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LDR Brachytherapy after HT

User
Posted 19 January 2017 13:22:52(UTC)

This is my 1st post so hope everything goes OK.

In June 2015, I was told that my brother (14 months younger than me) had recently been found to have ADVANCED LOCALISED Pc (G9(5+4 I think))

So I went for a check up and in Aug 2015 I was diagnosed with INTERMEDIATE LOCALISED Pc G7(4+3); PSA approx 10 and chose to go on ACTIVE SURVEILANCE. This gave me time to accustom myself to the enormity of what had just happened!

Having reached my early 70’s without any serious medical problems , I had got used to a feeling of near immortality. But it obviously could not last!!! I was in denial until a nurse at The Christie Hospital convinced me that I had CANCER!!

PROSTATE CANCER certainly can run in families!!

I felt well; no obvious symptoms (apart from more frequent nightly visits to the toilet).   

My family eventually convinced me that I should be more proactive.

So in March 2016, I chose to follow the LDR BRACHYTHERAPY route

23/9/2016 : Christies for Pre-op

30/9/2016 : Christies for Volume Study under general anaesthetic. Prostate found to be too large (70cc). Hormone therapy was required to shrink the prostate to about 40cc.

CYPROTERONE tablets (100 mg) were prescribed for about 3 weeks

ZOLADEX (3.6mg) 4 injections spaced 4 weeks apart (last and 4th one given 18th Jan2017)

What an experience HT has been – more like HOT and COLD treatment! My hands have never been so cold! I’ve certainly had more HOT FLUSHES than HOT DINNERS! I’m so glad I had to experience this during the winter!!

Ladies I salute you. I know just what you have to go through now!

6/1/2017 : Christies for 2nd Pre-op

17/1/2017 : Christies for 2nd Volume Study – given the go-ahead for full LDR BRACHYTHERAPY implant  on  31st January 2017. Prostate must have shrunk sufficiently but I don’t have details yet.

Will keep post going as and when required

User
Posted 06 February 2017 12:32:35(UTC)

Hello again.

My implant procedure went ahead as planned on 31st January 2017 and this post will describe my experience of that day (Day 0) and subsequent recovery over the next 5 days.

Tuesday (31/1/2017) (D+0):  Implants of 55 Iodine 125 seeds into my 40cc prostate (HT over previous months had reduced the volume from 70cc!) completed successfully and was allowed home after producing the required volume of wee.

At home, drank plenty of fluids, as advised, but it quickly became obvious that I could not wee!

Phoned The Christie and was advised to walk round the house but after about 2 hrs of this, still no joy, so phoned the hospital again. They immediately instructed me to return for catheterisation.

About midnight was catheterised and was quickly relieved of about 1 litre of urine! What a relief!!

Wednesday 1st Feb 2017 (D+1): Recovering in hospital all day. 1st Tamsulosin and Antibiotics taken.

Thursday 2nd Feb 2017 (D+2): Catheter removed about 6:30am and 15 min later produce about 5 ml of “red wine”! This was followed by 30ml (8am); 30ml (10am); 25ml (11am); 35ml (1pm). I thought to myself “This is hard work”. Then one of the nurses suggested my wife and I go for a walk outside in the lovely gardens. This seemed to do the trick because when I got back, “joy of joys” I managed 150ml (3pm) followed by another 150ml (4:30pm).

I was free at last and discharged at 5pm

Great to be home again; but started to have difficulty weeing again! Usually started with a bloody fluid but one bonus was my first poo!! .Worried that far more fluids were entering my body than leaving it! I was reluctant to drink too much as advised. Thoughts of a repeat of Tuesday night began to alarm me.

Friday 3rd Feb 2017 (D+3): Again very difficult to wee normally – not very productive. Took following tablets about 4am: 1xTamsulosin; 2xIbuprofen and 1xParacetamol

7am: had breakfast (cereals; toast and fruit tea) and went back to bed. I was absolutely exhausted from restless night.

9:30am: got up and had a more productive wee, so slightly relieved and enjoyed a lovely shower.

10:30 am: had a very productive wee (about 100ml). Can I see the light at the end of the tunnel at last?

11am: felt well enough to go out shopping

Afternoon:  More frequent urges to wee and these were very short and bloody to start with.

Throughout the night about 8 visits to the loo for short weeing sessions were necessary!

Saturday 4th Feb 2017 (D+4):  Up about 7:30am. Took all appropriate tablets with breakfast, but not long afterwards felt a bit lightheaded so went back to bed for about an hour.

10am: feeling much better now. Got up had a shower and a cup of tea.

