Any future new treatments?

You ask whether there are any new types of treatment that could be used to treat your prostate if brachytherapy proved ineffective (and apparently disregarding EBRT). There are focal treatments such as HIFU, Cryotherapy, Nanoknife(IRE) and FLA but unless given within a trial might need to be paid for privately. Cyberknife is another possibility some men have at a few hospitals within the NHS but this is another form of radiation which you don't seem to want to consider. If none of these salvage treatments work you are down to the systemic ones like Chemo, special drugs and radium 223 and wildly expensive immunotherapy.

Where cancer is caught quite early and is not extensive, sometimes focal treatments are given as an alternative to RT or Surgery. But this is normally done within a trial or privately and in only a few places.

Hi bluetrew - sorry its too late for your husband (and many others). At the moment I am basing my decision upon what treatments are available now but as you mention there are many new things happening at the moment - whether they will be available on the NHS is another thing though. I believe there is a good chance that if my prostate cancer was successfully treated by brachytherapy then it could return but by the time it returns then such new treatments might be available? One big question I now have is how long on average does prostate cancer take to return after brachytherapy or radiotherapy?

Edited by member 05 Jul 2018 at 11:24  | Reason: typo

As you asked I will summarise although you can read my histology by clicking on my Avatar profile and bio, or by doing this for anybody else you want to check on as most people detail their histology in this way because what they say in threads tends to be lost over time.

My PSA was stable for about 2 years after RT treatment but then began to increase slowly but persistently thereafter. This is not greatly surprising as there remains some good cells within the Prostate. However, towards the end of 2014 my PSA had climbed to 1.44 and my consultant felt that the way it had progressed indicated there was some new or residual cancer in the Prostate which was confirmed by MRI. I was then referred to Prof M E at UCLH and after more tests and scans was accepted into a trial providing salvage treatment (HIFU or Cryotherapy as appropriate - the former in my case) , for failed RT. Please note that biochemical failure is normally considered to be the case if PSA reaches 2.0 plus the patient's nadir. I had the HIFU in July 2015 by which time my PSA had reached 1.99 so before the usual threshold. After the procedure it went down to 0.39 but has again slowly risen and as PSMA scan (done privately) showed small amount of cancer, I hope will be eradicated with some further focal therapy to the prostate. Also note that it is not usual to give focal treatment if the cancer is outside the Prostate.

However, initial RT can work for a shorter or very much longer time or forever, it depends on many factors, so my case is not necessarily very typical. Be aware that it often takes many newer forms of treatment years before being generally adopted by the NHS, although some of them become available earlier privately or abroad where patient's PCa may be treated more aggressively.

Edited by member 05 Jul 2018 at 19:29  | Reason: Not specified