I'm interested in conversations about and I want to talk about
Know exactly what you want?
Show search

Notification

Error

Brachytherapy or not?

Email this conversation Print this conversation
User
Posted 09 Nov 2018 at 00:29

I'm due to make a decision whether to have Brachytherapy as part of my radiotherapy treatment.  Seeing I hate needles and the description of the treatment doesn't sound very pleasant, I'm waiting to be convinced that Brachytherapy (combined with external radiotherapy) is the way to go!

My flow rate is good and my PSA is down to 5.7 from 22, so Brachytherapy is an option according to my oncologist.

I'm more than happy to have 7 or 8 weeks of external radiotherapy at my local hospital, so unless anyone can convince me otherwise this is the route I intend taking.

User
Posted 09 Nov 2018 at 09:53

A combination therapy approach is considered to give a better overall outcome.

What type of brachy is being proposed by your onco? Permanent seeds or HDR?

In my case I am scheduled to have HDR brachy on the 29th November followed by 15 sessions of radio therapy.

The alternative to the above would have been 37 sessions of radiotherapy (74Gy in 37 fractions.)

 

 

User
Posted 09 Nov 2018 at 11:59

Hi and Welcome,

Like you i also hate needles but had no problems and the Brachytherapy operation as you are knocked out for the full operation.I had a choice of radical prostectomy or Brachytherapy and took the Brachytherapy.My Psa was 2.19 and Gleason 3+4=7 with 5 cores out of 20 positive.(click my avatar for more details).

I am two year on from operation and doing well with no over all problems apart from ED that i get Viagra for but over all a lot better than i expected.

PSA is down to 0.39 in June 2018 with next test in January 2019.

Regards John.

User
Posted 09 Nov 2018 at 14:18

Hi phil,

When i made the decision about my options of surgery if I had taken the Radical prostectomy it would have been done at the Lister Hospital Stevenage four miles from me and where all the early procedures where done but I still choose  Brachtherpy at the Mount Vernon at least 30 miles away and not a great place to travel to but distant did not come into the decision making only what i thought was the best option for my future.

John. 

User
Posted 10 Nov 2018 at 12:08
Hello Phil,

I had similar initial frustrations of not being told what was best for me (low dose seed Brachy or radical prostatectomy were the options offered). Those of us of a certain age are more used to doctors being paternalistic; this stuff of presenting us with the options, outlining the risks of each & leaving the decisions to us is very strange.

In the end, I opted for the LDSBrachy & for all of us the choice is very personal. I had a number of other procedures in the lead up to the LDSBrachy, so had become a bit "unfazed" about another hospital visit -- fear of the unknown diminishing, I guess. I had the LDSBrachy last Friday week (2nd November) & I have to say the experience was relatively smooth: in at 7am back home at 2:30pm. So there is nothing to fear in the procedure, at least from my experience. I was out walking my dogs the next day; no major side effects, little or no pain, but I have taken it moderately easy since, just in case.

The process is all very well; that's in the past now for me with the worry in the build-up gone. So there's a lot of post-op euphoria. However, there is a long road of monitoring to take to determine if it has actually worked.

Best of luck to you in whatever you decide.

User
Posted 10 Nov 2018 at 12:25

Hi Phil,

It is very difficult to make a decision and i felt much the same but tried to look up as much information i could and found this site and it's members most helpful.One of the things that pushed me towards Brachytherapy was there seemed to be less intrusion on the body and bowl and urinery problems but also reading some of the other members post operation issues, bu many  had little or no choice than to have the Radical removal because of high Gleason numbers.

There was one other factor that helped in the decision and that was a friend had had the brachytherapy two years earlier and was signed of in remission.

As to the operation at Mount Vernon my wife and daughter took me in on a Sunday afternoon and i was taken to a side room in the ladies section i think because they had no side rooms in the mens side and you have to be isolated because of the radioactive seed they put in you and you must stay away from pregnant woman and babies. A doctor came in an ask who i was as they could not find any notes, so not a great start but it became a standing joke as every nurse and doctor from then on knocked on my door and asked who i was.