11:30am: Walked to the local shop for a paper

Afternoon and evening uneventful - weeing reasonably effectively but invariably preceded by small bloody discharge. Had second poo since leaving the hospital

Sunday 5th Feb 2017 (D+5): Early hours frequent visits to the loo. Difficult to start with and not very productive.

6am: got up had my tablets and breakfast. Went to the loo managed a “wee” wee and 3rd poo

Mid morning: more productive “red free” weeing now. Dare I hope that this is “the end of the beginning”?

I hope my experience will be of help to others contemplating the Brachytherapy route and will add to this as and when I feel it would be usefull

My follow up appointment at The Christie hospital is set for April 28th 2017  

Thanked 2 times
User
Posted 19 January 2017 16:00:03(UTC)

Many thanks Johsan for your good wishes.

I have already read your posts on this subject (and printed it off for my wife) and found it extremely helpful in deciding what course to take and what side effects to expect post op. 

It's a tricky balance at our age (early 70's).

There is a lot of statistical evidence to suggest that we could easily die with it rather than from it?!

However, I did not want to hang around to find out!

Roll on 31st Jan 2017! 

Thanked 1 time
User
Posted 07 February 2017 10:11:09(UTC)
Hi tp
I read with interest your post. My brother just been dx and we have had to make decisions. Please visit my profile. Although our journeys are different I find your post very informative as part of the whole picture for people to gain real life latest experience. Do you think you could cut and paste ongoing diary into your profile? I actually need to update my profile with my brothers data. May I ask how is your brother and what treatment path is he on ?

Do you think you could have been dealt with any differently re. Retention? Is this common? If you had been living on your own do people still get realised ASAP ???

I do keep a basic diary.. as easy to forget info. I had da vinci and was dry practically immediately. . My visit to a & e was required due to excruciating pain / spasms not retention.



Best wishes
Gordon
Thanked 1 time
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User
Posted 19 January 2017 15:22:12(UTC)

Hello tp1944 and welcome to the site

 

My husband (also in his 70s) opted initially for AS and then followed that with permanent seed Brachytherapy.  You can click on my profile and see what his journey was like.

 

There are a number of men on here who chose that option.

I wish you well with the treatment.  Any questions you may want to ask then feel free.  No question is regarded as stupid or too personal.

 

We are all in this together (including us ladies who have undergone the hot flushes etc and those who still have that "pleasure" to come)

 

 

We can't control the winds - but we can adjust our sails
User
Posted 19 January 2017 16:00:03(UTC)

Many thanks Johsan for your good wishes.

I have already read your posts on this subject (and printed it off for my wife) and found it extremely helpful in deciding what course to take and what side effects to expect post op. 

It's a tricky balance at our age (early 70's).

There is a lot of statistical evidence to suggest that we could easily die with it rather than from it?!

However, I did not want to hang around to find out!

Roll on 31st Jan 2017! 

Thanked 1 time
User
Posted 06 February 2017 12:32:35(UTC)

Hello again.

My implant procedure went ahead as planned on 31st January 2017 and this post will describe my experience of that day (Day 0) and subsequent recovery over the next 5 days.

Tuesday (31/1/2017) (D+0):  Implants of 55 Iodine 125 seeds into my 40cc prostate (HT over previous months had reduced the volume from 70cc!) completed successfully and was allowed home after producing the required volume of wee.

At home, drank plenty of fluids, as advised, but it quickly became obvious that I could not wee!

Phoned The Christie and was advised to walk round the house but after about 2 hrs of this, still no joy, so phoned the hospital again. They immediately instructed me to return for catheterisation.

About midnight was catheterised and was quickly relieved of about 1 litre of urine! What a relief!!

Wednesday 1st Feb 2017 (D+1): Recovering in hospital all day. 1st Tamsulosin and Antibiotics taken.

Thursday 2nd Feb 2017 (D+2): Catheter removed about 6:30am and 15 min later produce about 5 ml of “red wine”! This was followed by 30ml (8am); 30ml (10am); 25ml (11am); 35ml (1pm). I thought to myself “This is hard work”. Then one of the nurses suggested my wife and I go for a walk outside in the lovely gardens. This seemed to do the trick because when I got back, “joy of joys” I managed 150ml (3pm) followed by another 150ml (4:30pm).

I was free at last and discharged at 5pm

Great to be home again; but started to have difficulty weeing again! Usually started with a bloody fluid but one bonus was my first poo!! .Worried that far more fluids were entering my body than leaving it! I was reluctant to drink too much as advised. Thoughts of a repeat of Tuesday night began to alarm me.

