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Brachytherapy experiences

User
Posted 27 Apr 2020 at 16:12

I underwent Brachytherapy for prostate cancer Nov 19 so I am approaching 5 months since the implants and am finding the side effects quite severe , certainly compared to my perception prior to the procedure and was one reason I chose this route . I have suffered quite badly with frequency  and urgency of both bladder and bowel movements along with burning pain and a constant irritation at the tip of my penis . It also seems to have become worse rather than better despite avoiding things like alcohol and spicy food, so I am just wondering how long I am likely to suffer this issue which has had a considerable  impact on lifestyle and sleeping patterns , one positive of Covid - 19 lockdown is never being far from my own toilet . Be good to hear of other peoples experiences with Brachytherapy and any tips to relieve the symptoms.    

User
Posted 27 Apr 2020 at 19:04
Have you been tested for urinary tract infection (properly tested by the GP sending a sample to the hospital, not just doing a dip test in the surgery), thrush and / or cystitis?
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 27 Apr 2020 at 23:38

I was HDR brachy, so not quite the same, but the symptoms match, if not the timing. (Mine was in the month after treatment, but my treatment lasted for 20 mins, yours is nearer 6 months.) I also had external beam radiotherapy, but I think most of the side effects (except bowels) came from the HDR brachy.

Depending on the isotope, you are coming to the end of the LDR radiotherapy around now, and the side effects are delayed by some weeks, so I would expect to be diminishing any time now. I did have an infection at tip of penis after the procedure caused by the catheter (which was only in for 24h). Although the infection had gone in a week, it took some months to heal so it wasn't painful anymore, and the pee stream returned to normal shape.

Another possibility - your brain has a body map to map pain on to, so you know where pain is coming from. Some parts of male urology (such as the prostate) are not on this map, and your brain may map such pain onto the penis, particularly the tip, so this can be referred pain and not the actual location.

For bowel movements, I had to switch to a low fibre diet. I still can't eat the amount of fibre I did before, but I can now eat most fruit and veg. For peeing, you might like to lookup bladder retraining.

User
Posted 28 Apr 2020 at 10:07
Hi Lynne & Andy 62 - thanks for your responses .

Lynne - thanks yes I have had proper test for urinary infection and was all clear so it was thought to be radiation cystitis

Andy62 - thanks for sharing your experiences and you make some good points , the low fibre diet being one that I might need to review as I tend to eat quite a plant based diet . thankfully I am a very fit 70 year old so I am able to maintain good levels of exercise between the loo visits .Just hope you are right and that eventually the symptoms will subside .

User
Posted 28 Apr 2020 at 11:59

Hi Willie.

I had Brachytherapy in September 2016 at 70 with PSA 2.19 and Gleeson 3+4=7 and 5 cores of 20 positive.

I was pleased with the operation and had some urgency and was passing water very frequently in the day and a least four times a night but no noticeable bowl problems,I was given a large box of laxatives that i never needed some pain killers and Tamulosen that i think was to relax the lower areas but i stopped taking them after six months as i felt i no longer needed them.

I think lynn may be right and you could have some sort of infection and it might pay you to ring your oncology team for advice.I am 43 months on and think i have been very lucky so far and have no changed my diet in any way and still drink white wine but no beer as i also get Gout. If you click on my avatar you can see my journey so far and if you need any more information or help please ask.

 

Good luck John

User
Posted 29 Apr 2020 at 10:48
thanks John - pleased that you have made such good progress .I have spoken to my oncology team but not very helpful , very matter a fact that I am one of the unlucky ones and somewhat par for the course that potentially will only resolve at the end of the treatment which could be 12 months !!

User
Posted 29 Apr 2020 at 11:40

Hi Willie,

I am sure it will improve soon as i believe the seeds finish at about six months but maybe you where a bit more sensitive to the procedure than me and could have had more seeds put in.I was not told the amount or strength of seeds put in but i never asked the question.

