Brachytherapy

I have been on a "watchful-waiting" program for 3 years, but my gleason score is now 7, and my PSA has jumped from 6 to 17.2 during the 3 years. I am considering brachytherapy treatment... it seems the lesser of the evils! I would like to hear from men who have undergone this treatment and how it worked for you; procedure, recovery and side effects - short and long term.

Thanks for any feedback.

Mike

I have not had brachytherapy, but here is a summary of my battle so far. I had surgery, which I would probably do again if i was in the samr situation. 

 

SUMMARY OF MY PROSTATE CANCER BATTLE

 

I am a white male that was 53 years old in 2007 with diabetes as my main health concern. I keep the diabetes well controlled with an insulin pump and pills.

 

First of all, I was watching my psa because of my family history. My father and uncle had prostate cancer. They were treated with hormones, and radiation, hormones respectively. They are both still alive and going strong. However neither had a real aggressive cancer and their psa was in the 7 range.

 

In 2007 my doctor had a psa test on my routine physical. It came back 2.3ng/ml. Not good, but it proved it would definitely need watching.

 

In October, 2007 another psa test was ran. My psa had climbed to 3.6. My doctor referred me to an urologist for further testing. In December 2007 we did a biopsy. It came back negative. So we took a wait and see attitude.

 

Towards the end of 2008 my psa had risen to 16.8. We scheduled another biopsy. Results were negative again. I took antibiotics for a while and then came off of them and gave my body time to level out again.

 

The next psa in early 2009 came back at 31. My doctor recommended a TURP (trans urethal resection of the prostate). The TURP procedure found the cancer on April 13th. It was in a rare place that the needle biopsies were not reaching. It was inside, next to the urethra. The Gleason score was a 9. It was in 5 of 16 chips. At the same time the doctor did a regular biopsy. That part was still negative. After the TURP the catheter was removed in a few days. It was the most painful experience that I had ever encountered although the pain lasted only a few minutes. Now I knew I had an aggressive cancer and I was scared to death. The doctor scheduled a bone scan for April 24th and a Cat scan for April 28th. Both came back negative and did not show any metastasis. Finally a little relief. I scheduled a RRP and continued my research. RCOG in Georgia looked good and proton radiation at Loma Linda in California looked good. But I decided to stay with the surgery and whatever follow-up is needed. I did start on some holistic dieting and vitamins to hopefully slow the cancer’s growth or to prevent it from spreading. I started on cottage cheese/flaxseed oil daily and LycoPom, tart cherry juice, saw palmetto berries, flor essence tea, vitamin c, vitamin e, folic acid, b6, selenium, coenzyme Q10, ginger and walnuts.

 

My surgery was performed on May 27th, 2009. All went well according to the doctor. He stated that the lymph nodes felt good. This gave me a little hope while I waited on the pathology during my healing (with another catheter). A few days later the doctor’s office called and said that the pathology on the lymph nodes were clear. The remaining cancer found in the prostate was a Gleason 7. He said that was the first time he had ever seen that happen. Makes me wonder if my holistic approach was working. Still I feel better knowing the cancer was cut out. I went back for my catheter removal. It was not as painful as my first removal was. Not to say it didn’t hurt, just not as bad. I do have pain in my testicles and on my rear end. I can’t sit or stand for to long and getting up and down is painful. I realize (hope) this is temporary. I have a small amount of leakage, when straining or moving too much. I am ok at night except still getting up 5 or 6 times to go to the bathroom. I think I will have this under control soon. I don’t know about ED yet.