Friday 3rd Feb 2017 (D+3): Again very difficult to wee normally – not very productive. Took following tablets about 4am: 1xTamsulosin; 2xIbuprofen and 1xParacetamol

7am: had breakfast (cereals; toast and fruit tea) and went back to bed. I was absolutely exhausted from restless night.

9:30am: got up and had a more productive wee, so slightly relieved and enjoyed a lovely shower.

10:30 am: had a very productive wee (about 100ml). Can I see the light at the end of the tunnel at last?

11am: felt well enough to go out shopping

Afternoon:  More frequent urges to wee and these were very short and bloody to start with.

Throughout the night about 8 visits to the loo for short weeing sessions were necessary!

Saturday 4th Feb 2017 (D+4):  Up about 7:30am. Took all appropriate tablets with breakfast, but not long afterwards felt a bit lightheaded so went back to bed for about an hour.

10am: feeling much better now. Got up had a shower and a cup of tea.

11:30am: Walked to the local shop for a paper

Afternoon and evening uneventful - weeing reasonably effectively but invariably preceded by small bloody discharge. Had second poo since leaving the hospital

Sunday 5th Feb 2017 (D+5): Early hours frequent visits to the loo. Difficult to start with and not very productive.

6am: got up had my tablets and breakfast. Went to the loo managed a “wee” wee and 3rd poo

Mid morning: more productive “red free” weeing now. Dare I hope that this is “the end of the beginning”?

I hope my experience will be of help to others contemplating the Brachytherapy route and will add to this as and when I feel it would be usefull

My follow up appointment at The Christie hospital is set for April 28th 2017  

Thanked 2 times
User
Posted 07 February 2017 10:11:09(UTC)
Hi tp
I read with interest your post. My brother just been dx and we have had to make decisions. Please visit my profile. Although our journeys are different I find your post very informative as part of the whole picture for people to gain real life latest experience. Do you think you could cut and paste ongoing diary into your profile? I actually need to update my profile with my brothers data. May I ask how is your brother and what treatment path is he on ?

Do you think you could have been dealt with any differently re. Retention? Is this common? If you had been living on your own do people still get realised ASAP ???

I do keep a basic diary.. as easy to forget info. I had da vinci and was dry practically immediately. . My visit to a & e was required due to excruciating pain / spasms not retention.



Best wishes
Gordon
Thanked 1 time
User
Posted 10 February 2017 09:24:28(UTC)

Hi Gordon .. apologies for the delay. Been celebrating my wife's 70th birthday and our latest grandchild's 1st birthday!

After reading many posts on this forum, it has been obvious that I have not been very proactive in accumulating more detailed info regarding my condition apart from "INTERMEDIATE LOCALISED CANCER" Gleason 7 (4,3) and PSA about 10 and that it can be treated.

I will seek more info from now on!!

My brother's cancer is more aggressive than mine and he is currently receiving anti-androgen hormone treatment (daily BICALUTAMIDE tablet). Sadly my brother is also showing signs of early onset Dementia.

Regards my experience with total urine retention, I was beginning to suspect that weeing was becoming more difficult after reaching the required target and mentioned this to the nurse. So it was largely my own fault for rejecting her suggestion that I could wait longer before going home. Two factors influenced this decision : my wife was on her way to collect me and the central heating engineer was visiting at this precise time to repair our boiler (we had been without hot water and central heating for about 5 days) and I was keen to be home to oversee the repair!!! - What perfect timing!!

Regards

Tom   

User
Posted 10 February 2017 15:09:40(UTC)

Many thanks for your posts i start my brachy on 1st of march and my treatment is the high dose Brachaytherapy
I am not getting the seed implants as my treatment appears to be slightly different in that the radiation source is not left within the prostate but is taken out after a particular period of time. This all happens of course whilst I am under the anaesthetic so I will not feel anything even the catheter would be removed before I left the theatre. If all goes well I would then be discharged in the early evening,I have also been assured that they have had very few complications with any of thier patients. I may have to take that with a pinch of salt as i have heard quite a number of stories regarding urine retention after this particular procedure and so the light side effects that I am currently experiencing after my radiotherapy could soon turn into major ones. Lets hope not eh?
I hope your urine flow is okay now and you have no further complications please let us know.

User
Posted 16 February 2017 11:02:35(UTC)

16th Feb 2017 (D+16) : Just visited GP to confirm continued supply of TAMSULOSIN! Without it catheterisation would be a very distinct possibility.

Currently weeing OK during the daytime, but waking up frequently during the night and struggling. It’s difficult to start and sometimes just a trickle or nothing at all. Because of this poor quality of sleep, I often have to nap during the day. However, I have not needed pads or “nappies”!

