A few days before my treatments began, radiology staff placed freckle-sized tattoos and ink marks on my hips and in the pubic area. They also made a cast of my legs. And then, on November 12, I started treatment. Most of my sessions were scheduled for 7:40 or 7:50 am.
I would arrive about 10-15 minutes earlier to change into my blue hospital gown, naked from the waist down, and, as instructed, with a full bladder. I’d sit in the waiting area until a radiology technician summoned me to the treatment room that houses the linear accelerator, the device that would deliver radiation beams to my prostate. I would lie down on the treatment table and the staff would position me. With the aid of laser beams emanating from the walls of the treatment room, they used the markings to align me in the same position for each treatment. For the same reason, I had to position my legs in the cast.
After I was situated, a radiology therapist obtained an ultrasound image of my prostate to get a precise fix on its anatomic location. The gland can be in a slightly different spot each day. The full bladder moved most of the bladder out of the path of the radiation beams. Then the radiology staff would leave the room and start the treatment. The main component of the linear accelerator rotates around the patient, delivering radiation beams at various angles. The idea is to deliver the prescribed radiation dose to the prostate without exposing other sites on the abdomen to too much radiation.
For me, radiation beams were administered at seven different angles, roughly corresponding to 8, 9, 10, 12, 2, 3, and 4 o’clock. I estimate that each location was exposed to the radiation beams for approximately 10-15 seconds. So, the treatment itself took only a few minutes. Then I got dressed. I would undergo this ritual a total of 38 times. Once a week, a nurse would weigh me, take my blood pressure, and ask the same series of questions aimed at discovering if I was experiencing any adverse effects of treatment. Soon thereafter, I met briefly with a radiation oncologist (not always my regular one). The visit centered mostly on whether I had any symptoms and if I had any questions.
About three weeks into my course of treatment, I started to experience one of the common side effects: urinary urgency and frequency. Interestingly, this seemed to be more of a problem during the day than at night, but some nights I would get up three or four times to go to the bathroom.
To help with these symptoms, doctors prescribed oxybutynin and recommended that I take ibuprofen to help quell inflammation. These medications helped. Before my treatments began, my radiation oncologist advised me to drink a glass of cranberry juice each day. He said it alkalizes the urine and patients report that this eases the urinary side effects.
My final treatment was on January 8, 2009. My urinary urgency and frequency, for the most part, have resolved and my erectile function is intact. My three-month follow-up PSA test showed a sharp drop in PSA level.
I am relieved that my course of treatment is behind me, but a sobering fact remains: I shall be a prostate cancer patient for the rest of my life, always facing the possibility of relapse. On the plus side, researchers continue to make advances in prostate cancer treatment, and if my cancer returns, perhaps some terrific new therapy will be available to me.
For now, I am going to cram as much interesting and enjoyable stuff into my life as possible.