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My LDR Brachytherapy Story

User
Posted 28 Jul 2021 at 18:59

I am 64 and was diagnosed with PC at the end of last year after having a health check through my employer in the October. My PSA came back as 10.23. I passed on the info to my GP who organised another test which came back as 8.4. As a result my case was passed on to the Urology Dept of the Royal Surrey County Hospital under the two week rule.

A couple of weeks later I was called in for an MRI scan. At the post-MRI consultation they said there was nothing abnormal but they would still have to find out why my PSA was high and I could either have a biopsy under a local anesthetic now or come back next week for one under a general. I opted for the local. It was a little uncomfortable during the procedure and afterwards for a couple of days, but nothing that would stop me having it again under a local. For the best part of a week you will be peeing blood as things heal. At this time they also did a flow test, the results of which was my urine flow was too low for Brachy.

On the 22th Dec I got the results of the biopsy in a telephone consultation. Out of the 22 samples taken 8 came back positive with a Gleason score of (3+4) 7. The doctor said I had three options prostectomy, radiotherapy or Brachytherapy which did I want to go for? I said it was rather a lot to take in right now and I would like to think about it. They said that there was no rush the make a decision at this stage and they would arrange a Brachy team Consultation.

My details were

  1. PSA 8.4, MRI 40cc, PIRAD 3 changes bilaterally
  2. Template biopsy Gleason 3+4, 8/22 cores, max length 9mm

Before the consultation the Brachy Centre sent me an information pack with booklets on PC and the various treatments, a more detailed booklet on the Brachy procedure and a DVD where 3 patients discussed their Brachy experience. Funnily enough I vaguely knew one of these people. So I made contact with him for more info.

The booklets are available for download here:

http://prostatebrachytherapycentre.com/Booklets-and-questionnaires/

I had the Brachy consultation in January where the pro and cons of Brachy treatment was discussed. there was another flow test carried and it was still too low. The nurse also carried out a digit check and said they could feel a tumour and  I was Grade 2, T Stage 2A. They also did an ultrasound on my bladder and confirmed that my Prostate has enlarged into my bladder which was restricting flow. If I went for the Brachy procedure they would carry out a mini-TURP to improve my flow.

At this consultation I said I was finding it difficult to make a decision on my treatment options as I favoured Brachytherapy and my wife wanted me to have surgery. I didn’t fancy the surgery route as I was concerned about possible long term continence problems. The Brachy team were very understanding and they said I still had a few months to make a decision. After much research both on this site and elsewhere I decided on Brachy treatment but within a couple of days the uncertainty returned, was I making the right choice?  After a day or so I said ‘right - Brachytherapy it is and I am not going to read any more articles on the subject of PC treatment’.  On 10 February I emailed the Guildford Prostate Brachytherapy Centre with my decision. 

On the 3 March I was admitted for the mini-TURP and an overnight stay. I had the surgery in the morning and came round about 11:00 with a double catheter in me. One feeding in a saline solution to flush the wound and the other to drain my bladder. I was told to drink plenty of fluid to get the colour of the contents of my catheter bag to change from Burgandy to a light rosé! The catheters came out the following afternoon after my outflow was clear. Withdrawing the catheter was uncomfortable but nothing compared to the first few pees which were like peeing glass. Before I could be discharged I had to be able to empty my bladder. After each pee they ultrasounded my bladder to to see what was left in there. I was finally discharged about 5 o’clock. 

Naturally they can’t perform the Brachy treatment until your prostate has recovered from the mini-TURP which takes about 6 weeks. Once the post catheter soreness had worn off I found I was peeing like a 20 year old again! There was the occasional shock to begin with when after days of clear urine you suddenly find yourself peeing blood again for a couple of pees as the scab comes off, then it all returns to normal.

After about 4 weeks I had a further consultation to discuss the procedure in detail, sign the paperwork and another flow test. The nurse said my flow test result will probably the best she sees all day!

On the morning of 14 May I was admitted for the Brachy treatment under a general. All told this procedure took about 3 hours and this includes a CT scan to ensure the 92 seeds are in the correct place. Once again you wake up with a catheter in (a single this time) and after the CT scan you are placed on a short stay ward.

My catheter was removed at midnight and once again they had to make sure I was voiding my bladder before discharge. This time there was no discomfort peeing.I was released a 08:00 the following day.

