HDR treatment for prostate cancer

Has anyone had HDR radiation treatment for prostate cancer? Would appreciate any input...thanks. Bill

Hi Bill, I recently completed the IMRT phase of treatment. As you may know, that is the recommended course of action following HDR Brachytherapy. I'd be happy to answer any questions you may have about the treatment and about my experience at the Cancer Treatment Centers. I've been to the one in Zion and the one in Tulsa. Feel free to reply back with the questions you have. I'm usually home most mornings until 11 AM. The best way to lick this thing is by being a part of a team. You can't have better team members then the good people at CTCA. Best regards, Larry J.

Thanks, Larry. I am going to Zion on the 28th for a second opinion and a review of treatment options. I am stronly leaning toward the HDR brachytherapy. My PSA is about 6, Gleason 3+3=6, stage T1c and prostate is 30 grams. With those numbers, from what I've read, I would be a good candidate for HDR brachytherapy. Were your numbers higher and thus the follow radiation? I'm hoping I don't have to go through that. Did you consider surgery? What was the deciding factor in choosing radiation over surgery. How were your post treatment discomforts or problems. Thanks for your time and info. Bill

Good Morning Bill, Sorry for the delay in posting an answer. I sent a reply out on Tuesday, however I just noticed it's not posted, so I'll try again. I've just completed the IMRT phase of treatment at Samaritan Hospital in Troy NY. I would have liked to complete my therapy in Tulsa, however it was not practical for me to be away from my home and business for a five-week period. CTCA worked with my local Cancer center and provided the parameters for the IMRT. My numbers were the same as yours with the exception that my gland was 23 grams. The tumor itself was located in the apex of the gland, which meant that it might not be effectively treated by conventional Brachytherapy - permanent seeding. This was an opinion offered by Dana Farber in Boston. All of the information I have indicates you are a great candidate for HDR, however don't stop asking questions. A close friend of mind offers the advice that "all decisions become easy if you ask enough questions". That advice served me well during my quest for info about treatments. I never considered surgery as a good option. I didn't care for the long recovery period, the risks from major invasive surgery, and the high rates of probability for serious side effects. I feel that the high success rate for normal Brachy will be improved by HDR. The application of the radiation is far more precise and done at a higher, more effective rate. I was also influenced by the follow-up therapy through the use of IMRT. This of course is also offered during normal Brachy. It is also used after some surgery cases when there is a need to "clean up" the area if it is found that the cancer has not remained encapsulated. All things considered, I feel that HDR offered me the best chance for total healing. Following HDR there was some discomfort around the area where the catheters were inserted. During the procedure there was absolutely no discomfort. I opted for the spinal for pain control. For five days following the procedure there was some rather intense pain at the start of urination. There is a little discomfort, even today, however I'm told that it will gradually fade away. In my case I think it's aggravated by the amount of coffee I continue to enjoy. I have not had any rectal problems stemming from either IMRT or HDR. My sexual appetites and abilities remain at pretreatment levels although I've been cautioned that they could diminish over the next eighteen months. The IMRT treatments are given in total comfort as long as you’re not too modest. Those are the high points of my adventure in dealing with this disease. I encourage you not to be rushed into making decisions, even by family and friends. This is probably the most personal decision you'll ever make. And you will make the one that's right for you. Having the right attitude makes a tremendous difference. Diet, exercise, and supplements play a huge role in your wellness. I think that's the one outstanding thing CTCA offers you. They look at you as a person and treat you as such. You're not just a number with a certain disease. I like the total approach. Take a hard look at their naturopathic, nutrition, and physical therapy programs. Total support for the total person can only add to your confidence. I made a conscious choice to have a good attitude about the fact I have cancer. I also was determined to surround myself with a supportive team. You cannot ask for better team members than the people at the CTCA. Good luck on your trip to Zion. If you're staying over, ask to be put up at the Villa. It's not the Hilton, however the lady that runs the place is an inspiration. Call or write if you have more questions that I may be able to help answer. Best regards Larry

Larry, thank you very much for your input. I've met a lot of great people over the internet while researching this subject and they've all been great about sharing information. You are at the top! For some reason, I haven't really had any down periods since I learned about this and have maintained a good attitude also. I find that somewhat surprising, but am very glad about it and thank the Lord. My cancer was found in only one of eight cores taken in the biopsy and that contained only 5% cancer. It was also in the left lobe and in the center. I hope I'm not being overly optimistic but I am still hoping that just the HDR will do it. I do, however, like that you were able to do the follow up locally. How many weeks/treatments did you need? Thanks again for your support. Take care, Bill S.