Monday morning came i can't remember if i got any breakfast maybe a cup of tea as i was going down at 11oclock an that was fine with me as i hate any waiting about as it gives you more time to think.I think I may have been given some premeds but not to sure then wheeled across the carpark to the surgical unit and they where still asking about my notes.In no time at all i was in to the premed room with four nurses and just as the asked again about my paperwork the My Specialist doctor turned up and said no problem John i have all the notes with me, two minutes later i was under out and the first thing i remember was being wheeled back to the ward.

My first thoughts where great thats over and apart from a little discomfort down below all i wanted was something to eat and a cup of tea.After a good nights sleep the Specialist came in and told me the operation went well and as long as i was passing water ok i could go home the following day.

After the operation you have to pee into a bottle to make sure no seeds get lost and the have a geiger counter on the window sill to check,I had 16 bottles by the next morning as i think they have to be checked by  Radioactive technician.

I was given the all clear to leave about 10 o'clock on doctors rounds but it took till three to get all the pill together to release me but that often happens in hospitals.

At  home i just took it easy and took a couple of tablets a day to stop infection,Tamulosen to relax water works and laxatives that i never needed or used.I found i had urgency to pee and that could be every couple of hours and i was getting up four times a night but never had any accidents at all.

 

Hope this helps you a little and if you need any more advice please ask.

Regards John

User
Posted 11 Nov 2018 at 21:26
I do not wish to raise concern about Low Dose Brachtherapy because if I was newly diagnosed today as found in 2007, I would most probably go this route in need supplemented by IMRT External Beam radiation. However, I would ask that the seeds be 'stranded' to help reduce the risk of seed migration which in certain situations can be dangerous. This is not a risk with High Dose Brachytherapy as the radiated probes are withdrawn as part of the procedure but the patient has to be a suitable candidate.
Barry
User
Posted 14 Nov 2018 at 07:22

Hi i had HDR and the side effects for me was minimal please read my post under bobby12 (skip to the end)

i was diagnosed with a PSA of 32 and a Gleeson of 7 my PSA had risen to 42 before i was put on Bicultamide and Tamoxefen (side effects of these drugs being a free NHS wax, as a lot of my body hair disapeared only on my back arms chest and legs though nowhere else,and a rather good set of man boobs) However my PSA on the drugs dropped within two weeks to 3.2

The man boobs have now shrunk back to normal. However ED and loss of libido is another side effect. And which still remains

It is coming up to two years since the Brachy and my PSA is still undetectable(due a blood test soon) hair has grown back and all seems good. Not sure on thirty odd sessions of RT as I had fourteen as part of my treatment,find out from others on this site about possible side effects and problems associated with that many sessions.

let us know how you get on

bobby12 

Edited by member 14 Nov 2018 at 07:25  | Reason: added to

User
Posted 19 Nov 2018 at 11:05

I'm 67 and I was diagnosed in August last year - psa 99.6, Gleeson score 4+5 and t3b N1 - it had spread outside the prostate and into my lymph nodes. I am having  hormone injections every six months. Started chemo (6 sessions three weeks apart) in October 2017 and finished in Jan 2018. Had a 6 week break before 23 daily sessions of radiotherapy(except weekends) followed by hdr brachytherapy. Finished in April 2018. It's taken six months since then before I've felt rid of all the nasty stuff and my symptoms have all but disappeared. MT Vernon and the NHS have been amazing. I found the after effects of the radiotherapy treatment more troublesome than the effects after chemotherapy - mainly because my symptoms (urinary flow etc) become much worse during and after treatment. All has settled down now, and, am delighted all seems well. Hopefully, this trend will continue as my psa is now 0.15!

