads this might comment?

To be optomistic, when my radiation began my PSA doubling time was about 4
months. Since having the radiation and also taking Lupron to supress the
testosterone I continue to have PSA readings <0.1 am now 18 months out.

I hope that you find the telling of my experience useful and I wish your
Dad similar success with his treatment!

Russ D

capnwhit@yahoo.com wrote:
> I would really appreciate some feedback from members of this group
> specially any who have undergone radiation therapy after a radical
> prostatectomy,

As you are aware by now, we and our cancers are all different and react
differently to our treatments and the treatments themselves are
different. EBRT can be administered in various doses at different rates
and with different amounts of shielding to protect non-target areas, and
so on. All of the replies you have so far do not sound too bad, so I'll
give you one reply from the other side to help balance things out.

Prostate cancer was visible on the surface of my bladder, and the
surgeon cleaned it up as much as possible and said that EBRT could
finish the job. EBRT was therefore not administered with any major
attempt to spare the bladder, cancer was known to be there. My after-RP
leakage had diminished to the point where a pad would handle a day of
mild physical activity. After EBRT there was no immediate change except
for bladder spasms, but with the passage of time, many months, urge
incontinence had to be controlled with medications. Over the following
several years general leakage increased to where 5 pads were needed for
a normal day with little exertion, a fresh pad every 1-2 hours on a day
where I was physically active, and I finally had an artificial urinary
sphincter installed. Medication is still used to reduce bladder spasms,
there is normally very little leakage because of the artificial
sphincter which I am very happy with, and life is good.

Your dad may have very little in the way of SE's from the EBRT, or they
may be substantial, and I have no idea what the odds are. I guess the
important thing might be that the EBRT does what it's intended to do,
kill the remaining cancer.

In my case, I chose an aggressive EBRT as recommended by the radiation
oncologist as we knew that there were cancer cells on the bladder
surface and likely all over the pelvic cavity. Your dads medical exerts
will tailor their treatments and opinion as to likely outcome based on
the unique situation of your dad, and his cancer, and how they are going
to do the radiation. That is my assumption, anyhow, but I have not yet
been able to get any of my medical team to tell me what they see in
their crystal ball. They all say that they do not have one.

Best of luck to your dad, and to you as well.