I asked the doctor for a copy of the Histology report dated 26th Aug 2015. I have added the following details to my Profile :

I was diagnosed with GLEASON 7 CARCINOMA OF THE PROSTATE

PSA currently 9.1 (normally around the 5 mark). Sudden jump up to 12 but now declining again

5 out of 7 cores on the left-hand side. Gleason 7 (3+4)

Right hand side benign

DRE T2 (only just)

It is now 4 weeks since my 4th and final ZOLADEX hormone implant so can hopefully look forward to regaining my masculinity and say goodbye to the HOT FLUSHES!!!

Will continue to report my progress as and when appropriate

In the meantime good luck to all who choose LDR BRACHYTHERAPY. It's not been as bad as I thought it might be!   

User
Posted 01 March 2017 11:58:29(UTC)

22nd Feb 2017 - Received latest blood test results from GP : 
Total PSA Level 1.0 nmol/L
Testosterone Level <0.2 nmol/L (normal range 6.7 to 25.7).
Although I have now finished with HT, I clearly have a long way to go before I recover my masculinity!!

If anyone has any idea how long this might take I would very pleased to hear from you!!

Regards Tom

User
Posted 04 April 2017 10:35:39(UTC)

4th April 2017 (D + 9 weeks): Just passed one half life of the radioactive decay of iodine 125

The Intervening period has been dominated by two inconveniences:

1) Still experiencing many hot flushes even though my last Zoladex 4 week implant was on the 18th Jan 2017.

2) Each night 3 to 5 nocturnal visits to the loo are required for a wee and the flow can be very weak and intermittent! This is almost always followed by a hot flush requiring the use of my rechargeable battery operated fan to cool me down! Consequently, I am getting quite tired during the day!

Could I be experiencing mild radioactive cystitis?

Apart from some tiredness and fatigue during the day, the urine flow is quite strong and apart from the urge to wee can suddenly surprise me, I am coping quite comfortably and day to day activities are not being too inconvenienced.

Will update with further stats and news after my next appointment on 28th April 2017.

User
Posted 04 April 2017 11:02:32(UTC)

Good luck for your next appointment.

By that time Paco will have his da Vinci don't. I wish the best to you and my husband.

User
Posted 04 April 2017 11:17:57(UTC)

Many thanks Lola for your good wishes. Please accept my very best wishes for yourself and your husband, Paco
Tom

Thanked 1 time
User
Posted 04 April 2017 11:29:31(UTC)

Great to hear you are managing I had my HDR (no seeds three weeks ago and I have no real side effects apart from the one visit to the toilet at night ,the hot flushes, and the daytime fatigue(which I work through)
My follow up appointment, with yet another doctor that I had never seen before, appeared to be rushed and it was as if he was reading from a script. I asked about the Tamousolin as the course finishes in another two weeks and he basicaly told me to get some more off of the GP and see how it went. He seemed more interested in the little survey that I filled out than to answering any of my questions. I even had to ask him what my PSA was (which was .1
I have another appointment in three months and I hope its with the consultant that did my Brachytherapy as his bedside manner was as it should expect from a consultant as t may be run of the mill to them but to us its a frightening experience.
So I am still in the dark about the actual results of the treatment, or is it to early to tell?
Good luck with your progress as I have another four months to run on my hormone treatment which means a lot more hot flushes and I hope that i have not become to reliant on the Tamosulin.

User
Posted 04 April 2017 20:14:22(UTC)

Thanks Bob, pleased to hear you are coping well after your treatment, but I envy your single trip to the loo each night!!

I am noticing a gradual fall in frequency of hot flushes. May it continue.

I too experience fatigue which can be overcome with a quick nap, usually in the afternoon. Fortunately I have the luxury of being retired!!

Sorry to hear about your experience with your follow up appointment. I get the impression that we need to be a bit more assertive at these meetings and ask plenty of questions.

Good luck with your continuing HT. I'm glad I'm finished with it, at least for the time being???!!!

Regards Tom 

   

User
Posted 05 April 2017 08:39:43(UTC)

Hi BB, I'm interested in your HT treatment.  I was put on HT about 5 monthd before my HDR Brachy. was told not to continue after the HDR. I don't miss taking the Ht, but shold I have done?

Thanks.

Dave.

User
Posted 08 May 2017 13:35:36(UTC)

Hello to all again. As promised here is the latest update.

28th April 2017 (approx D + 3 months) – 1st follow up appointment at The Christie :

Pleased with progress:

Scan shows all 55 radioactive seeds present and correct.

