Brachytherapy - Long term side effect?

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Twoyearsplus
New Member


Date Joined Jun 2009
Total Posts : 5
   Posted 6/15/2009 12:49 PM (GMT -6)   
I had brachtherapy treatment in Jan 07. My current PSA is .4 and I do not have a bladder or urinary tract infection. However, for the past two months, when I urinate, it burns at the beginning...not during nor after. Is this a long-term side effect of brachytherapy? Are there any prescribed cures for this?

Tudpock18
Forum Moderator


Date Joined Sep 2008
Total Posts : 2583
   Posted 6/15/2009 3:28 PM (GMT -6)   

Dear TwoYears:

This should NOT be a long term SE of your brachytherapy.  Some patients do experience some urinary side effects in the months immediately following the procedure, but those should have subsided by now for you.

Obviously you should see your uro-doc (or another one) to see what is going on...

Tudpock


Age 62
Gleason 4 +3 = 7
T1C
PSA 4.2
2 of 16 cores cancerous
27cc
Brachytherapy December 9, 2008.  73 Iodine-125 seeds.  Procedure went great, catheter out before I went home, only minor discomfort.  Regular activities resumed, everything continues to function normally as of 6/1/09.  6 month PSA now at 1.4 and my docs are "delighted"!

Twoyearsplus
New Member


Date Joined Jun 2009
Total Posts : 5
   Posted 6/15/2009 3:57 PM (GMT -6)   
Tudpock,

Thanks for your reply. Yes, I have discussed this with my urologist
and we decided to monitor it for now. He's mostly convinced it's
due to brachytherapy treatment and will eventually calm down.
Why it's occuring 2+ years later is the question.
Plus, he doesn't wish to go back inside and investigate for fear of
causing some other problem.

I just wanted to check with people like yourself and others who
ma have experienced the same thing and found a cure with
something other than Advil and warm baths.

Thanks again

Tudpock18
Forum Moderator


Date Joined Sep 2008
Total Posts : 2583
   Posted 6/16/2009 6:51 AM (GMT -6)   

Dear TwoYears:

After Googling "brachytherapy and burning urination", I could not find ONE site that suggested that this SE could manifest itself as long as two years after initial treatment.  I'm not saying your uro is wrong, but this just does not make sense.  Brachytherapy burning is usually an artifact of the radioactivity in your body.  After two years, that has been dissipated for some time.

There are many causes for burning urination (Google it and see) and it is unlikely that 2+ year post-seed treatment is one of them.  Since this has been going on for two months and your doc just wants you to wait, if I were you I would seek a second opinion.

Tudpock


Age 62
Gleason 4 +3 = 7
T1C
PSA 4.2
2 of 16 cores cancerous
27cc
Brachytherapy December 9, 2008.  73 Iodine-125 seeds.  Procedure went great, catheter out before I went home, only minor discomfort.  Regular activities resumed, everything continues to function normally as of 6/1/09.  6 month PSA now at 1.4 and my docs are "delighted"!

Hopeful in MD
Regular Member


Date Joined Apr 2009
Total Posts : 66
   Posted 6/17/2009 10:55 PM (GMT -6)   
Hi Two Years,

I had seed implants in Jan. 2008 and had burning in the penis and extending like a wire into the rectum off and on until about a month ago. Was it from the seeds? I don't know, but I was told by one urologist (not mine) that it was from the seeds. Like you, the burning was just at the beginning of urination. There is a med, Pyridium (sp?) that can be used to help. However, it did not help me much so I just put up with the burning, which has now disappeared. Hopefully yours will disappear soon as well. In the meantime, maybe the Pyridium or even an anti-biotic (Cipro?) might be in order. Good luck.
Hopeful in MD
Age 69.
Dx Dec 07. PSA 8.4. DRE confirmed tumor. Three of six biopsies positive. Gleason: 6 (3+3). Seed implants Iodine 125 Jan 08. PSA's 3.9, 1.7 after implants. Then rising PSA's: 2.3, 3.4, 3.9, indicating that seed therapy not working. Dr's decided to begin hormone injection therapy with Lupron 30 MG ea. 4 mos. First injection Apr. 21, 2009. So far so good. Slight fever and aches 2nd day after shot. Buttock soreness 2-3 days. Walking helped. Waiting for hot flashes etc. Hope they will be mild.  June - hot flashes vary in frequency and intensity but not a serious problem.  Feeling a lot of fatigue - not sure of cause.  Oncologist says that Lupron should not be the cause.  I wonder. 
 