As oncology don't seem interested maybe speak to your doctor about it for some ideas but i do hope it eases for you soon,

Good luck John.

User
Posted 30 Apr 2020 at 10:48
I had permanent seed Brachy in Nov. 2018 and I did suffer a bit from both bowel and urinary problems. I also had a UTI. I think you have to give it a bit more time, things will heal and side effects will slowly fade. I still have frequent peeing, some weird discomfort in the area of my prostate ( almost like itching inside!) but nothing to worry about.

My GP was happy to prescribe various medication to help with the side effects, you could try yours? I also found that diet was ( and still is) important to help regulate my bowels. Drink plenty, I found that plain water is the best, I try to drink at least 1.5 ltrs a day.

I had 74 seeds through 25 holes and a total of 70 Gy ( Greys units) of radiation.

John

Gleason 6 = 3+3 PSA 8.8 P. volume 48 cc Left Cores 3/3, Volume = 20% PSA 10.8 Feb '19 PSA 1.2

Jan '20 PSA 0.3 July '20 0.1 Jan. 21 < 0.1 Dec 21 <0.01 June '22 <0.01 April '23  <0.01

User
Posted 30 Apr 2020 at 11:19

Hi John(Sparrow)  - thanks for that insight , very helpful and is the sort of thing that assists in my optimism that this is just part of the journey and that given time things will improve . do you mind telling me what major changes you made to your diet ? 

The great news is your latest PSA score which shows the treatment has worked and makes the after effects seem minor by comparison and more bearable for that I am sure .

stay safe

User
Posted 04 May 2020 at 19:53

Dietary changes for me amounted to nothing more than reducing fibre during the period when I had what is called proctitis (bowel radiation sickness!) and increasing things like rice pudding, fish (I don't eat meat) , white bread ( instead of my usual wholemeal) and so on. My bowels were loose to the point I had to clench my buttocks firmly whilst peeing, not an easy feat!

I found yoghourt helped with wind in my bowels and plenty of water helped with cystitis ( non infection, again radiation induced).

Contrary to usual wisdom, beer helped with the cystitis, maybe the increase in fluid? Or maybe it helped me forget :-)

John

PS IT WILL GET BETTER.

Edited by member 04 May 2020 at 19:56  | Reason: Not specified

Gleason 6 = 3+3 PSA 8.8 P. volume 48 cc Left Cores 3/3, Volume = 20% PSA 10.8 Feb '19 PSA 1.2

Jan '20 PSA 0.3 July '20 0.1 Jan. 21 < 0.1 Dec 21 <0.01 June '22 <0.01 April '23  <0.01

User
Posted 06 May 2020 at 18:30
Hi Sparrow - John thanks again for your info on the problems you encountered and seems like with both the Proctitus and the Cystitis you have suffered what I am experiencing now .My question is how long did it last and how long before you felt any respite ? As far as I can glean from the oncology team it could last the full 12 months life of the implants before any improvement ? currently I am 5 months into it .

rgds

MIKE

User
Posted 06 May 2020 at 19:56
It's hard to remember how long it went on for Mike, it seemed like forever but I guess it gradually tailed off after 7-8-9 months. So stick with it, and please post when you are over the worst to let us know how things have improved for you.

I am sure that my problems did not last the full 12 months, but at the time it felt a lot longer!

Consider the alternatives to brachytherapy even with the side effects, and you may consider that it is still the best choice.

John

Gleason 6 = 3+3 PSA 8.8 P. volume 48 cc Left Cores 3/3, Volume = 20% PSA 10.8 Feb '19 PSA 1.2

Jan '20 PSA 0.3 July '20 0.1 Jan. 21 < 0.1 Dec 21 <0.01 June '22 <0.01 April '23  <0.01

User
Posted 22 Dec 2024 at 20:29

I was diagnosed in March 2024, had a physical examination (Marigold job) then MRI, CT and PET Scan and was told I would be ideal candidate for HDR. So after receiving all the info leaflets I did some research into what was actually involved not just in my area but 2/3 other areas. It seems the whole process differs from area to area. As I was going to have the procedure done in the Brighton Hospital, West Sussex I called the depart for more details.