Thanks for the info. I had robotic surgery scheduled last summer, but decide to wait. Good luck with your recovery. Mike ----quote------ On 6/27/2009 oldflyingfarmer wrote: I have not had brachytherapy, but here is a summary of my battle so far. I had surgery, which I would probably do again if i was in the samr situation.  SUMMARY OF MY PROSTATE CANCER BATTLE I am a white male that was 53 years old in 2007 with diabetes as my main health concern. I keep the diabetes well controlled with an insulin pump and pills. First of all, I was watching my psa because of my family history. My father and uncle had prostate cancer. They were treated with hormones, and radiation, hormones respectively. They are both still alive and going strong. However neither had a real aggressive cancer and their psa was in the 7 range. In 2007 my doctor had a psa test on my routine physical. It came back 2.3ng/ml. Not good, but it proved it would definitely need watching. In October, 2007 another psa test was ran. My psa had climbed to 3.6. My doctor referred me to an urologist for further testing. In December 2007 we did a biopsy. It came back negative. So we took a wait and see attitude. Towards the end of 2008 my psa had risen to 16.8. We scheduled another biopsy. Results were negative again. I took antibiotics for a while and then came off of them and gave my body time to level out again. The next psa in early 2009 came back at 31. My doctor recommended a TURP (trans urethal resection of the prostate). The TURP procedure found the cancer on April 13th. It was in a rare place that the needle biopsies were not reaching. It was inside, next to the urethra. The Gleason score was a 9. It was in 5 of 16 chips. At the same time the doctor did a regular biopsy. That part was still negative. After the TURP the catheter was removed in a few days. It was the most painful experience that I had ever encountered although the pain lasted only a few minutes. Now I knew I had an aggressive cancer and I was scared to death. The doctor scheduled a bone scan for April 24th and a Cat scan for April 28th. Both came back negative and did not show any metastasis. Finally a little relief. I scheduled a RRP and continued my research. RCOG in Georgia looked good and proton radiation at Loma Linda in California looked good. But I decided to stay with the surgery and whatever follow-up is needed. I did start on some holistic dieting and vitamins to hopefully slow the cancer’s growth or to prevent it from spreading. I started on cottage cheese/flaxseed oil daily and LycoPom, tart cherry juice, saw palmetto berries, flor essence tea, vitamin c, vitamin e, folic acid, b6, selenium, coenzyme Q10, ginger and walnuts. My surgery was performed on May 27th, 2009. All went well according to the doctor. He stated that the lymph nodes felt good. This gave me a little hope while I waited on the pathology during my healing (with another catheter). A few days later the doctor’s office called and said that the pathology on the lymph nodes were clear. The remaining cancer found in the prostate was a Gleason 7. He said that was the first time he had ever seen that happen. Makes me wonder if my holistic approach was working. Still I feel better knowing the cancer was cut out. I went back for my catheter removal. It was not as painful as my first removal was. Not to say it didn’t hurt, just not as bad. I do have pain in my testicles and on my rear end. I can’t sit or stand for to long and getting up and down is painful. I realize (hope) this is temporary. I have a small amount of leakage, when straining or moving too much. I am ok at night except still getting up 5 or 6 times to go to the bathroom. I think I will have this under control soon. I don’t know about ED yet. -----end quote------

hi paladino I realy feel your  holistic approach was working. and even though you had treatment I stay on the cottage cheese/flaxseed oil daily and LycoPom, tart and thew other things you were on as well

 Ive read that this  new pruduct called "New Chaper - LycPom " Ive read that LycoPom is among one of the class of protective compounds called carotenoids, I also know both lycopene and pomegranate extract  stands as the most brilliant.androgen depenent cancer fighting extract there is.  More than 35 scientific studies have shown lycopene's cell protective effects on multiple organsystems. An impressive body of research illustrates that pomegranate, revered since ancient times, can be particularly effective at supporting the cells in the prostate the cardiovascular system , and breast tissue all the best Ray

Mike,

With a Gleason 7 and PS of 17 I think you may have waited too long.

I had Brachytherapy 5 weeks ago, back home 3 hours after procedure, played golf the next day. Only side affects were frequency of urination for 4 weeks, almost back to normal now.

I think with a PSA of 17 you are going to need more than seeds. You have two high risk stats, a G7 and a psa over 10; this puts you in a high risk catogory, and you may have to have seeds plus IMRT.

