Zapping is Done!

The final zapping session is history. Hallelujah!

It’s important to me to recognize the staff of the UCSD Health Radiation Oncology – Chula Vista clinic. They turned what was initially a scary experience (for me) into something that was much more pleasant and positive. They radiation therapists were great coaches, provided compassionate care, and endured my stupid puns and jokes. The nurses were equally compassionate, thoroughly answered all of my questions, and helped assuage my fears in the process. To all of them: Thank you!

I went out for a celebratory brunch with my friend who was there for the first session and listened to me whine throughout the process.

Now it’s time to let my body recover from seven weeks of being stuck in a giant microwave oven. Hopefully, it recovers quickly and I get back to a more normal routine. Of course, we may not know for another year whether it was truly effective. Fingers crossed.

The effects from the hormone therapy will cloud the results of the radiation for quite a while. The six month dose will last into October (and beyond) and, if my PSA has, in fact, dropped, we won’t know whether it’s the ADT or the radiation (or both) that caused it. Realistically, we probably won’t know whether the radiation was successful until late next spring or even summer.

Enjoy your weekend! I know I will.

Zapping: The Final Week

Last weekend, I ran out to Cabrillo National Monument where I used to volunteer, just to hang out and chat with some of the volunteers there. It was a great visit and I felt quite energized while I was there. But then I discovered something.

There definitely is benefit in forcing yourself to get out and enjoy a lunch with a friend, a walk along the beach, or just a drive through the country. It is energizing while I’m doing it. But what I’ve noticed is that the fatigue kicks in much harder and much faster than if I’m just hanging out at home.

I could tell near the end of my conversation with my fellow volunteer that the fatigue was coming on fast, and that it was time to go home. When I got home, I was out for the count for a couple of hours after. Not fun.

Monday’s zapping session was dicey. I started drinking my liter of water at 8:30 a.m. and finished it at 9:05 a.m., well in advance of my 9:45 a.m. appointment. As I was leaving the house at 9:30 a.m., I felt pretty good about my bladder fullness, but once I got to the clinic, that feeling of fullness subsided substantially. I told the technician that I though I was borderline and we agreed to take another patient ahead of me. “It will take about ten minutes.” Famous last words.

Long story, short, it was nearly half an hour later when they put me on the table, and by this point I was ready to burst. They even put an absorbent pad on the table and a plastic urinal bottle on the counter “just in case.” Fortunately, neither were needed, the session was completed successfully, and there was no accident.

Word of advice to those managing their bladder fullness timing: Allow a cushion for delays.

When I got home, I was totally spent and spent the entire day in various stages of rest. Ditto for Tuesday. (Hence my Wile E. Coyote post!) Wednesday went as planned, although I was at about 60%-70% bladder fullness.

Thursday’s session went a bit awry. It actually started around 2 a.m. Thursday when I made one of my five runs to the toilet. After crawling back into bed, I just could not fall asleep again. Too many things running through my pea-sized brain kept me awake. I finally dozed off around 4:30 a.m. Ugh.

When I got up, I wanted to avoid a repeat of Wednesday, so I started drinking water as soon as I got out of bed around 7 a.m., and I started drinking my liter of water a full thirty minutes earlier than I normally start. When I got to the facility, I could tell I wasn’t ready, so we skipped me and brought another patient in. Fortunately, that was only about a fifteen minute delay which filled my bladder nicely.

I met with the radiation oncologist after the session Thursday, and we talked about the fatigue and urinary frequency. He said that the fatigue will likely last for about two more weeks after the end of the treatment and then I should see a noticeable improvement. He recommended that I stay on the Flowmax through the end of September to help with the frequency. We’ll schedule a follow-up session for three months from the end of treatment, so I’m guessing late November or early December.

Barring any technical issues, tomorrow morning’s session will be my last. Woo-hoo! I’ll post about that separately.

Be well!

Zapping Session #30 – Week Update

Week six of seven is done! Woo-hoo! I am soooo ready for this to be over.

Last weekend, I got out of the house for a bit just for a change of scenery, but those excursions were short-lived because the fatigue was kicking in. I stopped by Silver Strand State Beach to just hang out by the ocean and let the sound of the surf be a calming influence. But after only twenty minutes, a wave of fatigue came over me and I could barely keep my eyes open, so I went home. It’s funny how it can come on so suddenly.