Update : 9.12.2019. PSA now 0.07! Have my final hormone injection in March 2020. Feeling great and no bladder issues 👍😊

Update: 13.01.2022. All was going well until July 2021 when I had a PSA of 0.8 (cf 0.06 in Jan 2021), and at the end of  October 2021 it went up to 4.8. I have no symptoms. My consultant referred me for an MRI and PSA in December...but I'm still awaiting the results. I have heard that a physician in the USA suggests that Covid vaccines could affect PSA levels. Has anyone else any more information on this or had a similar experience after vaccinations?

Edited by member 13 Jan 2022 at 14:29  | Reason: Update

User
Posted 24 Mar 2020 at 12:50
Hi, because at the minute there isn't a lot of data on long term outcomes but for contained (T1 / T2a) prostate cancer the permanent seed brachy (aka low dose brachy) seems to be at least as effective as external beam RT or surgery and with fewer side effects.

It is some years ago now though and I am aware that most hospitals have changed their criteria since then, but at the time permanent seed brachy wasn't considered suitable for young men or those who already had urinary hesitation, G7 or above or PSA over 10. John was only 50 so they said no.

More recently, high dose brachy has become more common for men at higher risk of spread although still contained - usually in conjunction with external RT and hormone treatment. Higher risk includes PSA of over 10, G8 or above, T2b and up.

If you were offered all treatment types, I am assuming you are to have permanent seed brachy with or without hormones but it is worth you clarifying to help other members here respond appropriately.

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

Show Most Thanked Posts
User
Posted 09 Nov 2018 at 09:53

A combination therapy approach is considered to give a better overall outcome.

What type of brachy is being proposed by your onco? Permanent seeds or HDR?

In my case I am scheduled to have HDR brachy on the 29th November followed by 15 sessions of radio therapy.

The alternative to the above would have been 37 sessions of radiotherapy (74Gy in 37 fractions.)

 

 

User
Posted 09 Nov 2018 at 11:59

Hi and Welcome,

Like you i also hate needles but had no problems and the Brachytherapy operation as you are knocked out for the full operation.I had a choice of radical prostectomy or Brachytherapy and took the Brachytherapy.My Psa was 2.19 and Gleason 3+4=7 with 5 cores out of 20 positive.(click my avatar for more details).

I am two year on from operation and doing well with no over all problems apart from ED that i get Viagra for but over all a lot better than i expected.

PSA is down to 0.39 in June 2018 with next test in January 2019.

Regards John.

User
Posted 09 Nov 2018 at 12:27

Thank you for your replies, much appreciated.

I'm still due to receive actual confirmation of my radiotherapy treatment, but during the initial consultation with my oncologist Permanent seeds were mentioned. I was due to have a telephone conversation with my oncologist on 21st December, but due to her leave it's now been postponed until 9th January!

I understand why certain people would go for the Brachytherapy option, i.e. due to mobility/transport issues, but that isn't a concern with myself.

The hospital where my radiotherapy will be carried out is only 6 miles away, I also have a car park pass and it's very close to the gym (where I intend to go after my radiotherapy sessions) that I'm a member.

Whereas the Brachytherapy treatment is carried out at a hospital over 20 miles away and is an absolute nightmare to get to via car, due to traffic.

That said, if my oncologist/consultant states it's my best option, then that's the route I'll take, as long as John states, "I'm knocked out".

 

Phil

XX

User
Posted 09 Nov 2018 at 14:18

Hi phil,

When i made the decision about my options of surgery if I had taken the Radical prostectomy it would have been done at the Lister Hospital Stevenage four miles from me and where all the early procedures where done but I still choose  Brachtherpy at the Mount Vernon at least 30 miles away and not a great place to travel to but distant did not come into the decision making only what i thought was the best option for my future.

John. 

User
Posted 09 Nov 2018 at 22:53

Hello John, thanks once again for your thoughts and experiences. 

If you don't mind me asking how long were you in hospital for the Brachytherapy procedure and what was the recovery time?

