HDR Mono Brachytherapy

User

Posted 10 Feb 2020 at 10:46

My husband recently underwent hdr mono brachytherapy treatment. Thought there might be men on this forum considering this treatment option who might find his experience of use.

His first treatment was on 13 January. Admitted to hospital at 7 am on the morning of his procedure. Under general anaesthetic for over 6 hours, catheter removed whilst in recovery room. Consultant said the procedure was “textbook” and he was discharged on the Tuesday morning. He was prescribed Tamsulosin for his urine flow and ibuprofen as pain relief. He was surprised how tired the anaesthetic made him feel for a few days but the other side effects of the treatment were as we expected - urinating more often, including at night, a burning feeling when he urinated and blood in his urine. He was back driving on the Wednesday and was even able to go out for a family meal on the Thursday evening.

For the second treatment on 20 January the procedure was shorter (only four hours) so he recovered far quicker from the anaesthetic. He did however need the catheter to remain in overnight this time to wash the bladder out. He did not like this one bit and was relieved when it was removed 6am the following morning before being discharged later that morning. He found the side effects more intense after the second treatment but fortunately they seemed to calm down by Saturday and he felt well enough to go back to work on Monday.

So relieved that the treatment is finally over. As far as we are concerned we chose the best option FOR US. With only partial nerve sparing on offer if we would have gone down the surgery route this seemed to us the option with fewer side effects. We are however aware that it is very early days and several side effects may become more of a problem further down the road.

Next PSA test the first week of March followed by an appointment to see the consultant on the 12th.

Edited by member 18 Jan 2021 at 20:05 | Reason: Not specified

User

Posted 18 Jan 2021 at 16:55

Quick update after husband’s 6 monthly review with Consultant and one year anniversary from receiving HDR mono brachytherapy.

PSA now 1.0 - a drop of 0.2 in last 6 months. Consultant happy with progress. Next review in 6 months.

Edited by member 18 Jan 2021 at 17:52 | Reason: Not specified

User

Posted 19 Mar 2020 at 10:36

Note that there are two main types of brachytherapy.

LDR/seed/permanent brachytherapy is where radioactive seeds are inserted that deliver radiotherapy over a 6-9 month period (depending which isotope is used). The seeds are left in permanently, but become inactive after having delivered the intended dose. This treatment can be used by itself, or with hormone therapy and/or external beam radiotherapy.

HDR/temporary brachytherapy is where a single much more powerful seed is inserted into a number of tubes temporarily placed into the prostate, for 10-20 minutes. For the prostate, this is normally done as two treatments (fractions) 1-2 weeks apart, or as a single treatment (fraction) combined with a reduced dose of external beam radiotherapy (called HDR Boost).

LDR brachy is more common. HDR brachy tends to be available only in fewer highly specialised centres.

Edited by member 19 Mar 2020 at 10:40 | Reason: Not specified

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User

Posted 10 Feb 2020 at 13:30

Glad to hear treatment has been done and went well. Here’s hoping for a good result.

Ido4

User

Posted 10 Feb 2020 at 15:25

Pleased for you. HDR as a monotherapy seems relatively rare in UK, but more common in the US. Would be interested to know where it was done.

I had HDR together with a shorter course of external beam radiotherapy. This is called HDR Boost, and is done in a few centres, but only one HDR session/fraction is required in that case.

I am not aware of any increasing symptoms from the HDR in the 6 months since treatment, but it can happen.

User

Posted 10 Feb 2020 at 18:38

He had the treatment at Velindre Cancer Centre, Cardiff. It is a new treatment offered at the centre and my husband was one of the first to undergo it.

User

Posted 11 Feb 2020 at 00:10

Thank you Welshlady. Very informative post.

As Andy says hdr monotherapy isn't common, but for a patient presumably T2 but with the tumour near the nerves it sounds a very good idea. The radiation from hdr has a range of a few millimeters but over that range is very intense. So the tumour will have had a serious battering, but surrounding tissue will escape pretty much Scott free. For that reason I think side effects will not get any worse.

Dave

User

Posted 19 Mar 2020 at 08:28

Thanks for posting this, I was diagnosed back in mid February and I was offered three options including brachytherapy so that is the treatment that I intend to go with. I am meeting my Consultant in early April ( Covid 19 permitting ) to discuss the process. Having read all the information available this treatment appears to have the fewest side effects.

