Prostate Cancer

[Graeme]

Thanks all.

I would not object to a few snippets of "Did you know...?".

Ok, well, did you know (I didn't, (trigger warning not required!)) Before the radiotherapy starts they tattoo 3 targets on you to use for getting you in the correct position, then, during the sessions, once lined up, the bench slides into the machine. A CT scan is carried out and a 3D computed tomography scan is produced which shows the radiographer the exact shape, size and position of the prostate in real time. Then the radiotherapy starts, you hear the machine rotating around you. And the impressive bit is that the beam shape is adjusted using lead plates as it rotates to exactly match the profile of the prostate from the angle of the X-ray beam.

The accuracy of the process was a source of confidence for me.

Regards

Graeme

[ChrisGreaves]

... they tattoo 3 targets on you to use for getting you in the correct position, ... the exact shape, size and position of the prostate in real time. ... the beam shape is adjusted using lead plates as it rotates to exactly match the profile of the prostate from the angle of the X-ray beam.

Thank you Graeme. Most of this I did know from my fMRI brain scans on a study up at York University back in 2017, roughly. I remember having several tattoos on the head so that they could line me up each week⁽¹⁾. I still have the gif-movies that let me travel across my head in the three dimensions. My head is an egg-shell that contains a cauliflower, complete with stem. I still watch it every now and then, because I enjoy the recursive nature of my brain contemplating itself.
⁽¹⁾ I suspect that they don't try to align my body/head at all. I suspect they use the tattoos to let the fMRI stuff locate me, wherever I happened to shuffle along the gurney; but it amounts to the same thing.

Focusing by lead plates is new to me, but not surprising, really. I, for one, wouldn't touch those beams with a barge-pole.

So so far so good, eh? They sound like a competent bunch. Next time (but we hope NOT) you go in, would you mind asking if, what with all their technical expertise, they have considered opening an online high-interest bank? Instead of offering a toaster or a boom box, they could offer a free brain scan when you open an account!

I am not going to conduct a poll, but I would be happy with more news about what goes on, as long as you feel up to it.
Thanks again, Chris

[John Gray]

Graeme - do not put absolute faith in the result of PSA tests, for they are not regarded as particularly reliable, more "indicative". They give too many false positives and false negative. Unfortunately there is not (yet) a cheap and accurate prostate cancer test.
Your CT scan and a biopsy cost $lotsmore, but are more reliable.

[Graeme]

Graeme - do not put absolute faith in the result of PSA tests, for they are not regarded as particularly reliable, more "indicative".

It is certainly the case that PSA tests have a reputation for unreliability. My understanding though is that once a prostate has been repeatedly zapped by high energy x-rays the only source of the antigen would be from cancer cells and the probability of cancer remaining is highly unlikely. The reason for the test is more to do with establishing the correct dose for ongoing medication. The standard used to be to have 20 sessions of radiotherapy. 39 sessions is now more common. As long as there was no metastasis before the radiotherapy, it is highly unlikely that there is any remaining cancer afterwards. There are no plans for further biopsy or scans.

Regards

Graeme

[Graeme]

I would not object to a few snippets of "Did you know...?".

Did you know, whilst undergoing the radiotherapy it is important to remain at least moderately active. Those of us who moped about are more suspectable to blood clots. As a result, I developed a deep vein thrombosis in my leg. I'll probably be on warfarin tablets now for quite a while. The initial medication given though is a course of injections in the belly that I have to administer myself at home. Each injection is done in a line either side of the navel alternatively. My belly button and the bruises look like Jupiter and his Galilean moons!

Jupiter.jpg

[ChrisGreaves]

... I'll probably be on warfarin tablets now for quite a while..... My belly button and the bruises look like Jupiter and his Galilean moons!

Rat Poison? And you very own personal belly-button?
That's not quite what I had in mind by "more details"
Cheers, Chris

[John Gray]

Graeme: I would have expected you to be on Apixaban rather than warfarin for DVT - I know I was!

[Graeme]

Graeme: I would have expected you to be on Apixaban rather than warfarin for DVT - I know I was!

To be fair that was a bit of a generic guess! Not sure what it will be yet.