 

If when I next speak to my oncologist consultant she recommends Brachytherapy, then I'll go down that route.

However when we last spoke she wasn't recommending any particular treatment, she just outlined my options.

All very frustrating when I'm left to make the final decision as opposed to being given clear and precise direction.

Maybe all will be clear when I next speak to her, and maybe I just didn't hear correctly.

 

Phil

User
Posted 10 Nov 2018 at 12:08
Hello Phil,

I had similar initial frustrations of not being told what was best for me (low dose seed Brachy or radical prostatectomy were the options offered). Those of us of a certain age are more used to doctors being paternalistic; this stuff of presenting us with the options, outlining the risks of each & leaving the decisions to us is very strange.

In the end, I opted for the LDSBrachy & for all of us the choice is very personal. I had a number of other procedures in the lead up to the LDSBrachy, so had become a bit "unfazed" about another hospital visit -- fear of the unknown diminishing, I guess. I had the LDSBrachy last Friday week (2nd November) & I have to say the experience was relatively smooth: in at 7am back home at 2:30pm. So there is nothing to fear in the procedure, at least from my experience. I was out walking my dogs the next day; no major side effects, little or no pain, but I have taken it moderately easy since, just in case.

The process is all very well; that's in the past now for me with the worry in the build-up gone. So there's a lot of post-op euphoria. However, there is a long road of monitoring to take to determine if it has actually worked.

Best of luck to you in whatever you decide.

User
Posted 10 Nov 2018 at 12:25

Hi Phil,

It is very difficult to make a decision and i felt much the same but tried to look up as much information i could and found this site and it's members most helpful.One of the things that pushed me towards Brachytherapy was there seemed to be less intrusion on the body and bowl and urinery problems but also reading some of the other members post operation issues, bu many  had little or no choice than to have the Radical removal because of high Gleason numbers.

There was one other factor that helped in the decision and that was a friend had had the brachytherapy two years earlier and was signed of in remission.

As to the operation at Mount Vernon my wife and daughter took me in on a Sunday afternoon and i was taken to a side room in the ladies section i think because they had no side rooms in the mens side and you have to be isolated because of the radioactive seed they put in you and you must stay away from pregnant woman and babies. A doctor came in an ask who i was as they could not find any notes, so not a great start but it became a standing joke as every nurse and doctor from then on knocked on my door and asked who i was.

Monday morning came i can't remember if i got any breakfast maybe a cup of tea as i was going down at 11oclock an that was fine with me as i hate any waiting about as it gives you more time to think.I think I may have been given some premeds but not to sure then wheeled across the carpark to the surgical unit and they where still asking about my notes.In no time at all i was in to the premed room with four nurses and just as the asked again about my paperwork the My Specialist doctor turned up and said no problem John i have all the notes with me, two minutes later i was under out and the first thing i remember was being wheeled back to the ward.

My first thoughts where great thats over and apart from a little discomfort down below all i wanted was something to eat and a cup of tea.After a good nights sleep the Specialist came in and told me the operation went well and as long as i was passing water ok i could go home the following day.

After the operation you have to pee into a bottle to make sure no seeds get lost and the have a geiger counter on the window sill to check,I had 16 bottles by the next morning as i think they have to be checked by  Radioactive technician.

I was given the all clear to leave about 10 o'clock on doctors rounds but it took till three to get all the pill together to release me but that often happens in hospitals.

At  home i just took it easy and took a couple of tablets a day to stop infection,Tamulosen to relax water works and laxatives that i never needed or used.I found i had urgency to pee and that could be every couple of hours and i was getting up four times a night but never had any accidents at all.

 

Hope this helps you a little and if you need any more advice please ask.

Regards John

User
Posted 11 Nov 2018 at 01:56

Hello John and Phil, thanks for your replies.

I must admit Phil's experience with the Brachy sounds very encouraging and if it could be replicated for me then I'd have no issues with going down this route.

John's doesn't sound as promising as to the actual process, but it's the end result that counts.

