BRACHYTHERAPY HDR

User

Posted 11 Oct 2015 at 16:01

ANYONE JUST HAD THIS TREATMENT ON IT'S OWN NO HORMONE OR INJECTIONS OR BEAM RADIOTHERAPY FOR PROSTATE CANCER WITH A GLEASON SCORE 4+3 =7 ?????

User

Posted 12 Oct 2015 at 06:03

Hi Brian,

HDR Brachytherapy is still fairly new, when I had it earlier this year (as salvage treatment) I was told I was only the second bloke from Norfolk to be offerred this treatment. But lots more will be having it as the new kit is introduced into hospitals and I understand that long term it will become the standard form of radiotherapy.

I would recommend it, it is far easier on the side effects than the 'old fashioned' or should I say 'classic' external beam radiotherapy.

The conventional thinking is that if you have 3-6 months Hormone therapy before radiotherapy, that actually shrinks the tumour, so they don't have to radiate so much of your body.

The other good thing about radiotherapy viz-a-viz prostectomy is that it leaves you with a prostate gland after treatment, I say 'good' because this means that you have a chance of resuming a fully functioning sex life after treatment. Some would say this is 'bad', because it also means that you have a chance of developing prostate cancer again.

When I had old fashioned radiotherapy first time around, I was on hormone treatment for 3 years, once I stopped it took a good six months before I started to recover sexual functions and a good 12 months before I was back to normal.

So I only had a couple of years of post radiotherapy sex life before I got prostate cancer again, but hey ho never mind, I am looking forward to next spring when I will once again be off the hormone treatment, and back to normal, whatever my new 'normal' will be, as they say hope springs eternal?

Dave

User

Posted 12 Oct 2015 at 14:41

Hello. My other half had brachytherapy in Jan this year. We have 3 friends that have had it too. (There are a few guys on here too) none had hormones first. I am not sure of the exact reason they don't give hormones with brachytherapy but do with radiotherapy. I'm sure someone else will tell you why on here. We were told my other half would not need hormones for radiotherapy either, but I've noticed all the other guys on here have had hormones with radiation treatment. I asked why they were not needed for brachytherapy only to be told they are not necessary. Which wasn't a helpful answer! Perhaps someone may have a better idea, but I think it is normal. All the best.

User

Posted 13 Oct 2015 at 20:50

My OH is booked for brachytherapy next month, he's been on hormones since June and finished 25 sessions of radiotherapy last week - he was told that was his " brachytherapy package".

Maureen

"You're braver than you believe, stronger than you seem and smarter than you think." A A Milne

User

Posted 14 Oct 2015 at 08:15

Hello MLJ. Just out of curiosity I wondered why your husband is having both. We were offered one or the other. I didn't know you could have both. I know I've seen people have brachytherapy as salvage treatment after radiotherapy. I'm only being curious. Hope all goes well.

User

Posted 14 Oct 2015 at 08:44

Sjtb, your other half I think had the same Brachy as my John did ie seed implants whereas brian/alnie and possibly MLJ are talking High dose beam Brachytherapy which is different.

I could be wrong, not unheard of !!

We can't control the winds - but we can adjust our sails

User

Posted 14 Oct 2015 at 09:26

Hi Sandra,

I believe you are spot on.

When I was first diagnosed back in 2007, the seed implant brachytherapy was widely available, but it was restricted to guys with relatively low gleason scores and non advanced tumours still in the capsule. Most guys who were offerred it, had a wide choice of treatments prostectomy/external beam radiotherapy/ or even Hifu etc. It certainly wasn't an option for Gleason 9 guys like me.

That sort of brachytherapy involves positioning small radioactive seeds in the tumour and leaving them there, I don't know if for ever? but certainly for a long time, I am sure I read somewher that guys with that sort of treatment shouldn't let children sit on their knee.

The new sort of HDR (High Dose Rate) Brachytherapy is to be used for all sorts of cancers, my local support group raised £50,000 last year to give to our local hospitals appeal, I think they needed, and got, £600,000 to build a new brachytherapy suite.