Apparently, the Brighton Hospital does not have a dedicated Brachytherapy, and I will be pushed around from department to department. With the prospect of 21 needles in my Perineum and being moved around I shopped around other Regions, It proved to be very involved to change so stuck with Brighton.  

 So, 1st August I had the HDR in Brighton Hospital. The Staff were excellent and very attentive and the initial parts of the procedure went well even though they had to push me around the hospital. However, after waking up from the mild General Anesthetic I found myself on a bed in a storeroom, where I was given something to eat and drink. As I had to be at the hospital at 7am this was welcome as it was now midday. I remained here with all the needles still in place and on a drip and Catheter while they programmed the computer with a plan for me.

Between 4/5pm I was connected up to the Brachytherapy Machine, which had been sitting next to me all the time...looking like a Jet wash machine. After having the needles connected the Staff leave the room and the Radioactive seeds are inserted into each needle consecutively for 3/4 mins each. The Staff return and kept me talking until the Consultant arrived to remove the manifold and needles. After a few breaths on gas and air He and a nurse placed their hands either side of the block and removed the block/needles in one go. After applying pressure with pads to stop the bleeding everyone left except one nurse. At this point I mentioned that the room temperature was really warm, they said it's because the Air-conditioning is turned off at 5pm and so they brought in a couple of Fans.

It's now 5/5.30pm and the nurse is checking the Catheter for fluid flow and blood clots, is just pink coloured and there are no blood clots and she asks if I clot easily? She decides with another nurse who has returned that they can take the Catheter out, at which point one supported my groin and yanked it out in one quick pull. The room temperature was now so hot that I started to faint as they sat me up to transfer me to a wheelchair as they had to push me through most of the hospital to a side entrance to wait for a Family member to collect me. The Staff were determined to discharge me that evening and did tell me there was no facilities for overnight stays.  

While waiting the nurse waited outside to meet my Family member I started to get chronic bladder pain, I managed to wheel myself to a toilet close by, even the lights had been turned off in this section of the hospital. It's now 7pm.

I stood at a urinal in agony not being able to pee, after straining my pelvic muscles I managed to pee which included lots of glutenous blood clots, the passing of these was agonising. 

My Daughter arrived as I returned and drove me the 17 miles home, this was 17 miles of agony with two stops to pee more agonising blood clots. Needless to say I didn't sleep at all that night and at one point was contemplating a trip to A&E with the pain of trying to pass more blood clots, the next 48 hours was very painful. The bruising developed on my undercarriage like bruising I've never seen before.

Having time on my hands I found that the last part of the whole process which had not been done was 'TWOC' 'Try with out Catheter'. This wasn't carried out by the staff, which is why I had so much trouble with blood clots after.

Apparently, the nurse should have waited longer for blood clots to come out via the Catheter tube first then remove it to see if I could actually pee normally.

I did make an official complaint via 'Patients know best' which was forwarded to the department Manager and and received an apology........would have preferred the correct procedure.

Apologies for the length of this experience, but I wanted to outline the whole days procedure for anyone else having it at a hospital not having a dedicated Brachytherapy unit.

If you have it done at a Hospital with a dedicated unit then you will be kept in for the night to make sure everything is functioning.

Since, I have had a month of Radiotherapy and which was hard work and very exhausting continue to have 3 monthly Hormone injections.

The side affects of all this in the extreme, are lack of energy and fatigue combined with hot flushes which are really starting to get to me. I am taking Morning Primrose capsules plus sage capsules and sage herbal tea, all of which do not seem to be having any effect.

Two or three times a night is still normal for pee-ing and I continue to take the Tamsulosin.

My last PSA test was 0.5 and Testosterone also very low, but then it will be with continuing Hormone injections. Don't think I can take 3 years of these.

 

 

 

 

 

 
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