I now need to wait until 9th January when I speak to my oncologist and if she believes LDSBrachy is the preferred treatment, then thanks to the positive comments from this forum, that's the option Ill take even with my fear of needles and surgery.

 

Phil

 

 

User
Posted 11 Nov 2018 at 17:37

Hi Phil ... I too had LDR Brachy nearly 2 years ago. Please click on my Username (Avatar) for a long and detailed description of my experience. Good luck with whichever journey you take.

Hello to you John ... pleased to hear from you again. I'm currently awaiting the results of bone and MRI scans to try and determine why my PSA is close to 5 and not 1? Will post the results as soon as I have them.

The sad news for me is that my younger brother died last Friday from Advanced Prostate cancer. He had been taking a 4 month holiday from the Bicalutamide he had been on for about 2 years. However, he deteriorated rapidly and a scan found that the cancer had spread throughout the rest of his body and that there was nothing they could do for him. Another complication was that he also had dementia! Still can't believe he's gone!

Regards Tom

User
Posted 11 Nov 2018 at 18:26
Johsan's husband seems to have had great results from brachy and not too many side effects. It would have been my husband's first choice but he didn't meet the criteria.
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 11 Nov 2018 at 21:20

Hi john just saw your post ad i have been messing around on mc millan for a while

i had brachy HDR. Hormones in pill form (bicultamide and tamoxifen)fourteen sessions of RT and then the brachy (seeds not left in) I had next to no side effects was back to work after five days and have been clear ever since (PSA still undetectable) fingers crossed

please read my post where I  go through my full experiences (skip to the end)or mighty bored you’ll be

let us know how you get on 

bobby12

Edited by member 11 Nov 2018 at 21:22  | Reason: Not specified

User
Posted 11 Nov 2018 at 21:26
I do not wish to raise concern about Low Dose Brachtherapy because if I was newly diagnosed today as found in 2007, I would most probably go this route in need supplemented by IMRT External Beam radiation. However, I would ask that the seeds be 'stranded' to help reduce the risk of seed migration which in certain situations can be dangerous. This is not a risk with High Dose Brachytherapy as the radiated probes are withdrawn as part of the procedure but the patient has to be a suitable candidate.
Barry
User
Posted 12 Nov 2018 at 00:15

Thanks for your reply Tom.

Very sorry to read the sad news about your younger brother.

 

Regards,

Phil

User
Posted 14 Nov 2018 at 00:44

Just received a letter from my oncologist stating that I'm suitable for HDR Brachtherapy, whereas I thought she had said Low Dose Brachtherapy was an option for me.

I'm still uncertain as to whether to take up the option of HDR Brachtherapy of just go for the 37 sessions of external radiotherapy.

Still waiting to be convinced which is the best route, especially seeing I'm totally mobile and attending my local hospital 5 times a week won't be an issue.

User
Posted 14 Nov 2018 at 07:22

Hi i had HDR and the side effects for me was minimal please read my post under bobby12 (skip to the end)

i was diagnosed with a PSA of 32 and a Gleeson of 7 my PSA had risen to 42 before i was put on Bicultamide and Tamoxefen (side effects of these drugs being a free NHS wax, as a lot of my body hair disapeared only on my back arms chest and legs though nowhere else,and a rather good set of man boobs) However my PSA on the drugs dropped within two weeks to 3.2

The man boobs have now shrunk back to normal. However ED and loss of libido is another side effect. And which still remains

It is coming up to two years since the Brachy and my PSA is still undetectable(due a blood test soon) hair has grown back and all seems good. Not sure on thirty odd sessions of RT as I had fourteen as part of my treatment,find out from others on this site about possible side effects and problems associated with that many sessions.