Monday’s session went well, and Tuesday I could tell that my bladder wasn’t quite where it needed to be, so we let another patient go ahead of me. At the end of the session, the technician commented it was worth the wait because my bladder was “perfect.”

One thing that popped up for the first time on Tuesday morning was that I noticed a small amount of blood on the toilet paper after my bowel movement. Needless to say, that concerned me considerably. I had a second bowel movement and there was no blood evident then.

I spoke with the nurse after my zapping session and she said that it’s not out of the ordinary this to happen for being at this point in the treatment. I mentioned that I have had a history of hemorrhoids that would bleed on occasion, and she said the radiation could irritate them, too. She encouraged me to make sure that my stool was soft, either through diet or stool-softeners. There hasn’t been a repeat occurrence since.

Wednesday’s session was weird. I went in feeling as though my bladder was full and after the treatment, the technician said it was barely into the treatable category and encouraged me to start drinking earlier. That frustrated me because I’ve been hydrating before going to bed, drinking a bit each time I go to the toilet (six times the night before!—so much for the Flomax working), and even starting to drink when I first wake up. Grrr.

Thursday’s session went well, cutting it almost a tad too close with bladder. Afterwards, I met with the radiation oncologist (RO) who just flew in from his vacation in Bavaria the night before.

We talked about my fatigue and how the Flomax doesn’t seem to be doing much of anything positive for me yet (it can take a week to kick in). We’ll keep an eye on things this week and beyond, although he said that the urinary issues could continue for a month or so after treatment ends.

It was interesting that, without prompting, he mentioned that it’s really the last few sessions that really do the most damage to the cancer cells and it’s not wise to stop early. I’m guessing that there are those who are tired of the side effects, as I am, who ask to cut the treatment short. Not me. I’ve come this far, I’ll finish it off.

We also talked about the follow-up plan once treatment is ended. In a nutshell, he’ll see me again in three months, near the end of November and review my PSA and if there are any lingering side effects. He agreed that these first few PSA tests will reflect the effects of the androgen deprivation therapy far more so than they will the results of the salvage radiation. He said it will be a year or more before we really know if the radiation was successful. Not a surprise to me, but nice to have it confirmed.

Even though I’ve started drinking my water earlier than I have been, I could tell that my bladder wasn’t ready for this morning’s session, so we let another patient go ahead of me while my bladder filled. No biggie. If I had another five minutes on the table, I would have fallen asleep. (Thanks, fatigue!)

Time for a nap. 😴💤

Common Steroid Could Improve Prostate Cancer Radiotherapy Outcomes

A link to this article showed up in one of my prostate cancer newsletters that I receive. There’s a link to the original study report in the article, and it’s way over this layman’s head to make heads or tails of it in a brief read-through before my zapping session.

I didn’t dig deep enough to see if this applies equally to primary radiation therapy and salvage radiation therapy (because it’s not yet approved for use and too late for me).


A new study suggests that unwanted side effects of radiation treatments for prostate cancer could be reduced by the common steroid betamethasone.

Source: Common Steroid Could Improve Prostate Cancer Radiotherapy Outcomes

Zapping Session #25 – Update

This week’s sessions went well for the most part.

Tuesday, though, was a close call. As I was getting ready to leave the house, my brain was telling me to empty my bladder—soon. I debated whether to follow my brain knowing that I’d likely delay the zapping session because of emptying my bladder ten minutes before or just head off to the appointment hoping that I could hold it.

Death Ray Machine

Luckily, the technician came out within a minute of me scanning my barcoded check-in card and asked if I was ready. I told him, in a somewhat panicky voice, that I was more than ready and we had only a few minutes to get this done before the dam burst. We made it happen, and I was trotting out of the room to the nearest toilet, making it there by a matter of seconds before having to let it all out. Too close for comfort.

Thursday’s session wasn’t as fast, but had me on the brink and pretty much sprinting out of the treatment room to the toilet. Again, too close for comfort.

This morning’s session (Friday), the pendulum swung in the complete opposite direction. Despite following my normal fill-the-bladder routine, I could tell that I was nowhere near ready to get zapped. They skipped over me and took not one but two patients for their sessions as I waited for my bladder to fill. After the second patient, I hopped on the table, still a little uncertain about my bladder fullness, but the scan showed it was filled sufficiently to go ahead with the treatment (about 70%).