Bloods taken: PSA 0.92.

Advised to keep taking Tamsulosin until next appointment in 6 months time.

Hot flushes showed signs of diminishing in frequency and severity from the middle of April 2017. Thankfully, as of now (8th May), I am now completely free of this side effect!!

I feel that the weeing situation is improving with time. Presumably as the physical and radioactive effects of the Brachytherapy procedure subside.

I regularly read other posts on this excellent forum and am constantly reminded how lucky I currently appear to be. I was in my early 70’s before I was diagnosed, but I can hope for a treatment which will probably allow me to eventually die WITH this horrible disease and not from it!!

I am constantly saddened by the many far more serious cases that I read about, especially when it involves younger men, and my heart and good wishes go out to all those affected, both patients and family members. Thank you for the strength and fortitude you all demonstrate. You are an inspiration.

Thanked 1 time
User
Posted 08 May 2017 14:41:44(UTC)

Hello again tp.

Glad you've made good progress.

I agree with your sentiments regarding how lucky we are compared to some.

I really feel for some on here and they are so brave in how they deal with it all

We can't control the winds - but we can adjust our sails
User
Posted 02 August 2017 11:40:08(UTC)

Back again with latest update :

26th July 2017 (approx D + 6 months) 

PSA 1.1 ug/l (acceptable level <5 for age >70)

Testosterone 10.3 nmol/l (acceptable range 6.7 to 25.7)

Radiation level now down to approximately 10% of original strength.

Glad to have my Testosterone back but unfortunately still having ED problems!! Maybe a Tamsulosin side effect?  

Still require 4 to 5 nocturnal visits to the toilet during the night which is proving rather tiring.

Hopefully, the situation will improve over time and that I can eventually survive without Tamsulosin!!!

Will update after my next meeting at The Christie at end of October

User
Posted 02 August 2017 12:51:11(UTC)

Hi Tp,

Good results hope it continues,I was not sure about the side affects of the tamulosin and managed  to get off them in April and water works are ok so far but can still get up a few times in the night but no real urgency but if i wake up i just tend to go.

At six months i was still had a bit of urgency but it does improve with time, (10 months on) my PSA is only down to 0.56 but don't go back till January  for next blood test.Good luck.

 

John.

User
Posted 02 August 2017 13:08:02(UTC)

Many thanks, John. Pleased you are progressing OK. It is very useful to contrast and compare experiences with others undergoing the same treatment paths.
Regards Tom

Thanked 1 time
User
Posted 06 November 2017 16:14:53(UTC)

November 6th 2017

Now approximately 9 months since my Brachytherapy operation and can report that my latest PSA is 1.3 and that The Christie Hospital have moved me onto 6 monthly monitoring appointments.

I have to request a PSA test from my GP about 2 weeks before each appointment so am now effectively back on Active Surveillance.

Until recently, my large prostate (70cc) would have ruled out Brachytherapy as a treatment option but this is no longer the case if HT is first used to shrink it.

Still taking Tamsulosin but trying just 1 tablet every 3 days. Will probably stop altogether at the end of the week and see how I get on?!

Regular night time trips to the loo still a bit of a problem, but showing signs of improving.

ED issues are slowly improving with the aid of Viagra!!

Mean while, can I take the opportunity to wish all my fellow sufferers all the very best for the future.

To those families whose loved ones sadly do not see the light at the end of the tunnel, my sincerest condolences.

Tom        

       

Thanked 1 time
User
Posted 06 November 2017 22:16:20(UTC)

Thanks for the update Tom, I love threads like yours- giving the full journey and being prepared to update post treatment on the big 3! Of cancer control, continence and functionality?

Really helpful to those who may follow a similar path!

Thank you and great news that it's all going well.

Clare

User
Posted 07 November 2017 10:12:29(UTC)

Hi Tp,

Sounds like you are winning I am a few months ahead of you from operation it will be 14 months on the 25th November.I got off the Tamulosen last April and my last PSA was down to 0.59 and at last meet with the specialist team they seemed happy but i did not get all my questions answered.

Apart from that it's nice to hear from another LDR Brachytherapy patient as it does boost the spirit a bit.I still have the dreaded Ed but like you we can get by with the pills.I was also given a three month break to my next blood test in mid January so have come over to Europe in my motorhome and will tour till the New Year ( Spain at moment) before returning to the UK.I am finding being away from home very useful as it gets me away from the over thinking and analysing what's happing to me.

Good luck for the future and keep us all posted on your progress.

And high all the rest of the members on here I have not forgotten you all and your own journeys with PC and still follow you and try to give some help if i can.

 

John.

 
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