I would get a 2nd opinion from a prostate oncologist as a psa of 17 is troublesome and could indicate some lymphnode involvement. The Prostate Cancer Research Institute website has a list of Prostate Oncologists and their location. I would not trust this to either a radiologist or a urolologist. A good prostate oncologist can run more tests and recommend the best treatment without any bias.

A good book to read is A Primer on Prostate Cancer, by Dr Stephen Strum one of the best oncologists around. Educate yourself as much as you can and get 2nd opinions on everything.

JohnT

Hi Paladino,

In response to your message I had brachytherapy done in November of '07.  I was 68 years old and my PSA was 4.39, my Gleason score was 3+4=7 and I had a stage T1c.  I opted for brachytherapy because of my total outlook with my diagnosis.  Since having the procedure my PSA at 6 month intervals has been 0.33, 0.27 and most recently 0.16.  I had very minimal aftereffects from the implantaion. I did have some small amount of irritation when I urinated at the beginning.  My doctor gave me treatments for that which constisted of weekly injections of 50cc of DMSO in the bladder.  I had to hold the DMSO for 3 minutes then it was ok to urintate.  The treatments lasted for only 6 weeks which was less that the doctor recommended, but I had to drive 100 miles each way on a weekly basis and I was doing fine, and never had any other problems. I would recommend anyone that has simular diagnosis to have brachythereapy.  By the way I had 68 seed of Iodine125 implanted.  If you would like to have any more information you may contact me privately.  Best of wishes for a complete recovery from prostate cancer regardless of what you chose.

 

Thank you for your encouraging response. I have been married for only 3 years and ED is a major concern for me, as well as the other side effects. I may contact you again as things progress. Thanks again. ----quote------ On 6/28/2009 adepose wrote: Hi Paladino,In response to your message I had brachytherapy done in November of '07.  I was 68 years old and my PSA was 4.39, my Gleason score was 3+4=7 and I had a stage T1c.  I opted for brachytherapy because of my total outlook with my diagnosis.  Since having the procedure my PSA at 6 month intervals has been 0.33, 0.27 and most recently 0.16.  I had very minimal aftereffects from the implantaion. I did have some small amount of irritation when I urinated at the beginning.  My doctor gave me treatments for that which constisted of weekly injections of 50cc of DMSO in the bladder.  I had to hold the DMSO for 3 minutes then it was ok to urintate.  The treatments lasted for only 6 weeks which was less that the doctor recommended, but I had to drive 100 miles each way on a weekly basis and I was doing fine, and never had any other problems. I would recommend anyone that has simular diagnosis to have brachythereapy.  By the way I had 68 seed of Iodine125 implanted.  If you would like to have any more information you may contact me privately.  Best of wishes for a complete recovery from prostate cancer regardless of what you chose.   -----end quote------

Thanks for the feedback. I'm glad to hear treatment went well for you. I am at stage T1c, which is not high risk as yet. As you know, there is much controversy about the relationship between PSA levels and cancer, which confuses even the doctors. My doctor (highly respected) had me on high dosage antibiotics for 3 weeks thinking the rise in PSA might be caused by an infection. I have been under the care of University of San Francisco Medical Cancer Center, have had 2 biopsies and a recent ultrasound, plus consultaion with a second top brachytherapy specialist in the S.F. bay area. So I have done extensive research, but feeling like it may be time to make a move to treatment after trying alternative natural methods. My main concern with brachy is the long term ED side effects. Thanks again for your response. On 6/28/2009 Johnt wrote: Mike,With a Gleason 7 and PS of 17 I think you may have waited too long.I had Brachytherapy 5 weeks ago, back home 3 hours after procedure, played golf the next day. Only side affects were frequency of urination for 4 weeks, almost back to normal now.I think with a PSA of 17 you are going to need more than seeds. You have two high risk stats, a G7 and a psa over 10; this puts you in a high risk catogory, and you may have to have seeds plus IMRT.I would get a 2nd opinion from a prostate oncologist as a psa of 17 is troublesome and could indicate some lymphnode involvement. The Prostate Cancer Research Institute website has a list of Prostate Oncologists and their location. I would not trust this to either a radiologist or a urolologist. A good prostate oncologist can run more tests and recommend the best treatment without any bias.A good book to read is A Primer on Prostate Cancer, by Dr Stephen Strum one of the best oncologists around. Educate yourself as much as you can and get 2nd opinions on everything.JohnT -----end quote------