I had HDR Brachytherapy as a salvage job, but I do not believe that is the primary purpose of it, I think the doctors intend using it as the initial treatment for many cancers. As I understand it, it is better for the patient, because the radio active needles are pushed into the tumour and left there for a few minutes for the tumour to cook, a bit like a microwave oven, however because the tumour is cooked from the inside, they don't have to use so much radiation and surrounding tissues get much less radiation, so side effects are less.

I have absolutely no knowledge about the benefits of using it with/without simultaneous Hormone Treatment, other than my radiologist was keen for me to be on hormone therapy for some months before and after the HDR Brachytherapy, some might call it a belt and braces approach, but when it is my life they are placing with I don't mind.

Dave

User

Posted 14 Oct 2015 at 11:29

Well, with belt AND braces, at least your trousers won't fall down.

As far as I understand it the HT is to shrink the tumour a bit before the Brachytherapy is used and afterwards presumably to knock out any little buggers they've missed?

I can't comment on HT or even radiotherapy as my John just had the seed implant Brachy. He had 58 seeds implated on 3rd June 2014 with a gleason of 6.3.
Just over a year later and that is down to 0.5 so hopefully show it's working.

As far as nursing children on your lap, yes that is a recommendation for a short while, when the seeds are at their most active - ie within the first three months or so.
The seeds remain in there but as time goes on they diminish in strength until all useful radioactivity has gone and they have, hopefully, done their job.

We can't control the winds - but we can adjust our sails

User

Posted 14 Oct 2015 at 14:20

Ah, ok. But I am still wondering why you would have brachytherapy and beam therapy.

As for the children on laps, yes our youngest was 5 when OH had his seed implant. The hospital said it was fine for him to sit on his lap for a story or a cuddle as long as it was only for a few minutes. He said not to worry too much, he said sitting next to him without touching was fine.

User

Posted 14 Oct 2015 at 14:28

Before the option was removed at the MDT meeting , and I was forced to have Surgery , my treatment plan was 3 yrs Hormone Therapy , with HDR Bracchy 3 months into it , and finally 5 weeks of RT . MLJ's husband is having it the other way around . Onco's have different plans but im thinking HT / RT / HDR Bracchy is a cure path rather than surgery , without the life-long possible side-effects of surgery , although they will probably kick in later ??
Chris

User

Posted 14 Oct 2015 at 19:23

Hi Guys,

I won't pretend that I thoroughly understand everything that is written in the scientific journals, but if you want to get to grips with the concept of having hormone therapy before, during and after Brachytherapy or external beam radiotherapy, the key words to search are adjuvant and neoadjuvant.

If you type them into Google 'neoadjuvant + prostate cancer' or 'adjuvant + prostate cance' you will find lots written on the subject.

I guess the clever ones amongst you will be able to tell the rest of us why it is a good idea!

Dave

User

Posted 14 Oct 2015 at 21:14

Ok thanks I'll do that. I asked the consultant why my other half didn't need hormones and he said they are completely unnecessary with brachytherapy. So I just took his word. But he also said in our case weren't needed for radiotherapy either. But I never really looked into it. OH didn't want them anyway so breathed a sigh of relief.

User

Posted 15 Oct 2015 at 00:21

External beam can be used to augment either HD or seed Brachy as a primary treatment. It is clear from this and what has been said in this thread that oncologists use methods they feel best for an individual perhaps with some personal bias preference. Certainly, there are becoming more options in the way RT is delivered, the latest I believe is Cyberknife which I understand is a more refined and accurate way of delivering External Beam. Non RT treatments apart from Surgery and various drugs, include HIFU, which basically destroys cancer cells by burning them within the prostate or very very close to it with High Intensity Focal Ultrasound or the even more rare Nanoknife (IRE) where probes are inserted that electrocute the cancer cells. So there are ever growing variety of ways to tackle PCa. Clearly, it's going to be a long time before all of these are widely available - many hospitals don't even have robotic surgery yet. Hopefully, oncologists will be aware of various treatment options and offer patients referral to hospitals that can provide the best one for an individual patient.

Barry

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