Once back home there were no issues until 3 weeks later when I felt a tender area on the left hand side of my groin. I rang the clinic and the nurse said this was due to the prostate getting inflamed by the radiation. She said as you can’t feel your prostate  prostate irritation can manifest itself anywhere in the area around it. Sometimes the tip of the penis. She said just take 400 mg of Ibubrofen 3 times day for a month. This I did and have had no further problems.

The only other side effect I've noticed is that my stools are a lot softer and I have to go to the loo within an hour of getting up in the morning.

Last Friday I had my first post procedure PSA test which came back as 1.73. I will have 3 further PSA tests this year and 2 a year for the next 4 years.

I hope my experience helps someone.

Edited by member 06 Aug 2021 at 17:34  | Reason: Correct typos and add info.

User
Posted 28 Jul 2021 at 18:59

I am 64 and was diagnosed with PC at the end of last year after having a health check through my employer in the October. My PSA came back as 10.23. I passed on the info to my GP who organised another test which came back as 8.4. As a result my case was passed on to the Urology Dept of the Royal Surrey County Hospital under the two week rule.

A couple of weeks later I was called in for an MRI scan. At the post-MRI consultation they said there was nothing abnormal but they would still have to find out why my PSA was high and I could either have a biopsy under a local anesthetic now or come back next week for one under a general. I opted for the local. It was a little uncomfortable during the procedure and afterwards for a couple of days, but nothing that would stop me having it again under a local. For the best part of a week you will be peeing blood as things heal. At this time they also did a flow test, the results of which was my urine flow was too low for Brachy.

On the 22th Dec I got the results of the biopsy in a telephone consultation. Out of the 22 samples taken 8 came back positive with a Gleason score of (3+4) 7. The doctor said I had three options prostectomy, radiotherapy or Brachytherapy which did I want to go for? I said it was rather a lot to take in right now and I would like to think about it. They said that there was no rush the make a decision at this stage and they would arrange a Brachy team Consultation.

My details were

  1. PSA 8.4, MRI 40cc, PIRAD 3 changes bilaterally
  2. Template biopsy Gleason 3+4, 8/22 cores, max length 9mm

Before the consultation the Brachy Centre sent me an information pack with booklets on PC and the various treatments, a more detailed booklet on the Brachy procedure and a DVD where 3 patients discussed their Brachy experience. Funnily enough I vaguely knew one of these people. So I made contact with him for more info.

The booklets are available for download here:

http://prostatebrachytherapycentre.com/Booklets-and-questionnaires/

I had the Brachy consultation in January where the pro and cons of Brachy treatment was discussed. there was another flow test carried and it was still too low. The nurse also carried out a digit check and said they could feel a tumour and  I was Grade 2, T Stage 2A. They also did an ultrasound on my bladder and confirmed that my Prostate has enlarged into my bladder which was restricting flow. If I went for the Brachy procedure they would carry out a mini-TURP to improve my flow.

At this consultation I said I was finding it difficult to make a decision on my treatment options as I favoured Brachytherapy and my wife wanted me to have surgery. I didn’t fancy the surgery route as I was concerned about possible long term continence problems. The Brachy team were very understanding and they said I still had a few months to make a decision. After much research both on this site and elsewhere I decided on Brachy treatment but within a couple of days the uncertainty returned, was I making the right choice?  After a day or so I said ‘right - Brachytherapy it is and I am not going to read any more articles on the subject of PC treatment’.  On 10 February I emailed the Guildford Prostate Brachytherapy Centre with my decision. 

On the 3 March I was admitted for the mini-TURP and an overnight stay. I had the surgery in the morning and came round about 11:00 with a double catheter in me. One feeding in a saline solution to flush the wound and the other to drain my bladder. I was told to drink plenty of fluid to get the colour of the contents of my catheter bag to change from Burgandy to a light rosé! The catheters came out the following afternoon after my outflow was clear. Withdrawing the catheter was uncomfortable but nothing compared to the first few pees which were like peeing glass. Before I could be discharged I had to be able to empty my bladder. After each pee they ultrasounded my bladder to to see what was left in there. I was finally discharged about 5 o’clock. 

Naturally they can’t perform the Brachy treatment until your prostate has recovered from the mini-TURP which takes about 6 weeks. Once the post catheter soreness had worn off I found I was peeing like a 20 year old again! There was the occasional shock to begin with when after days of clear urine you suddenly find yourself peeing blood again for a couple of pees as the scab comes off, then it all returns to normal.