User

Posted 19 Mar 2020 at 10:36

Note that there are two main types of brachytherapy.

LDR brachy is more common. HDR brachy tends to be available only in fewer highly specialised centres.

Edited by member 19 Mar 2020 at 10:40 | Reason: Not specified

User

Posted 19 Mar 2020 at 13:28

Thank you Andy62,

I am learning all the time about the treatments, I didn’t realise that there were 2 different types of brachytherapy, I have been offered the seed/permanent Brachytherapy, surgery or external radiation therapy with HT. After a lot of reading etc. I have elected to go for the permanent seed Brachytherapy and meeting up with my Consultant early next month.

User

Posted 21 Mar 2020 at 08:19

I had hdr bracy too but only one procedure 6 hrs seems diff hosp do things differently saw a juinor reg who said 2 procedures but was then told by Nurse no only 1 ( poole dorset ) 1 year later my psa was undetectable 😀 ( now 18 mths later stil have hormone injections ) you will be in my thoughts & 🙏

User

Posted 09 Jul 2020 at 11:55

Six months on from my husband’s HDR brachytherapy treatment and his PSA is down to 1.2 (7.2 before treatment). The consultant was delighted with the result and his next appointment/PSA test will now not be for another six months.

He was advised that he could now stop taking the Tamsulosin but he will keep taking the 5mg daily Tadalafil (much improvement with the ED - virtually back to pre treatment performance).

So relieved - shame we are unable to go out for a drink to celebrate!!

User

Posted 09 Jul 2020 at 14:12

Thanks WelshLady for keeping us updated. PSA figure is really good news. I know some on here will be thinking shouldn't it be <0.1, but no, Hubby still has plenty of healthy prostate cells they will be producing psa as per normal. It's only people who have had prostatectomy who get near zero psa, and they also get the unpleasant side effects which hubby has managed to avoid. Keep us updated over the coming years.

Dave

User

Posted 09 Jul 2020 at 17:50

Originally Posted by: Online Community Member

He was advised that he could now stop taking the Tamsulosin but he will keep taking the 5mg daily Tadalafil (much improvement with the ED - virtually back to pre treatment performance).

So relieved - shame we are unable to go out for a drink to celebrate!!

I hope he does not get the heartburn, as I did with Tadalafil.

User

Posted 09 Jul 2020 at 18:11

Originally Posted by: Online Community Member

I hope he does not get the heartburn, as I did with Tadalafil.

Heartburn (acid reflux) is a possible side effect of all the PDE5 inhibitors, because it's caused by the PDE5 inhibition itself. It tends to only happen in people who suffer from acid reflux anyway. Reducing the PDE5 inhibitor dose can resolve it in some cases.

People who suffer from acid reflux should get that checked out, because it is a cause of esophageal cancer, and you don't want that too.

User

Posted 18 Jan 2021 at 16:55

Quick update after husband’s 6 monthly review with Consultant and one year anniversary from receiving HDR mono brachytherapy.

PSA now 1.0 - a drop of 0.2 in last 6 months. Consultant happy with progress. Next review in 6 months.

Edited by member 18 Jan 2021 at 17:52 | Reason: Not specified

User

Posted 18 Jan 2021 at 18:01

Hi WelshLady,

That is a great result.

Dave

User

Posted 18 Jan 2021 at 21:09

Good to hear, and thanks for the update.

User

Posted 19 Jan 2021 at 13:05

Great result.

Ido4

User

Posted 16 Sep 2023 at 07:51

Hi There,

I’m hoping you are still on this forum?
I was delighted to find your post. I was starting feel lonely, believing I was the only person in the UK that had had HDR brachytherapy Mono treatment!

Thank you for sharing the information around the results I’m very interested in hearing how this particular treatment has worked out for others.

My diagnosis - Gleason 7, T2a, PSA 8.9 at time of procedure, (6.4 at time of first diagnosis.)

Six weeks post second procedure/op I am down to PSA 6.1, approx 30% drop. I was told about the potential PSA bounce so not unduly worried and at least it’s going in the right direction for now. I’m due my second PSA test in around 3 weeks time.

Best wishes to your husband, fingers crossed for low PSA’s all round!

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