First a big thanks to this forum for guidance on the various issues/expectations for the decision making, especially Dramcf, JohnthePrint, LynEyre, Andy62 to name but a few. I think it’s only right that I reciprocate and document my experiences in case it might help others.
I was diagnosed Nov last year having visited the doctors due to nocturia. Aged 67, Psa 11, Gleason 4:3 with possible abutting tumour (T2/T3a). Fortunately, bone scan and lymph nodes were all clear. Very fit and active, ideal weight. More details in Profile.
Had the usual two choices, surgery or HT/EBRT which included LDR Brachy option as I met the criteria. After an agonising month in making the decision, I elected to go for the latter route as:
- Relatively non-invasive.
- Specialist nurse (at another hospital) felt that surgeons don’t always highlight side effects as much as they should, and felt the latter route “had the edge” in my situation.
- EBRT would extend treatment area to around the prostate region. I had read that some people had surgery and ended up requiring EBRT giving two sets of side effects to handle.
- Having the Brachy option as I understood adds another 8% or more in life expectancy after 10 years compared to straight EBRT. It also reduces the extent of EBRT side effects as I had 23 fractions compared to the normal 40.
I started the HT in Feb with the expected drop in libido, but fortunately no hot flushes or other issues. I was also pleased that treatment had also started and was stopping the growth in its tracks. Started on Tamsulosin to reduce nocturia- took a couple of weeks to take effect. I was so pleased all my diagnostic tests were completed prior to Covid as any delays in testing would have increased my anxiety. Just had the last 3-month injection which will make one year in all. Regular exercise and weight/ resistance band training which helped keep my weight the same.
Covid delayed the start of RT by 3 months but wasn’t an issue as the hospital updated my plans and kept to this. In October I had 23 fractions of the prostate and surrounding area (inc lymph nodes). This was ~ 8 months after starting the HT. As has been mentioned often here the main issue was holding a full bladder. Being only 10 mins drive from the hospital was a huge benefit. I did some “training” beforehand to make sure that I could hold 500mm water for 80 mins. As recommended here I took spare pants but didn’t need them, but it helped my confidence. Had some bowel issues which meant I had to go on a low fibre diet which solved the issue after a week. No urinary issues.
I then self-isolated for 2 weeks and as the Covid test was negative, had the brachy last week. I was very nervous as never had a General Anaesthetic before and now suffering from Atrial Fibulation that I thought might affect the Op. However, the chat with the anaesthetist beforehand allayed my concerns. Due to Covid they were only handling one Brachy per week, so I felt very fortunate that it was still going ahead.
I thought that the whole process was remarkable and having my own room for recovery was a welcome surprise. The staff were amazing! Found out that they had implanted 63 seeds making 115 greys adding to the 46 greys from the EBRT. Pretty powerful combination. I was pretty groggy from the Op, but soon improved. Consultant was very happy with the procedure. Catheter was removed after a couple of hrs. I managed to pass urine OK a couple of times and the Geiger counter confirmed no leakage of seeds. I left the hospital at 8pm, making ~12 hrs in all.
I had a very restless night the first night as had to go to the toilet about 7 or 8 times which I put the issue down to soreness from the catheter. Six nights on my urinary frequency is now around 3 times per night which I was expecting as the seeds begin their business for a few months. I suspect that it might get worse before it gets better…
Slight bruising soreness from the Op, but I have walked for an hour every day with no adverse effects. Aiming to play golf next week if I feel ok, though might only be for a part round.
I am very pleased with progress so far and full of admiration for the all of the NHS staff supporting me through the treatment. Scan in 5 weeks and chat with the consultant in 3 months to discuss the psa result.
In summary I’m very pleased with the whole process, especially having experienced minimal side effects. Just hope I’m as lucky with the outcome.