After about 4 weeks I had a further consultation to discuss the procedure in detail, sign the paperwork and another flow test. The nurse said my flow test result will probably the best she sees all day!

On the morning of 14 May I was admitted for the Brachy treatment under a general. All told this procedure took about 3 hours and this includes a CT scan to ensure the 92 seeds are in the correct place. Once again you wake up with a catheter in (a single this time) and after the CT scan you are placed on a short stay ward.

My catheter was removed at midnight and once again they had to make sure I was voiding my bladder before discharge. This time there was no discomfort peeing.I was released a 08:00 the following day.

Once back home there were no issues until 3 weeks later when I felt a tender area on the left hand side of my groin. I rang the clinic and the nurse said this was due to the prostate getting inflamed by the radiation. She said as you can’t feel your prostate  prostate irritation can manifest itself anywhere in the area around it. Sometimes the tip of the penis. She said just take 400 mg of Ibubrofen 3 times day for a month. This I did and have had no further problems.

The only other side effect I've noticed is that my stools are a lot softer and I have to go to the loo within an hour of getting up in the morning.

Last Friday I had my first post procedure PSA test which came back as 1.73. I will have 3 further PSA tests this year and 2 a year for the next 4 years.

I hope my experience helps someone.

Edited by member 06 Aug 2021 at 17:34  | Reason: Correct typos and add info.

User
Posted 22 Jun 2023 at 13:33
Update June '23 - Just received my latest PSA result two years after Brachytherapy - I am down to 0.308. When diagnosed I was 8.4 and the two previous readings taken before this on were 0.58.
User
Posted 28 Aug 2021 at 11:45

Hi Chas,

I'm not sure if the question was for me but i can tell you the Brachytherpy operation was a lot easier than i expected

I was taken to the Mount Vernon the day before my operation and put into a side ward in the ladies ward as i had to be isolated because of the radioactive seeds and was left for the night to think about the big day.

The next morning i was told the operation would be early afternoon so after a pre-med was wheeled into the theatre and remember nothing until i was back in recovery feeling ok and given a couple of pain killers and sent back to my room. I did not have a epidural or catheter and all i wanted was some food as starving.

The surgeon came in the following morning and was very happy with the results and said i could go home as soon as i was passing water ok and after i had filled or half filled 16 bottles that where lined up on my window sill to check for lost seeds i was sent home. I think in the early days you worry if you made the right decisions and only time will tell.

If you click on my Avatar you can see the full journey and i would be pleased to answer any questions you have before your operation.

John.

 

Edited by member 28 Aug 2021 at 11:46  | Reason: Not specified

User
Posted 22 Jun 2023 at 16:06
I haven't had any major problems.

About 12 months post procedure I had a routine bowel cancer screening and blood was found in my sample so I was booked in for a Colonoscopy. The result of this was that they found 'Radiation telangiectasia and pallor of mucosa anterior low rectum due to brachytherapy' it boils down to radiation burns that will heal. There was no bowel cancer.

Around this time I found I had soft stools and generally needed to go to the loo first thing in the morning, but I didn't have to rush to the loo or anything like that. Some time after visiting the loo and cleaning myself with toilet paper I found my bum was irritated. Cleaning my bum again I found there has been some leakage, not enough to mark my underwear but it irritated my skin. I could clean myself with soap and water but a couple of hours later my bum would be irritated again. I would them wash myself again and generally I would be OK until my next movement. I spoke to one of the nurses about this on the routine follow up and she said it was mucus leakage and prescribed Ispaghula Husk granules that you mix with water and take once or twice a day. I can't really say if they did any good as although I took the medication a few times things seemed to have sorted themselves out for the most part now.

I've had no problems with the water works or with 'Percy Filth' (you have to be a certain age to understand that). I used to have to get up at about 4 oc to go for a wee, this was the same before the diagnosis, but very recently I don't need to get up until about 7 oc.

Apologies if I have been too graphic and I hope it is of some benefit to others.

User
Posted 15 Aug 2023 at 19:27

You are welcome. I am pleased my post was of help. It was difficult decision to make initially on what treatment to choose, as one of the nurses said said at the time, normally it is the hospital that is telling you what treatment you are having. One this occasion it is down to the patient to make a decision that they feel comfortable with.

User
Posted 19 Jun 2024 at 08:06
I have just had my 3 yr PSA test and it is now down to 0.13.

