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If you are a candidate for Calypso, you will need to have 3 Beacons (transponders) placed into the prostate. This procedure is very similar to a biopsy and is done at The Center for Radiation Oncology without the need for general anesthsia or sedation.

If you are not a candidate for Calypso (i.e., you have a pacemaker or defibrillator, you had a hip replacement, or you have other metal in your pelvis), you will need to have 3 gold markers placed into the prostate. Again, this procedure is very similar to a biopsy and is done at The Center for Radiation Oncology without the need for general anesthsia or sedation.

In either case, you will be given specific instructions that you will need to follow in preparation for the placement of the Beacons or gold markers. At this time, please inform us if you are on any blood thinners (i.e., aspirin, coumadin, heparin, plavix).

Keep in minid that the Beacons or gold markers are permanent but inert, so you should not experience any long-term effects from them. As a result of the placement, however, you may experience symptoms similar to those from your biopsy, such as temporary rectal bleeding or discomfort. As a precaution, you will also be given a 3-day course of antibiotics to start the day of the placement.

Once completed, you will be given an appointment for a CT simulation, to be done in approximately one week.

The CT simulation begins the treatment planning phase. During this, a CT of your pelvis will be obtained while you are lying in a very specific position. A cast/mold will also be made for your legs. You will also have small temporary marks or subtle permanent tattoos placed on your skin. This entire process takes approximately an hour.

With this information, your physician and dosimetry team will generate a plan that optimally treats the prostate while minimzing the radiation to the surrounding normal structures. This plan, which is unique to you, may take several days, depending on the complexity, to finalize.

Once your plan is completed, you will be asked to come in for a dry run. Once this quality assurance process is completed, we can begin your treatments.

When you are brought into the treatment room, you are placed in same position you were in during the CT simulation. The therapists will often need to move you to get you into this very specific position. The therapists will then ensure that the prostate itself is in the correct position, using either Calypso or x-rays. Once this has been done, the therapists will leave the room and begin the treatment. The treatments are given daily, Monday through Friday with each treatment lasting approximately 10 minutes.

When treating the prostate, a small amount of the surrounding structures, such as the bladder and rectum, are invariably treated. As these organ receive radiation, they may become irritated or inflammed, leading to clinical symptoms.

For example, you may experience urinary urgency, trouble getting started, a weaker urine stream, trouble emptying the bladder, an increase in frequency, discomfort/pain when urinating, or a urinary tract infection.

In addition, you may develop rectal discomfort, a false sense of needing to have a bowel movement, changes in your bowel habits, and rarely rectal bleeding.

Lastly, you may experience fatigue or develop skin changes from where the radiation beams enter your body.

These effects do not occur with your first treatment. Instead, these symptoms may develop several weeks into your treatment and may therefore last several weeks after your complete radiation. If you experience any side effects, discuss them with Dr. Singla who may be able to prescribe medications that could help to alleviate or reduce these symptoms.

As a reminder, you will be meeting with Dr. Singla every Wednesday, after your treatment. If, however, you are experiencing a problem or have a question, Dr. Singla can meet with you at any time. If you would like, you may also call Dr. Singla at 314.315.9980 or you may email him directly at rsingla@metroradiation.net.

Essentially, no. Unless otherwise mentioned, you do not need to alter your diet or lifestyle. For example, you can continue to work, drive, or play golf during radiation therapy.

Ideally, patients should receive radiation treatments continuously, without interruption. However, we realize that this is not always possible. Missing one treatment here or one there should not effect the efficacy of radiation therapy. If you cannot make it for a treatment, please inform our therapists.

You will meet with Dr. Singla approximately 6 weeks after completing radiation to ensure that you are doing well and that any side effects you may have developed have resolved.

Currently, the best way we have of following your prostate cancer is by measuring the PSA and examining you on a regular basis. With radiation, the PSA should ideally fall close to, if not to, zero or undetectable levels. More importantly, though, the PSA should remain at this level. As long as it does, the cancer is felt to be controlled. On the other hand, any consistent rise in the PSA suggests that the cancer has returned.

Patients whose cancer returns after undergoing radiation therapy typically cannot have a prostatectomy. Instead, patients are started on hormonal therapy. This medication essentially eliminates the testosterone in our body which inturn "starves" the prostate cancer. Though this treatment can keep the cancer "in check", it is not a curative treatment. There are several other options for patients which your physician can discuss with you.