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Advice on brachytherapy combined with radiotherapy

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User
Posted 10 Apr 2018 at 10:26

Hi Looking for any advice or anyone who has had brachytherapy combined with radiotherapy?


My Update


The meeting with Oncologist went well and was really reassuring I was offered External beam radiotherapy this will be applied to the prostate and to surrounding pelvis area. They will also keep me on Bicalutamide for 3 months then carry on for 3 years after radio.


Also told it may be possible to have permanent seed brachytherapy at another hospital depending on meeting and flow test combined with radiotherapy as my prostate is quite small.


I was also told I may be eligible for the Stampede trial as they are now having a different approach for treatment for Gleason 9 with even with my PSA of 45.8. cut off was 40 but now 50. not sure about that yet.


Blood test result PSA down to 4.9 from 45.8 after 27 Bicalutamide tablets PHEW.


Any advice appreciated thanks


Awaiting another meeting .    

User
Posted 10 Apr 2018 at 16:10

Just bumping you up Mike - I think it would do no harm to talk to the brachy specialist; as far as I am aware, the parameters for brachy as a stand-alone treatment are usually PSA < 10 , Gleason 7 or less and no pre-existing urinary problems, but in combo with IMRT it might be great. I would want to know for IMRT-brachy how long the hormones would be for.


As for Stampede ... well they have just published some amazing data on the latest arm - abiraterone in conjunction with ADT - so well worth serious consideration. See here:


https://www.independent.co.uk/news/health/hope-for-20000-prostate-cancer-patients-after-worlds-biggest-treatment-trial-a7770871.html


 

Edited by member 10 Apr 2018 at 16:11  | Reason: Not specified

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard
User
Posted 10 Apr 2018 at 16:54

Mike, your diagnosis and experience mirrors my own from over ten years ago. If you manage to get earlier abiraterone than me you should beat my longevity! I agreed with Lyn - those trial results are stunningly good.

Good Luck

AC

User
Posted 10 Apr 2018 at 20:41
Hi mikeuk my OH diagnosed psa 27 gleason9 t3b invasion in seminal vesicles he had high dose brachytherapy 29th december 2017, then had external beam radiotherapy 23 sessions finished 14th february 2018, hes also been on zoladex HT since september 17, told he.l remained on hormones until sept 2020 3years in total, hes doing well, up to now no side effects from brachy or imrt, he worked through his radiotherapy and he was off for xmas shutdown for a week after brachy but was up and about after been discharged although a little sore and quite a bit of blood in urine for first few days, im not sure what the critera is for brachy but our hospital dont do it so was refered to leeds but imrt and follow ups at our hospital,..hope this helps..

Jo.
User
Posted 19 Apr 2018 at 21:31
Hii had fifteen sessions of Rt plus Brachay HDR please read my post ad i go through it from diagnosis to completion of treatment
My PSA at the time of diagnosis was 32 rising to 47 Iwad placed on bicultamide and tamoxifen immediatly and before RT my PSA was down to 3.2 (after two weeks)
I was taken off the pills this monday
Side effects at the moment are sore btreasts although the soreness is already dissapating.
Slight pain whilst urinating (this began about a month ago) ED which appears normal for these treatmants.And an urgency to go quickly which also started at the same time as the slight discomfort. PSA is now undetectable and i see my Onc within the next four weeks (should have seen him in December)however i can now finally contact him through his seceratary and an answer to my question or query is answered hence the coming off of the pills after fourteen months.
Ready my post and keep us posted ALso use the Macmillan site as you canlog onto to their prostate page and tick the box once youbregister and recieve e mail nearly everyday from the prostate page as members update thier progress or seek advice
User
Posted 29 Apr 2018 at 12:43

37 fractions (sessions) at 2Gy is routine. They will hopefully give you an information sheet when you attend the planning scan.

Not sure there is much you can do to prepare, apart from enjoy that holiday to Greece.

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard
User
Posted 14 Jun 2018 at 09:02

Glad you enjoyed your holiday and hoping all goes well with your planning day. I think all of us are a bit apprehensive but once the treatment starts you are kind of back in control and dealing with it gets a bit easier.


All the best.