The hospital is pleased with my progress and will drop from the 6 month follow up consultation period and now I will have one annually although I will have a further PSA test in 6 months.

The bowel problems I mentioned a year ago have now cleared up and i am back to normal.

User
Posted 19 Jun 2024 at 10:32

Hi ,

Good to see another Brachytherapy  going so well it will help other members with their choices.

I am coming up to eight years from brachytherapy in September and doing well.

John.

Show Most Thanked Posts
User
Posted 28 Jul 2021 at 21:53
Brilliant report VC and great PSA response.
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 28 Jul 2021 at 22:31

Yes, great report and great psa response. 

Dave

User
Posted 28 Jul 2021 at 23:56
Good news. Do let us know how things go over time.
Barry
User
Posted 29 Jul 2021 at 05:35

Hi VC,

Good results long may it last, I am coming up to 5 years after Brachytherpy in September and all good so far PSA 0.08 last September.

Its good to see more members having Brachytherapy as i was getting a bit lonely on here with nobody to compare results with, long may it last.

John.

User
Posted 28 Aug 2021 at 10:53

Hi - reading your experience as I am in a similar situation - am leaning towards brachytherapy -  but have been told I would have epidural and have to go twice in 7 days - how are you feeling now? all good I hope 

User
Posted 28 Aug 2021 at 11:45

Hi Chas,

I'm not sure if the question was for me but i can tell you the Brachytherpy operation was a lot easier than i expected

I was taken to the Mount Vernon the day before my operation and put into a side ward in the ladies ward as i had to be isolated because of the radioactive seeds and was left for the night to think about the big day.

The next morning i was told the operation would be early afternoon so after a pre-med was wheeled into the theatre and remember nothing until i was back in recovery feeling ok and given a couple of pain killers and sent back to my room. I did not have a epidural or catheter and all i wanted was some food as starving.

The surgeon came in the following morning and was very happy with the results and said i could go home as soon as i was passing water ok and after i had filled or half filled 16 bottles that where lined up on my window sill to check for lost seeds i was sent home. I think in the early days you worry if you made the right decisions and only time will tell.

If you click on my Avatar you can see the full journey and i would be pleased to answer any questions you have before your operation.

John.

 

Edited by member 28 Aug 2021 at 11:46  | Reason: Not specified

User
Posted 29 Aug 2021 at 20:18
Thank you John for your reply it is very helpful - I have not managed to find many men who have had this prosedure to find their personal views on it so was good to read yours - hope you are still doing well Chaz
User
Posted 30 Aug 2021 at 13:27

Hi Chaz

Thanks for your reply i hope it helps a little to make a decision I think i was leaning towards Brachytherapy at an early stage mainly because a friend of mine had the procedure a few years before and was in remission and i did have two choices, but unfortunately he died of a heart attack while on holiday so we will never know his end result.

Good luck with your decision and keep in touch with results.

John. 

User
Posted 31 Aug 2021 at 13:06

Hi Chaz ....

If you have not clicked on my avatar yet you will find a detailed account of my journey with LDR Brachytherapy - not a complete success unfortunately ....but there are subsequent treatments available and I haven't regretted the route I chose to take ... particularly at my age!!! 

Good luck with which ever treatment you choose and please keep us all on this site updated regularly

Regards

Tom    

User
Posted 01 Sep 2021 at 16:51

Hi my friend, just told the hospital consultant that I will have the HDR 2 times over 7 days, fingers crossed it goes well. 

User
Posted 01 Sep 2021 at 18:43

Good luck 🤞 Chaz we all must have faith in the choices we make... Please keep us all updated

Regards Tom

 

User
Posted 19 Nov 2021 at 16:13

First, sorry I didn't see your post Chaz654. Good luck with your procedure.

This week I have had my second (6 month) PSA test since having the Brachytherapy and my PSA is now 1.25. To save you scrolling back I was originally 8.4, 3 months after the procedure I was 1.75

Edited by member 19 Nov 2021 at 16:30  | Reason: Correct typo

User
Posted 19 Nov 2021 at 16:27

Thanks for the information my friend, that sounds great, I've had 2 doses of HDR in the last couple of weeks & now trying to recover, getting my results 23 December 🙏

User
Posted 21 Nov 2021 at 10:44

Hi Paul - thank you for your reply -  you gave  info about a couple of things  that I was concerned about - I had 2nd brachytherapy treatment on 10th November - still in a little discomfort but getting easier! - won't have any PSA results until 23rd December fingers crossed all will be good - many thanks Chaz 

User
Posted 27 May 2022 at 15:00
12 months on from Brachytherapy my PSA is now 0.59.
User
Posted 27 May 2022 at 18:29

Great news VC. A long steady fall. I guess it will level off at about 18 months post treatment.

