RT + LDR Brachytherapy

Hi and welcome to the club.

My prostate cancer was picked up on a private medical for the renewal of my 7.5 ton driving licence in April 2016 with PSA 2.19 and Gleason 3+4 =7.I was offered robotic surgery at my first meeting but i asked to speak to another specialist about the options of Brachytherapy. I joined this site and asked questions and read up on both options and i felt that Brachytherapy had lesser side affects than robotic surgery.

The Brachytherapy was an easy procedure in and out over two days with little pain just pain killers if i needed them. I had PSA tests every three months for a year and as it was dropping at a good rate i later went over to yearly ones. I am seven years on and was signed off in 2020.If you click on my Avatar you can see my journey so far.

John.

Edited by member 04 Jan 2024 at 16:59  | Reason: change end date

Hi Goose,

I think John had LOW DOSE Brachy given that he had low-intermediate cancer at diagnosis. You would be getting I think the HIGH DOSE brachy which is delivered over a much shorter term and more potent given that your cancer is at a more advanced state.

Hope that helps.

Edited by member 04 Jan 2024 at 15:49  | Reason: Not specified

Hi Gooose, 

I’ve just come home today from having HDR brachytherapy and I saw your post and thought I’d reply 😬. The whole procedure was done whilst I was put out with the fairies - I actually really appreciated and enjoyed an excellent rare and uninterrupted sleep under the anaesthetic.
I’m T3A N1 M0, Gleason 4&3, PSA 9.1 in May 2023 down to 0.34 in Nov. I think they decided to throw the kitchen sink at mine as I’ve been on HT (bicalutamide followed by Prostap) for 6 months and will continue for 3 years. I’ve also had 6x3 weekly chemo (docetaxel). 
Followed by RT which is the only treatment where I was offered options either HDR Brachy followed in 2 weeks time by 4 x 5 days EBRT or EBRT on it’s own. I treated it as a personal choice based on all the facts and advice I could get. My approach is to be ‘in for a penny in for a pound’, the HDR Brachy made a lot of sense in terms of how effective it appears to be. I also accept that the list of side effects from all these things is hugely impacting i.e. none of the treatments offer ‘no risk of side effects’. Strangely, it is the hot sweats from HT at night that I’m currently suffering from most and they wake me up constantly affecting my quality of sleep big style - making me tired. Also wakes the wife up, she says it’s like being in bed with an oven.

Anyway, I found the brachy experience relatively straightforward, even the catheter bit of it was fine. I drunk several jugs of water and filled the bag several times over (a good experiment 😁) and I had a laugh with the nurses comparing the bag emptying tactics with that of Nana’s into the sink in the Royce Family. Worst bit though was being kept awake all night from the constant loud moans of one of the other patients on the ward, TBF he did seem to be in a lot of pain, I don’t think his was prostate. I was grateful that I remembered to equip myself with a fully charged IPod to blot out the noise. (Those nurses are saints to put up with all this 😊).

Good luck Gooose with your decision making and treatment.

Spongebob

I had RT [with HT] alone without brachy for a G9 with 3 local lymph nodes and 3 years later all is well. It might depend on the RT equipment and computer guidance systems available in your hospital to determine if RT without brachy would be a good option.

I haven't seen a discussion here on the topic of different RT equipment but LINACs seem to be the latest. In a way the RT is the tip of the iceberg in that these machines are backed by massive computer power, several back-room technicians and a raft of monitoring screens.

Technological advance has been very rapid for radiotherapy, so it's probably worth checking out what your hospital has in place.

Jules

Edited by member 05 Jan 2024 at 04:31  | Reason: Not specified

Well done buddy and good luck. 👍 

Edited by member 09 Jun 2024 at 15:16  | Reason: Typo

Well done.

The LDR brachy will still be treating - it takes 200 days for Iodine 125 to drop below the effective minimum treatment level, although because most of the dose is up-front due to the way radioactivity decays, at 150 days, you've had around 93% of the dose already.

At this stage, most of that low level is due to the hormone therapy. That masks the effect of the radiotherapy.

It will be around a year after you finish the hormone therapy that you will see the level due to the radiotherapy. It is unlikely to be that low, and you do expect a bit of a rise as your Testosterone comes back.