I met with the radiation oncologist on Monday and we talked about the fatigue and urinary frequency. Once again, he offered Flomax and I declined. However, Monday night and into the entire day Tuesday, I was emptying my bladder every sixty to ninety minutes, day and night. That gets old, fast. After my session on Wednesday, I spoke with the nurse, gave in, and requested the Flomax prescription.

The Flomax seemed to help that very first night, getting me down to two trips to the toilet. Last night was about as good with only three trips.

But, as I mentioned a few posts ago, I didn’t have a positive experience with Flomax the first time I tried it years ago, and it seems to be kicking me in the butt again by adding more side effects on top of the ones I’m already experiencing from the Eligard and radiation.

Of the listed Flomax side effects, I seem to be experiencing drowsiness, headache, body aches, and faster heart rate. Yippee.

Yesterday, my first full day on Flomax, I was exhausted the entire day (as if the fatigue from the radiation wasn’t bad enough…). I also had a low-grade headache throughout the day and just felt blah. The one that concerned me the most was the heart rate.

I monitor my blood pressure and pulse each morning and, since March, my resting pulse has been averaging 66 beats per minute. This morning, it was 88 bpm; yesterday, it was 74 bpm. That sudden uptick concerned me, so I spoke with the nurse about it this morning and she reassured me that it wasn’t a real problem, but something to keep an eye on if it keeps increasing.

I’ll continue with the Flomax for now because they say it can take five or so days for it to really settle into your system. But if these issues continue or intensify, we’ll have a discussion about continuing on Flomax.


On a more positive note, I did manage to join a friend for lunch on Wednesday and that went fine, with preventative runs to the toilet just before entering the restaurant and just before driving home. By the end of the lunch, though, I was fading fast and was ready for a little siesta at home.

At this point—compared to how I was doing last winter when my only concern was a rising PSA—I can tell that I’m on the “treatment is worse than the disease” roller coaster. I know that many of these side effects are supposed to subside within a few months after treatment ends, and I’m looking forward to that happening. In the meantime, ten more sessions / two weeks to go!

On that note, I’ll wish you a happy weekend! Be well.

Zapping Session #21 – Week Update

This morning’s Zapping Session #21 was canceled because of equipment issues—a make-up session will be added at the end—but the rest of this week’s zapping sessions were quite routine across the board, with a minor issue on Monday.

In addition to having to have a full bladder, you also have to have an empty rectum. Despite having had a bowel movement just prior to the session, the CT scan revealed a little stool left behind. That concerned the technicians, so they called the radiation oncologist over to see if they could proceed with the zapping. He gave the green light after evaluating the size and positioning and we completed the session as usual. That was a first. Glad to see that the imaging safeguard in place is working.

I had a different set of technicians zapping me this week and the one seemed to be a bit more persnickety about my bladder status, which I appreciate. She gave me some updated guidance on how to make sure my bladder was full. In essence, she said to make sure to drink water throughout the day so that my body is hydrated (especially in our warmer weather). Otherwise, if I’m not hydrated, when I drink the liter of water in the morning, it gets diverted to where it’s needed in the body first rather than to the bladder. Makes sense.

Based on that, I’ve actually started drinking water after each time I empty my bladder—even in the middle of the night—and that seems to have helped keep me closer to a full bladder (after only one day of using this method).

Yesterday’s session was the fastest yet: 23 minutes from leaving my house to being back in my house. The patient who’s normally ahead of me on the schedule was done, and not more than a few minutes after I checked in, I was on the table getting scanned for positioning.

That really makes me appreciate the fact that I am able to use this facility and not the other one offered up. The other facility is 18 miles / 29 km from home and, depending on the the time of day and traffic, it could take 35 to 60 minutes to get to, plus there could be delays at the entrance gate to the military base the hospital is located on. Managing bladder timing under those circumstances would have been a nightmare.

On a positive note, my fatigue has been noticeably less this week than last, and that’s a good thing. That just means that I have more energy to run to the toilet more frequently. 😂 The frequency is a bit annoying and even limiting.

I find that it’s a little challenging to go out and play immediately after the zapping session unless I could guarantee that a toilet is available on relatively short notice. After surging my system with water in the morning, I find that I’m emptying my bladder three or four times in the first two hours or so after the session ends. Once that water is purged from my system, I get back onto a more normal schedule of emptying my bladder every two hours or so, give or take.