Dave

User
Posted 27 May 2022 at 18:59
Very encouraging!
Barry
User
Posted 22 Jun 2023 at 13:33
Update June '23 - Just received my latest PSA result two years after Brachytherapy - I am down to 0.308. When diagnosed I was 8.4 and the two previous readings taken before this on were 0.58.
User
Posted 22 Jun 2023 at 14:38
Really good news in respect of PSA indicator.. I am sure it would be of interest if you would be prepared to say, the extent of any downsides you have been left with following the procedure as it was quite some time ago.
Barry
User
Posted 22 Jun 2023 at 16:06
I haven't had any major problems.

About 12 months post procedure I had a routine bowel cancer screening and blood was found in my sample so I was booked in for a Colonoscopy. The result of this was that they found 'Radiation telangiectasia and pallor of mucosa anterior low rectum due to brachytherapy' it boils down to radiation burns that will heal. There was no bowel cancer.

Around this time I found I had soft stools and generally needed to go to the loo first thing in the morning, but I didn't have to rush to the loo or anything like that. Some time after visiting the loo and cleaning myself with toilet paper I found my bum was irritated. Cleaning my bum again I found there has been some leakage, not enough to mark my underwear but it irritated my skin. I could clean myself with soap and water but a couple of hours later my bum would be irritated again. I would them wash myself again and generally I would be OK until my next movement. I spoke to one of the nurses about this on the routine follow up and she said it was mucus leakage and prescribed Ispaghula Husk granules that you mix with water and take once or twice a day. I can't really say if they did any good as although I took the medication a few times things seemed to have sorted themselves out for the most part now.

I've had no problems with the water works or with 'Percy Filth' (you have to be a certain age to understand that). I used to have to get up at about 4 oc to go for a wee, this was the same before the diagnosis, but very recently I don't need to get up until about 7 oc.

Apologies if I have been too graphic and I hope it is of some benefit to others.

User
Posted 03 Aug 2023 at 11:46

This has been a really helpful post.  I am in a similar situation and was leaning towards Brachy.  The post and replies have helped me opt for this option.

Thank you for sharing.

User
Posted 15 Aug 2023 at 19:27

You are welcome. I am pleased my post was of help. It was difficult decision to make initially on what treatment to choose, as one of the nurses said said at the time, normally it is the hospital that is telling you what treatment you are having. One this occasion it is down to the patient to make a decision that they feel comfortable with.

User
Posted 19 Jun 2024 at 08:06
I have just had my 3 yr PSA test and it is now down to 0.13.

The hospital is pleased with my progress and will drop from the 6 month follow up consultation period and now I will have one annually although I will have a further PSA test in 6 months.

The bowel problems I mentioned a year ago have now cleared up and i am back to normal.

User
Posted 19 Jun 2024 at 10:32

Hi ,

Good to see another Brachytherapy  going so well it will help other members with their choices.

I am coming up to eight years from brachytherapy in September and doing well.

John.

User
Posted 20 Jun 2024 at 16:48
Continuing to sound extremely positive VC, congratulations!
User
Posted 19 Oct 2024 at 19:53
Last of week I found blood in my urine, I had no pain or any discomfort. I contacted my Brachy nurse who said it was probably my prostate bleeding but to go through my GP who she said would check for any UTI's and take bloods for tests. She also said blood in the urine is taken seriously and there is a NHS fast track investigation that consists of a CT scan of my kidneys down and also a flexible cystoscopy to check my urethra and the inside of my bladder.

The bleeding stopped after 4 days and started again Thursday. Just to reassure you it is not major bleeding just a light rose colour.

The test results came back after a couple of days and were all OK. My PSA was 0.114

Yesterday I had the CT Scan and cystoscopy. There were no problems on the CT scan and the cystoscopy confirmed the blood was coming from my Prostate, the bladder was OK. The doctor said that Brachy treatment can weaken the walls of blood vessels in the prostate. If it becomes a problem they can cauterise the vessels.

 
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