let us know how you get on

bobby12 

Edited by member 14 Nov 2018 at 07:25  | Reason: added to

User
Posted 19 Nov 2018 at 11:05

I'm 67 and I was diagnosed in August last year - psa 99.6, Gleeson score 4+5 and t3b N1 - it had spread outside the prostate and into my lymph nodes. I am having  hormone injections every six months. Started chemo (6 sessions three weeks apart) in October 2017 and finished in Jan 2018. Had a 6 week break before 23 daily sessions of radiotherapy(except weekends) followed by hdr brachytherapy. Finished in April 2018. It's taken six months since then before I've felt rid of all the nasty stuff and my symptoms have all but disappeared. MT Vernon and the NHS have been amazing. I found the after effects of the radiotherapy treatment more troublesome than the effects after chemotherapy - mainly because my symptoms (urinary flow etc) become much worse during and after treatment. All has settled down now, and, am delighted all seems well. Hopefully, this trend will continue as my psa is now 0.15!

Update : 9.12.2019. PSA now 0.07! Have my final hormone injection in March 2020. Feeling great and no bladder issues 👍😊

Update: 13.01.2022. All was going well until July 2021 when I had a PSA of 0.8 (cf 0.06 in Jan 2021), and at the end of  October 2021 it went up to 4.8. I have no symptoms. My consultant referred me for an MRI and PSA in December...but I'm still awaiting the results. I have heard that a physician in the USA suggests that Covid vaccines could affect PSA levels. Has anyone else any more information on this or had a similar experience after vaccinations?

Edited by member 13 Jan 2022 at 14:29  | Reason: Update

User
Posted 09 Dec 2019 at 19:25

Click avatar and read my blog

i had hormone treatment 18 months but within three months of my diagnoses i was booked in for my HDR Which started with  fourteen sessions of rt followed by the brachy, no needles as you are out for the entire procedure 

side effects are ED which has now diminished and a nice set of boobs which has not 

my psa was 32 with a gleeson of 7 at diagnosis it is now .7 and thats two years later

check out how many rt sessions you will get and remember they are not as accurate as brachy

let us know what you decide

apart from wd 

User
Posted 09 Dec 2019 at 20:14
Last post from Phil was over a year ago. Trust he made his treatment decision and had it by now!
Barry
User
Posted 24 Mar 2020 at 11:36

Hi lynEyre,

I was offered HT / RT, RP or Brachytherapy  and I have chose to go with Brachytherapy, I am due to meet with the relevant consultant on the 9th April 2020, I see that you say that Brachytherapy would have been your husbands first choice but he wasn’t offered, I am interested to know why he would have chosen that treatment. I hope you don’t mind me asking but I am trying to reassure myself that I am making the right decision and your contributions on this forum are much valued, thanks in advance.

 

David

User
Posted 24 Mar 2020 at 12:50
Hi, because at the minute there isn't a lot of data on long term outcomes but for contained (T1 / T2a) prostate cancer the permanent seed brachy (aka low dose brachy) seems to be at least as effective as external beam RT or surgery and with fewer side effects.

It is some years ago now though and I am aware that most hospitals have changed their criteria since then, but at the time permanent seed brachy wasn't considered suitable for young men or those who already had urinary hesitation, G7 or above or PSA over 10. John was only 50 so they said no.

More recently, high dose brachy has become more common for men at higher risk of spread although still contained - usually in conjunction with external RT and hormone treatment. Higher risk includes PSA of over 10, G8 or above, T2b and up.

If you were offered all treatment types, I am assuming you are to have permanent seed brachy with or without hormones but it is worth you clarifying to help other members here respond appropriately.

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 24 Mar 2020 at 16:28

Thanks LynEyre,

The Oncology Nurse who discussed my diagnosis with me didn’t mention RT with the Brachytherapy but I am meeting my Consultant in a fortnights time so will no more after that, I will update after that but thanks for your input it is really appreciated.

Regards

 

David 

 
Forum Jump  
Email this conversation Print this conversation

Join the online community now.

Click through to become a member and gain access to support, information and real time replies.




MenuTop ▲
©2024 Prostate Cancer UK