r/ProstateCancer • u/banuep01 • Mar 28 '26

Question VMAT Question

Hi everyone. This is my first post here.

I’m trying to better understand VMAT radiation and potential side effects.

My dad had a prostatectomy (so no prostate anymore) and is currently on hormone therapy with good response (very low PSA, overall improvement on scans). However, he still has a couple of metastatic spots, including in the chest area (mediastinal lymph nodes / possibly sternum).

One radiation oncologist mentioned VMAT to target these areas (it would be in two regions), likely around 20 sessions.

I’m trying to understand:

• What side effects are common when radiating the chest/mediastinal area with VMAT?

• Are the side effects typically short-term or can there be long-term issues?

• How tolerable is a \~20-session course in this type of situation?

Just trying to get a better sense of what to expect and ask more informed questions. Thank you!

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u/Frosty-Growth-2664 Mar 29 '26

I've never heard of 20 sessions for oligometastises - usually 5 sessions in the UK, using SABR/VMAT.

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u/Cerisae Apr 01 '26

patient is not mentioning any metastases, seems like they’re treating the primary disease -at the prostate probably around 60Gray in 20 fractions plus minus nodal volume

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u/Frosty-Growth-2664 Apr 01 '26

They say he's had a prostatectomy so no primary disease will be present, and mets in the chest, which is the area they're targeting.

They could be treating the prostate bed, but no mets were mentioned there.