Larry, sorry, I just reread your message and I see it was 5 weeks. No need to reply. Thanks. Bill

Good morning Bill, Thank you for the kind words. Many others have helped me along this same path. I'm trying to do the same. Good luck on your trip to Zion this week. After your visit, should you have additional questions that I might be able to help you answer, please contact me. Best regards, Larry

Hello Larry, I just had my first HDR treatment. The radiation part was totally painless as you said. Had a bit of a problem putting the catheters in and after the CTscan, they had to place a few of them deeper and they couldn't do a spinal on me because of an old back surgery so they did a general and it had worn off some, so pushing them deeper was not painless, but wasn't a killer, just a hurt a bit. Were you here or in Tulsa? You hit the nail on the head when you said the people were caring. I agree, they are wonderful. The only complication that could have threw me a curve was a nodule at the top of the prostate that is up against the bladder and Dr. Eden wasn't sure he could get a catheter up in there far enough so sufficient radiation would cover it all. But he and the physicist worked it out and they believe they got it so I may be lucky enough to just have to do two HDR sessions, the next one on the 24th. Dr. Eden said he would not do one HDR session and let me do external radiation somewhere else...said it was bad medicine. How did you swing that? If I had to do that here, I would have opted out somehow. Did you find it OK to drive a day after discharge or wait two days? I have a 40 foot motor home and pull a car so I have some concern although if I feel as well tomorrow after two more treatments, I think if I take it easy, I should be OK.

Hey Bill, I'm really happy to hear that the HDR went well. Looks like you got yourself a homerun. I thought you were going to Zion just for a second opinion. Sounds like you heard some things you liked. Your HDR is a little different than mine. I received 3 treatments over a period of 24 hours. Too bad about not being able to receive a spinal, however it sounds like the general worked well. I took the HDR treatments in Tulsa. I think all of the people with the CTCA read from the same book with regards to how people should be treated. Your description of how that nodule was treated is one of the great features of HDR. Permanent seed implants would not have worked in that area. I'm sure that they will give you good advice about how many treatments are appropriate. After checking with Troy Samaratan, here at home, Dr. Kelley never suggested that it wasn't a good idea to receive treatment there. In fact he had treated another patient from NY state who when to the same hospital and received IMRT from the same Dr. I saw. I think you'll be fine driving tomorrow. I ended up staying in Tulsa an extra day because the Urologist suggested I might not want to be on a plane and find I was unable to urinate. If you were traveling by motor home and found you had a problem you could quickly find help. I never experienced any problems of that nature. My good wife and I actually spent the day following my treatments, at the Tulsa Zoo. We spent the evening at a nearby Outback restaurant. I just read your note again and I see you are having a total of 3 treatments at this time. Sounds like your going for a second session of HDR instead of IMRT. That will be one heck of a lot quicker and I'm sure just as effective. Again, I'm glad to hear from you and I hope things continue to go well. Let me know if there's something else I can share, however, soon all of this will be behind you and you'll be one of the vets. Best regards, Larry

Hi Larry, well I made it back to Zion on Monday and had my final three treatments on Tues. and Weds. All went ok. The first time I was sick after the third treatment and this time I got sick just before my thrid one. All in all, I'm very glad it's all over. I had blood in my urine for two weeks after first treatments and found that flomax didn't work for me. Terazosin did work and I have switched to that. Again, I'd like to thank you for all your information and help. Time will tell in both our cases. Take care and God bless. Bill