Stalked by a Stealthy Cancer, Part 2: Radiation Treatments

In Part 1 of this series, I discussed the diagnosis of an elusive form of prostate cancer that nearly cost me my life.

Here in Part 2, I will discuss the initial treatments I received. Read Part 3.

Considering treatment options

The first step after my diagnosis of stage IIIC prostate cancer was a consultation with a team of oncologists and surgeons at Miriam Hospital in Providence, RI. The team presented the treatment options and asked if I wanted radiation or surgery.

Being a bit squeamish, I chose radiation. Squeamishness is not a sound way to pick treatments; I think it's good to discuss the options with medical professionals before deciding on your own. So far radiation has worked out well for me, but it may not be the best option for everyone.

The team at Miriam recommended androgen deprivation therapy (ADT) plus 47 courses of radiation. The doctors warned me that the ADT would be rough, but I blissfully agreed to it, if only to avoid going under the knife. As I was to find out, the ADT treatment was rough, but the actual radiation treatment went very well.

Seeing if the cancer had metastasized

The first step was a bone scan to check if the prostate cancer had metastasized to my hip or spine, as it is wont to do. I was injected with a short-half-life radionucleotide, sent to the waiting room for a couple of hours, and scanned.

Thankfully, the results were negative, but it was narrow escape for me considering how badly cancer had ravaged my prostate.

Going through radiation

The next step was a single dose of Bicalutamide to suppress my testosterone, followed by three doses of radiation in each breast to inhibit gynecomastia, i.e. enlarged male breasts (because of the ADT). Of all the radiation I got over the course of my treatment, this was the only one that hurt; it felt like a bad case of sunburn.

In preparation for the main treatment, gold beads were inserted into my prostate to guide the radiation. Dr. Harisaran was able to do this in his office with local anesthetic, and it went smoothly.

Then I began 44 Intensity-Modulated Radiation Therapy (IMRT) treatments. They laid me out a flat “couch” and slid me under a Varian Linear Accelerator. I felt like a Thanksgiving turkey on a baking pan being slid into an oven, but it worked out well. This radiation treatment was not an unpleasant experience at all; the oncologists, nurses, and staff were all very friendly and supportive.

My employer allowed me to work at home during this period, so I was out of our high-stress office for the duration. I worked at home in the morning and had radiation in the afternoon.

Effective for me

In general, the radiation treatments along with the ADT proved to be very effective for me, and my PSA readings began their slide into the undetectable range.

As far as radiation side effects, aside from some issues with proctitis, I escaped with nothing serious so far. The ADT side effects were a different story, and I will cover them in Part 3.