Kevan 

User
Posted 09 Oct 2018 at 20:33
Brilliant :-)
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard
User
Posted 09 May 2019 at 18:20

Originally Posted by: Online Community Member


Completed 37 fractions on the 17th August 2018 call from hospital today PSA now 0.2 feeling great :)


Update April 2019 PSA 0.1 



Great news Mike, I was PSA 38 Gleason 4:5 T2C March 2018.  I finished my 20 fractions IMRT on the 3rd of September 2018, I then had to wait until November where I was told my PSA was 0.5. My next review was in March this year and it was 0.2, I have my final review in July and I’m hoping it’s going to be below 0.1. My oncologists has agreed that as I have responded so well to the RT I can finish hormone therapy with a final injection in July which will last until October.  At first she wanted me to continue and do a full three years on HT, but quality of life does count for something when you’re only 67! The wait till April 2020 till next PSA test is going to be playing on my mind, constantly concerned it might come back, But even if it does I am going to go on intermittent hormone therapy.


All the best with your prognosis and recovery Mike 


Alan


 

Edited by member 09 May 2019 at 18:22  | Reason: Not specified

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User
Posted 10 Apr 2018 at 16:10

Just bumping you up Mike - I think it would do no harm to talk to the brachy specialist; as far as I am aware, the parameters for brachy as a stand-alone treatment are usually PSA < 10 , Gleason 7 or less and no pre-existing urinary problems, but in combo with IMRT it might be great. I would want to know for IMRT-brachy how long the hormones would be for.


As for Stampede ... well they have just published some amazing data on the latest arm - abiraterone in conjunction with ADT - so well worth serious consideration. See here:


https://www.independent.co.uk/news/health/hope-for-20000-prostate-cancer-patients-after-worlds-biggest-treatment-trial-a7770871.html


 

Edited by member 10 Apr 2018 at 16:11  | Reason: Not specified

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard
User
Posted 10 Apr 2018 at 16:54

Mike, your diagnosis and experience mirrors my own from over ten years ago. If you manage to get earlier abiraterone than me you should beat my longevity! I agreed with Lyn - those trial results are stunningly good.

Good Luck

AC

User
Posted 10 Apr 2018 at 20:41
Hi mikeuk my OH diagnosed psa 27 gleason9 t3b invasion in seminal vesicles he had high dose brachytherapy 29th december 2017, then had external beam radiotherapy 23 sessions finished 14th february 2018, hes also been on zoladex HT since september 17, told he.l remained on hormones until sept 2020 3years in total, hes doing well, up to now no side effects from brachy or imrt, he worked through his radiotherapy and he was off for xmas shutdown for a week after brachy but was up and about after been discharged although a little sore and quite a bit of blood in urine for first few days, im not sure what the critera is for brachy but our hospital dont do it so was refered to leeds but imrt and follow ups at our hospital,..hope this helps..

Jo.
User
Posted 11 Apr 2018 at 10:59

Thakyou for the advice off for a flow test today fingers crossed and legs :)

User
Posted 19 Apr 2018 at 08:15

18.04.2018


Had a meeting today with the Oncologist and was told flow test was not good enough to have brachytherapy also I was not emptying my bladder fully but not a problem.


Plan in place told to go on planned holiday to Greece at the end of May then on my return to have radiotherapy to the prostate and pelvic lymph nodes also to stay on Bicalutamide for 2 and a half to 3 years, Stampede trial still there if I decide to go on it.

User
Posted 19 Apr 2018 at 21:31
Hii had fifteen sessions of Rt plus Brachay HDR please read my post ad i go through it from diagnosis to completion of treatment
My PSA at the time of diagnosis was 32 rising to 47 Iwad placed on bicultamide and tamoxifen immediatly and before RT my PSA was down to 3.2 (after two weeks)
I was taken off the pills this monday
Side effects at the moment are sore btreasts although the soreness is already dissapating.
Slight pain whilst urinating (this began about a month ago) ED which appears normal for these treatmants.And an urgency to go quickly which also started at the same time as the slight discomfort. PSA is now undetectable and i see my Onc within the next four weeks (should have seen him in December)however i can now finally contact him through his seceratary and an answer to my question or query is answered hence the coming off of the pills after fourteen months.
Ready my post and keep us posted ALso use the Macmillan site as you canlog onto to their prostate page and tick the box once youbregister and recieve e mail nearly everyday from the prostate page as members update thier progress or seek advice
User
Posted 29 Apr 2018 at 10:09

Hi


Looks like I am going to go down the radiotherapy route I was told they would be 37 in all as the pelvic lymph nodes have to be treated I was just looking for any advice/ tips in preparation for this.