Hi Mike,

I had the bracciotherapy (HDR Boost) therapy last October.  I had 2 treatment options offered...2 HDR Boost events during the course of a long day at Kaiser Santa Clara Cancer Treatment Center coupled with 5 weeks of radiation treatments  OR 2 HDR Boost events one day followed by another 2 events in one day 2 weeks later.  This option eliminated the need for the 5 weeks of radiation treatments.  I opted for the latter treatment plan.

I researched a variety of treatment options.  My 2nd choice would have been the robotic surgery, but I felt the risk of erectile disfunction was significantly less with the bracciotherapy (HDR Boost),  Also you are left with the ability to have ejaculate during orgasm.

My cancer was limited to one lobe and my PSA was 6.3 but had climbed from 5 over about a year.  I thought about waiting and watching another year or two but the thought of knowing it was there and growing moved me to action.  Now, I would have probably waited a bit longer.  The healing time was about 2-3 months ..somewhat longer than I thought.  I still suffer from a lower libido and more dificulty in getting and keeping a hardon.  I use Cialis and at times I use an injectible...feel free to email me to ask any questions.

 

Rod 

--Message edited by CancerCompass staff. For personal protection, email address removed. Consider private reply. Please review CancerCompass Member Guidelines at http://www.cancercompass.com/common/guidelines.html--

 

On 6/28/2009 Johnt wrote:

Mike,

With a Gleason 7 and PS of 17 I think you may have waited too long.

I had Brachytherapy 5 weeks ago, back home 3 hours after procedure, played golf the next day. Only side affects were frequency of urination for 4 weeks, almost back to normal now.

I think with a PSA of 17 you are going to need more than seeds. You have two high risk stats, a G7 and a psa over 10; this puts you in a high risk catogory, and you may have to have seeds plus IMRT.

I would get a 2nd opinion from a prostate oncologist as a psa of 17 is troublesome and could indicate some lymphnode involvement. The Prostate Cancer Research Institute website has a list of Prostate Oncologists and their location. I would not trust this to either a radiologist or a urolologist. A good prostate oncologist can run more tests and recommend the best treatment without any bias.

A good book to read is A Primer on Prostate Cancer, by Dr Stephen Strum one of the best oncologists around. Educate yourself as much as you can and get 2nd opinions on everything.

JohnT

 

I think Johnt is quite correct.   People on watchful waiting should be EXTREMELY careful about the timing of their actions.   You can do WW or Active Surveillance or whatever its called but if you wait past the opportune window, you have failed to take your best shot.   One thing that they always fail to tell you is that you are doing WW or Active Surveillance so you can determine when you should take action and if your PSA is going up, or your Gleason is greater than 6, or any number of other indicators that tell you you no longer have an early, treatable cancer still INSIDE the prostate, you have to act, and act fast for treatment or run the risk of getting an uncurable, chronic disease which is treatable only by hormone treatment.     So, it is not untreatable, just uncurable. 

I did WW, I changed my diet, I bought perhaps a year but I decided that with my PSA moving up after a period of plateauing out, it was best to get treatment.   My cutoff criteria was a PSA of 8, though I actually decided when it was 5.25 -- REMEMEBER, the best shot you have of a cure, whether it be surgery or radiation, is when the PCa is in its early stage and has not metastized.   The longer one waits, the more dangerous it is.    Watch out!  In a couple of years, perhaps 10 -15 years, we will see an increase in the death rate as people who opted for WW surface that did not act for treatment when their best time to act occurs.

If you want to do WW or AS, its best to go to John Hopkins University or Duke or someplace where they have a special unit for Watchful Waiting and have studied the process.    Its best not done as a DIY thing or left in the hands of inexperienced PCP or Urologists who don't have PCa as a specialty.