Sanjay Mehta, M.D.

And for the most part, although incontinence is still described to some degree in the literature, in my personal experience, I don't think I've seen a single patient who came in continent who left with anything less than that. There's no pads, there's no nothing. And then, of course, as I talked about with breast cancer, we can also focus very precisely on the prostate itself.

And for the most part, although incontinence is still described to some degree in the literature, in my personal experience, I don't think I've seen a single patient who came in continent who left with anything less than that. There's no pads, there's no nothing. And then, of course, as I talked about with breast cancer, we can also focus very precisely on the prostate itself.

So the dose to the penile bulb, the dose to the rectum, the dose to the bladder are so low now that the side effect profile is essentially zero from a radiation standpoint. Now, they may be having hot flashes from the androgen deprivation and decreased libido and fatigue, as you know.

So the dose to the penile bulb, the dose to the rectum, the dose to the bladder are so low now that the side effect profile is essentially zero from a radiation standpoint. Now, they may be having hot flashes from the androgen deprivation and decreased libido and fatigue, as you know.

But on the radiation side, because we have all these tricks now, very much like with breast, the way we can avoid the heart and the lungs, in the case of the prostate, we can almost completely avoid the bladder and the rectum and even the penile bulb now. So the quality of life, those are the reasons why people tend to choose radiation.

But on the radiation side, because we have all these tricks now, very much like with breast, the way we can avoid the heart and the lungs, in the case of the prostate, we can almost completely avoid the bladder and the rectum and even the penile bulb now. So the quality of life, those are the reasons why people tend to choose radiation.

In fact, I think Ted had mentioned in his last talk, there's a gel spacer that is often inserted. It's an injection that's done transperineally, and it separates the rectum from the bladder. But in my years of doing this, when you're very diligent about how you do this, very much like a surgeon pays attention to the details, so do we.

In fact, I think Ted had mentioned in his last talk, there's a gel spacer that is often inserted. It's an injection that's done transperineally, and it separates the rectum from the bladder. But in my years of doing this, when you're very diligent about how you do this, very much like a surgeon pays attention to the details, so do we.

I can actually trim the dose off of the posterior prostate and just make sure the dose fall off between the posterior prostate and the anterior rectal wall is so rapid that the anterior rectal wall is always going to get some dose, but usually it's not clinically significant.

I can actually trim the dose off of the posterior prostate and just make sure the dose fall off between the posterior prostate and the anterior rectal wall is so rapid that the anterior rectal wall is always going to get some dose, but usually it's not clinically significant.

And what we do to manifest to make sure that that is a daily thing, because we're talking about treating patients for multiple weeks, we actually coach the patient to come in with a full bladder and an empty bowel. And by being diligent about that and imaging daily to Double check that, in fact, the bowel is empty and the bladder is full. That allows those two organs to separate from the prostate.

And what we do to manifest to make sure that that is a daily thing, because we're talking about treating patients for multiple weeks, we actually coach the patient to come in with a full bladder and an empty bowel. And by being diligent about that and imaging daily to Double check that, in fact, the bowel is empty and the bladder is full. That allows those two organs to separate from the prostate.

And even a few millimeters of separation is all we need to take advantage of our modern focused radiation beams.

And even a few millimeters of separation is all we need to take advantage of our modern focused radiation beams.

Not so much for pelvic patients, but we do that for breast cancer, especially left-sided breasts. So just to go back to that, you actually have a deep breath hold, which will get the chest wall away from the heart. So we do that in the case of thoracic tumors, but in the pelvis, the diaphragmatic position doesn't really make any difference.

Not so much for pelvic patients, but we do that for breast cancer, especially left-sided breasts. So just to go back to that, you actually have a deep breath hold, which will get the chest wall away from the heart. So we do that in the case of thoracic tumors, but in the pelvis, the diaphragmatic position doesn't really make any difference.

It's more about bladder and rectal filling and emptying, respectively. That's much more important.

It's more about bladder and rectal filling and emptying, respectively. That's much more important.

I get that question all the time. And from a LASIK standpoint, I think I would be worried about it. That's probably why I'm still wearing these Coke bottles, unfortunately. Yeah. But in the case of prostate cancer, first of all, the dose is given over the course of several minutes. And then each of those fractions is, again, talking about one fraction out of multiple weeks.

I get that question all the time. And from a LASIK standpoint, I think I would be worried about it. That's probably why I'm still wearing these Coke bottles, unfortunately. Yeah. But in the case of prostate cancer, first of all, the dose is given over the course of several minutes. And then each of those fractions is, again, talking about one fraction out of multiple weeks.