My planning is due to start on the 14th of June 2018


Thankyou

User
Posted 29 Apr 2018 at 12:43

37 fractions (sessions) at 2Gy is routine. They will hopefully give you an information sheet when you attend the planning scan.

Not sure there is much you can do to prepare, apart from enjoy that holiday to Greece.

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard
User
Posted 14 Jun 2018 at 08:40
Well fantastic holiday now for radiotherapy planning day thanks Lyn
User
Posted 14 Jun 2018 at 09:02

Glad you enjoyed your holiday and hoping all goes well with your planning day. I think all of us are a bit apprehensive but once the treatment starts you are kind of back in control and dealing with it gets a bit easier.


All the best.


Kevan 

User
Posted 15 Jun 2018 at 12:25

Thanks Kevan all went ok the only problem was getting the right amount water in my bladder as it was not emptying fully they went for 2 cups of water instead of 3 in the end ? Got my first tattoo dots lol.


 

User
Posted 29 Jun 2018 at 20:17

I am going back to see my Oncologist ASAP, as I made an impulsive decision to just go for 20 fractions of RT


I was offered HRD Brachytherapy, but dismissed it out of hand after listening to the brief description I was given and that put me off. 


Now a 9 days later I am maybe regretting my knee jerk reaction and think that at Gleason 4:5 T2c, with good urinary stream, well fit enough for general anaesthesia I might want to reconsider. so i have requested further consultation with Oncologist


I wanted to know, is External Beam RT always given as well as the HRD Brachytherapy? And if so, are less fractions at a lower intensity administered.


Thanks for reading


 

User
Posted 30 Jun 2018 at 00:46
Hi, EBRT can be given with both High and Low Dose Brachytherapy but either can be given without EBRT. I am not sure about the dose/number of fractions but might depend on what a consultant feels is appropriate in a specific case.

A survey of many studies indicated that as a treatment Brachytherapy (at least with seeds ) gave more and longer good results for disease control than EBRT alone. Seeds plus EBRT gave further longer control which according to my reading of a graph was further improved long term by the addition of ADT to these two. There is quite a difference of results for each type of treatment within it's ellipse so the foregoing is a generalization.
Barry
User
Posted 09 Oct 2018 at 19:55

Completed 37 fractions on the 17th August 2018 call from hospital today PSA now 0.2 feeling great :)


Update April 2019 PSA 0.1 

Edited by member 08 May 2019 at 23:47  | Reason: Not specified

User
Posted 09 Oct 2018 at 20:33
Brilliant :-)
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard
User
Posted 09 May 2019 at 18:20

Originally Posted by: Online Community Member


Completed 37 fractions on the 17th August 2018 call from hospital today PSA now 0.2 feeling great :)


Update April 2019 PSA 0.1 



Great news Mike, I was PSA 38 Gleason 4:5 T2C March 2018.  I finished my 20 fractions IMRT on the 3rd of September 2018, I then had to wait until November where I was told my PSA was 0.5. My next review was in March this year and it was 0.2, I have my final review in July and I’m hoping it’s going to be below 0.1. My oncologists has agreed that as I have responded so well to the RT I can finish hormone therapy with a final injection in July which will last until October.  At first she wanted me to continue and do a full three years on HT, but quality of life does count for something when you’re only 67! The wait till April 2020 till next PSA test is going to be playing on my mind, constantly concerned it might come back, But even if it does I am going to go on intermittent hormone therapy.


All the best with your prognosis and recovery Mike 


Alan


 

Edited by member 09 May 2019 at 18:22  | Reason: Not specified

User
Posted 09 May 2019 at 19:57

Thanks Alan 


I am having my PSA tested every 3 months the last 2 were 0.1 still 2 years of bicalutamide to go.


26th June 2019 latest PSA now less than 0.1 feeling great 


Mike 

Edited by member 26 Jun 2019 at 13:59  | Reason: Update

 
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