Now, it’s off to the barber shop without fear of having to bust out of the chair and run to the toilet. I hope.

Enjoy the weekend and be well!

Thank You!

If you’ve read more than three posts on this blog, you already know that I’m a numbers guy. Well, on 29 July 2022, this little old blog that was created to share updates with family and friends has just surpassed a quarter million views from over 40,000 visitors.

Never in my dreams did I think this blog would have such a reach, so thanks to each and every one of you for following along and offering your insights and support.

With gratitude, —Dan

Zapping Session #16 – Update

This morning’s session had an unexpected surprise. At the end of the session, the technician told me that my bladder was “borderline” not filled enough, and I found that to be really odd. I used the same bladder-filling timeline and technique this morning that I’ve been using all along. She encouraged me to practice over the weekend.


I met with the radiation oncologist on Tuesday, which was unusual because our normally scheduled meeting day is Thursdays. He told me he was going away for a few weeks, and I asked him where he was going. Long story short, his wife is from Germany and they were going to visit her family in a town that was about an hour from where my grandfather was born. Also, his wife studied at Würzburg, and my cousin is a professor and doctor at the university hospital in Würzburg. Small world.

During the meeting, I mentioned that the side effects were beginning to kick in more, and he commented, “Yeah. You’re at the dosage level where they typically start showing up.” I thought that was interesting because I never considered there to be a dosage threshold for side effects. It makes perfect sense though.

Fatigue

The fatigue is really kicking in now, although it happens in waves of varying amplitudes. For example, after yesterday’s session (Thursday), I was energetic enough to stop by an event at my former employer and just hang out for a few hours and see how everyone was doing. By mid afternoon, I was a tad tired (70% on my internal “battery”) but was able to keep going through the afternoon, past dinner, and into the evening.

Today, though, was a considerably different story. As soon as I was done with the session at 10:15 a.m., I ran and bought groceries, had lunch, and by 11:45 a.m. my internal “battery” was down to about 20% and I was napping until about 2:30 p.m. Hard. Even now, as it’s approaching 4 p.m. as I’m writing this, I feel as though my battery is about 50-60% charged even after the nap.

I may attribute part of the fatigue to my urinary frequency, because it’s definitely increased through the week.

Wednesday night into Thursday morning, I had to empty my bladder just twice. Last night, I had to empty it four times. That’s four sleep interruptions that would contribute to the fatigue.

The doctor did offer to put me on Flomax (Tamsulosin) to relax my bladder and hopefully reduce the frequency. For now, I declined his offer because at some point years ago (perhaps even before I was diagnosed), I had been prescribed Flomax and I recall that it wasn’t a very positive experience with its side effects (extreme dizziness).

Urinary Frequency

As you saw in a previous post, I was using a spreadsheet to track when I was emptying my bladder, but that was cumbersome to use, especially logging an entry in the middle of the night. I found an app called “Simple Time Tracker” that has a widget that I can have on my phone’s home screen, and all I have to do is tap it to start recording when I go to the toilet and tap it again when I’m done. It automatically records the date and time, and that’s all that I’m after. (The only downside is that I can’t export the data to my spreadsheet.)

Between 1 a.m. and 4 p.m. today, I’ve made eleven trips to the toilet, and my only fluid intake was about 1.5 liters of water before the zapping session and another 0.5 liters of soda after the session. It’s not like I’m consuming a high volume of liquids to have me going so often.

Irritation

My skin irritation remains about the same and applying moisturizing lotion does help. But now I have a general constant mild burning sensation in my urethra and hints of it starting in my rectum. It doesn’t hurt to urinate (yet), but the burning sensation is mildly annoying right now. I also think the irritation in my urethra is triggering my brain to empty my bladder when I really could probably wait a while longer without incident. I’m guessing it will likely worsen as the cumulative dosage increases.

Emotions

For one of the first times since starting the hormone therapy, I found myself to be a bit on the emotional side this week. I’m guessing the fatigue contributed to that, too. I’ll leave it at that for now, and I may write about it separately in the days ahead.

Summary

After Monday’s session (1 August) I’ll be halfway through the treatments. If the side effects stay at the current level, that can be manageable. If they get worse, I guess I’ll just have to suck it up and power through them like the countless thousands of radiation patients before me.

Enjoy your weekend!