Brachy+Ebrt+Ht - how might it change my quality of daily life?

Hi Mike. Welcome

I'm going to take a guess it will be hdr brachy, as the three treatments would be identical to mine. I was in my early 50s so a good bit younger than you, but most 67year olds now a days are in very good health so the difference in age is probably irrelevant. 

The side effects are not too bad. The brachy will require an over night stay in hospital, and a general anaesthetic. Not very pleasant but it is only one day out of your life. Pissing a little blood afterward not a big issue. 

The ebrt was 15 fractions for me. Plenty of people carry on going to work. I chose not too but I could have. I went in and out of Manchester by motorbike. For me I can not remember any side effects apart from a pain in the arse one night. You might need toilet a bit more urgently, so buy a key for disabled toilets off line, it's about £3 and you are entitled to it. 

HT is the biggest problem. Complete loss of libido, not a dreadful problem, you don't miss the sex with no libido, it can be a problem in your relationship though. I reckon my penis has lost a few inches, because of atrophy. I'm sure ANDY62 will post soon, he is an expert on surviving HT. I didn't put on much weight, but I think I gained fat and lost muscle. I was on HT for two years and now off it for six months with hardly any return of libido.

I had no great problem with fatigue. Exercise is important whilst on HT to preserve muscle mass. Walking dog etc should be easy. Personally I've never been a gym bunny, but if you enjoy it then definitely do exercise. I really don't think you will be incapacitated by this.

I was only on HT for two years, if I were told I had to take it for the rest of my life, which happens to people with advanced cancer, I would be hesitant about trying to preserve my life over QoL, but I can handle it for two years. 

Hi Mike, My husband David had HDR, Brachytherapy, followed by 4 weeks of RT & 3 yrs of HT, all of which he completed over 2 yrs ago. He found the RT the hardest to deal with, he had sleep problems, mood swings, and he was constantly exhausted. He also had to live away from home during the week which he hated.

The HT was difficult, but the more he exercised the easier it was to manage,we have a small holding, where we grow our own food, and he continued to play at home every day, and the occasional gig, as he’s a retired muzo.... his advice is keep going, keep moving. The lack of libido we discussed and planned how we hoped we would deal with it.... well we did, it wasn’t easy but love is powerful. He’s now 70, his PSA has fluctuated from <0.1 to 0.2 so far. His libido has returned, and he’s doing really well. His original diagnosis was Gleason 9 Tb3 NO MO. Q.O.L is good, and we have just harvested our winter spuds. Hope this helps. 

Leila 

My diagnosis and treatment are pretty identical to yours, except my PSA was 58. Have a look at my profile.

I am 14 months post radical treatment now, PSA has been <0.01 since treatment. I injected my last hormone therapy on Tuesday (unless it comes back), which will take me to 22 months. Onco said I could stop anytime from 18 months given my PSA, but if it had been higher, he would have wanted 36 months. Hormone therapy hasn't hit me badly and I already had next injection in the fridge, so I made that my last one.

At my 12 month review, my comment to my consultant was that all the short term side effects had gone at about 10 months, and that I was in a much better state at this stage than I ever imagined I would be at the outset. I have one long term side effect so far, occasional painless minor rectal bleeding, which has no impact on Quality of Life. I didn't have SpaceOAR fitted - we talked about it and I could have had it on the NHS as part of a trial, but my onco said not recommended for a high risk patient, and long term serious bowel issues lower with HDR Boost than with just external beam radiotherapy.

The treatment path you refer to is call HDR Boost (there is also an LDR Boost). HDR Boost is a good combination for a high risk diagnosis (which both you and I are, due to PSA and staging), giving good outcomes with low risk of long term side effects.

The treatment hasn't inconvenienced me, beyond 23 visits for radiotherapy and 3 days in hospital for the HDR Brachytherapy (many hospitals do that faster than 3 days). Had urgency for a few weeks after the HDR brachy. Note that I regard exercise as essential while on hormone therapy - it significantly reduces a number of the side effects. I cycle a lot and continued doing so during treatment, and I also attend some online trainer led classes specifically for cancer patients, so it has exercises to counter things like calcium loss from bones.

Wishing you all the best.

Hi Mike, the hot sweats on HT may or may not occur, I had a few. Evening primrose oil and sage tablets are possible solutions. I used EPO a few times, but not consistently enough to prove if it worked. One of our contributors SR12 recommended both to his dad and it seems to have been successful, once you are on HT if you get sweats (mine were worse in hot weather, you may not get them in winter) try the EPO and sage, and report back to us, it's not exactly a clinical trial, but it may help others.

I have to say I never did much exercise before HT and I didn't do any more whilst on HT. I'm not saying that was a good thing, but an energetic dog may give you enough exercise if you aren't a gym bunny. 

HT hot flushes - these are still affecting me 5 weeks after stopping HT.

Primrose oil - didn't help me

Sage Leaf tablets - I have been on these for 4 weeks and they appear to reduce the duration of each flush and maybe the frequency at night. I still don't sleep through the night.

Exercise - this is what helped me most. I was on HT before and after RARP. Once I had my surgeon review after surgery and got the OK to get back into the gym I felt better - physically and mentally. I read here that exercise is important during HT and I found that as well. I had lost muscle on HT and whilst I am not able to lift the weights I could before HT I see gains. Another improvement is that with no libido I am not distracted by females in the gym.

HT has been the biggest SE for me but there are lots of tips on here and people much more experienced than me that can help.

I wish you every luck with your treatment.

Reg