I'm interested in conversations about and I want to talk about
Know exactly what you want?
Show search

Notification

Error

Oncologists Plan

User
Posted 24 Jan 2025 at 10:38

I had my 1st appointment with an Oncologist this week. He told my cancer is high risk, I think classified as T3b.

I am on HT, then after about 3 months he wants me to have 23 EBRT sessions followed straight afterwards by HDR Brachytherapy. It is the Brachytherapy that troubles me, he told me that I would spend 2 nights in Hospital, the HDR Brachytherapy would consist of 2 treatments under a local anesthetic. 

It is the multiple Brachytherapy sessions that trouble me, having to lie still in an uncomfortable position with the needles/tubes inserted into my prostrate for hours on end, this includes approximately 6 hours between treatments, is this correct?

Has anyone else had experience of multiple HDR Brachytherapy treatments? I would like to read how they faired.

Thank you for any information.

User
Posted 24 Jan 2025 at 12:58

Hi Del 

I'm sorry that you've had to join the club but welcome to the forum mate.

I'm afraid I can't help you with brachytherapy but there are blokes on here that have had the treatment. Someone will pop along and help.

Your T3b is a cancer staging, not how aggressive your cancer is, that is indicated by your Gleason score. I believe your cancer staging means that unfortunately it has spread to your seminal vesicles, but there are a few blokes on here with the same staging who are doing fine.

Best of luck mate. 👍

User
Posted 24 Jan 2025 at 21:55

Your treatment is known as HDR Boost, a very good treatment for high risk T2 or T3 disease. I also had this treatment, 23 fractions (sessions) of external beam and 1 fraction of HDR Brachy. You seem to be having 2 fractions of HDR brachy - different hospitals do have different protocols. Mine did 2 fractions of HDR when it's being used as a monotherapy (without the external beam), in which case they do one late afternoon and the other the following morning, and you have to remain on your back in bed in between with the tubes in place. Even for my treatment, I had to lay still from about 9am when the brachytherapy tubes were inserted, until about 5pm when the brachy treatment was done, which included some trips to MRI and CT scanners to record accurately where the tubes were. This was not too onerous. It wasn't painful, although I could feel it (minor discomfort) and they did offer pain killers if necessary. I had paracetomol when the tubes were inserted (with anesthetic), and another paracetomol around mid afternoon. They gave me co codamol to take home, but I never needed it.

A treatment option I had was to include the pelvic lymph nodes in the external beam treatment, or not. There was no evidence of cancer in them, but that's where it would probably go next, and if there were micro-mets there already, they wouldn't show on scans. I opted to have the pelvic lymph nodes included, which is done at a lower dose (46Gy) when there's no evidence of spread to them.

We also did 2 nights in hospital - going in the evening before to be checked by the junior doctors. Brachtherapy tubes inserted first thing next morning under anesthetic. Then off to imaging for MRI and CT scans for medical physics to work out the dosing schedule. When the dosing schedule is ready, another MRI just before the treatment in late afternoon to make sure none of the tubes have moved, and then straight into the brachy suite for the actual treatment. Then they whip out the tubes and continually flush your bladder overnight through the catheter, and go home in the morning after removing the catheter and demonstrating you can pee.

I'm not sure why you need two lots of local anesthetic. It's the insertion of the brachytherapy tubes which is done under anesthetic. The bachytherapy treatment isn't painful. There's a tiny wince when they pull the tubes out, but I think that only took about 3 seconds.

There was nothing painful.

User
Posted 25 Jan 2025 at 00:36

I had 1 fraction of HDR brachy, and 15 fractions of EBRT. I was treated at the Christie in Manchester. My treatment was completely different to Andy's. I arrived about 7:30 and was shown to a very nice private ward where I waited for about an hour. Then someone came along and said "Oh, that's where you are" and they took me to a more crowded NHS ward. I have to say as they do this treatment all the time it seems odd that they couldn't check me into the correct ward.

Anyway, prep for the procedure, measure blood pressure, questions about health, enema all took about an hour. At about 11:00 I was taken to "theatre" and given general anaesthetic. I was in the recovery suite about 17:00 with a catheter in. I assume that all the things Andy described happened to me under GA, I was aware of none of it. I was in for one night and discharged about 18:00 the following day.

I guess it depends on what hospital you are at, but as far as I was concerned HDR brachy is no big deal at all.

Dave

Show Most Thanked Posts
User
Posted 24 Jan 2025 at 12:58

Hi Del 

I'm sorry that you've had to join the club but welcome to the forum mate.

I'm afraid I can't help you with brachytherapy but there are blokes on here that have had the treatment. Someone will pop along and help.

Your T3b is a cancer staging, not how aggressive your cancer is, that is indicated by your Gleason score. I believe your cancer staging means that unfortunately it has spread to your seminal vesicles, but there are a few blokes on here with the same staging who are doing fine.

Best of luck mate. 👍

User
Posted 24 Jan 2025 at 15:00

Adrian56,

Thanks for your reply.

The MRI result was that I had a PiRADs 5 lesion which had spread just outside the prostrate and had gone into the seminal vesicles, my PSA was 18.7. I knew I had cancer before the Biopsy and it was another 3 weeks after the Biopsy when it was finally confirmed by the Urologist.

I wasn't given a Gleason score, only that the cancer was Intermediate, with 16 Biopsy samples showing cancer cells out of 22 samples taken. It was my Son-in-Law who came with me heard him say T3b, I must have missed it.

I've had a bone scan and that did not show any cancer in my bones or in the lymph nodes.

One thing I learned is that the Radioisotope Bone Scan shows up Arthritis, which I have in my right knee.

del1949.

User
Posted 24 Jan 2025 at 21:55

Your treatment is known as HDR Boost, a very good treatment for high risk T2 or T3 disease. I also had this treatment, 23 fractions (sessions) of external beam and 1 fraction of HDR Brachy. You seem to be having 2 fractions of HDR brachy - different hospitals do have different protocols. Mine did 2 fractions of HDR when it's being used as a monotherapy (without the external beam), in which case they do one late afternoon and the other the following morning, and you have to remain on your back in bed in between with the tubes in place. Even for my treatment, I had to lay still from about 9am when the brachytherapy tubes were inserted, until about 5pm when the brachy treatment was done, which included some trips to MRI and CT scanners to record accurately where the tubes were. This was not too onerous. It wasn't painful, although I could feel it (minor discomfort) and they did offer pain killers if necessary. I had paracetomol when the tubes were inserted (with anesthetic), and another paracetomol around mid afternoon. They gave me co codamol to take home, but I never needed it.

A treatment option I had was to include the pelvic lymph nodes in the external beam treatment, or not. There was no evidence of cancer in them, but that's where it would probably go next, and if there were micro-mets there already, they wouldn't show on scans. I opted to have the pelvic lymph nodes included, which is done at a lower dose (46Gy) when there's no evidence of spread to them.

We also did 2 nights in hospital - going in the evening before to be checked by the junior doctors. Brachtherapy tubes inserted first thing next morning under anesthetic. Then off to imaging for MRI and CT scans for medical physics to work out the dosing schedule. When the dosing schedule is ready, another MRI just before the treatment in late afternoon to make sure none of the tubes have moved, and then straight into the brachy suite for the actual treatment. Then they whip out the tubes and continually flush your bladder overnight through the catheter, and go home in the morning after removing the catheter and demonstrating you can pee.

I'm not sure why you need two lots of local anesthetic. It's the insertion of the brachytherapy tubes which is done under anesthetic. The bachytherapy treatment isn't painful. There's a tiny wince when they pull the tubes out, but I think that only took about 3 seconds.

There was nothing painful.

User
Posted 25 Jan 2025 at 00:36

I had 1 fraction of HDR brachy, and 15 fractions of EBRT. I was treated at the Christie in Manchester. My treatment was completely different to Andy's. I arrived about 7:30 and was shown to a very nice private ward where I waited for about an hour. Then someone came along and said "Oh, that's where you are" and they took me to a more crowded NHS ward. I have to say as they do this treatment all the time it seems odd that they couldn't check me into the correct ward.

Anyway, prep for the procedure, measure blood pressure, questions about health, enema all took about an hour. At about 11:00 I was taken to "theatre" and given general anaesthetic. I was in the recovery suite about 17:00 with a catheter in. I assume that all the things Andy described happened to me under GA, I was aware of none of it. I was in for one night and discharged about 18:00 the following day.

I guess it depends on what hospital you are at, but as far as I was concerned HDR brachy is no big deal at all.

Dave

User
Posted 25 Jan 2025 at 09:25

Andy 62,

Many thanks for the reply and the information. I was talking to my son-in-law last night who came with me to the oncologist appointment, good job he did.

I have got it wrong with the Brachytherapy, he tells me I'm having 1 treatment, not 2. I don't know how I got that in my stupid head!!!

The information on your Brachytherapy treatment is really appreciated.

del1949

 
Forum Jump  
©2025 Prostate Cancer UK