Saw radiation oncologist Jun 17.  DRE negative for nodules - hooray!  He said that new guidelines  (believe contained in recent Urology journal - name unknown) call for 3 years of Lupron therapy instead of the previous protocol of 2 years  before stopping it.  Will check this out with my urologist next visit in Aug.
 
Began seeing psychologist Jun 4 for anxiety and depression (maybe from Lupron?).  Anxiety caused primarily by serious IBS (irritable bowel probs).  Doctor is using hypno-therapy for the IBS - talk therapy for anxiety on alternating weeks for each.  Also started Celexa for anti-anxiety / anti-depressant.  Think I made a smart decision to get help.  Recommend any of you who have difficulty coping with PC or other chronic conditions etc. get professional help.  For me, it is worth it.


Twoyearsplus
New Member


Date Joined Jun 2009
Total Posts : 5
   Posted 6/17/2009 11:18 PM (GMT -6)   
Hopeful in MD,

Thanks for your reply. I tried Cipro in April...no relief. My urine test revealed
no urinary tract or bladder infections.

I talked to the doctor who did my BT...he agreed with my urologist's
suggestion to 'wait and see.' I'll do that and also look into your
suggestion regarding Pyridium.

Take care.

Twoyears

Spectre
New Member


Date Joined Jun 2009
Total Posts : 6
   Posted 6/18/2009 1:57 AM (GMT -6)   
My uro and oncologist both warned me off acidic drinks, especially red wine!? (Always, everything in moderation ;p)
Age at Diagnosis: 58 PSA: 5.92 (05/03/09)
Bone Scan: 14/04/09 Negative
Biopsy: 4 cores positive Right Quad CS = T1c
Gleason: 2+3=5 Volume: 24.6ml
Brachytherapy: 22/05/09


Twoyearsplus
New Member


Date Joined Jun 2009
Total Posts : 5
   Posted 6/18/2009 2:12 AM (GMT -6)   
Spectre,

Your correct...I've pretty much eliminated acidic drinks from my diet. One
thing I am doing is taking wheat grass, flax seed oil and an herbal
concoction from an Chinese herbalist and accupuncturist...cleanses the
liver and colon.

What's your doctor say about tea? I do drink a lot during the day as a
substitute for coffee...gone for three years.

Thanks for your input.

Twoyearsplus

Spectre
New Member


Date Joined Jun 2009
Total Posts : 6
   Posted 6/20/2009 11:41 AM (GMT -6)   
Tea and coffee were also listed as 'culprits', however caffine-free herbal teas are apparently OK.
I had a post-brachy check-up a few days ago and my onco said the burning sensation could come and go for quite some time and was entirely dependent on the individual.
Age at Diagnosis: 58 PSA: 5.92 (05/03/09)
Bone Scan: 14/04/09 Negative
Biopsy: 4 cores positive Right Quad CS = T1c
Gleason: 2+3=5 Volume: 24.6ml
Brachytherapy: 22/05/09 59 Seeds
Post-brachy CAT Scan: 18/06/09 Clean


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 23847
   Posted 6/20/2009 12:00 PM (GMT -6)   
The pyridium med can be had as a generic, and is cheap to buy. It worked well for me when I had the burning issue (non seed related). I still have a bottle on the shelf just in case.
Age 56, 56 at DX, PSA 7/7 5.8, 7/8 12.3,9/8 14.5
3rd Biopsy Sept 08: Positive 7 of 7 cores, 40-90%, Gleason 7, 4+3
Open RP surgery 11/14/8, Right nerves spared, 4 days hospital, staples out 11/24/8, 5th cath out on 1/19/9
Post-surgery Pathlogy Report:Gleason 3+4=7, pT2c, 42 grm, tumor 20%, Contained in capsular, clear margins, clear lymph nodes 
First PSA Post Surgery   2/9 .05, 5/9 .10 doubled in 3 months, new test in six weeks, then possibly off for salvage radiation
 
 


Twoyearsplus
New Member


Date Joined Jun 2009
Total Posts : 5
   Posted 6/20/2009 12:57 PM (GMT -6)   
Purgatory,

Thanks for the input on Pyridium. I'm tracking it down today and hoping
for the best...the pharmacist should know.

Twoyearsplus

RobertMcC
New Member


Date Joined Oct 2013
Total Posts : 2
   Posted 10/30/2013 11:22 PM (GMT -6)   
I realize these posts are old, but I have just come upon them. I too have had on again off again burning sensation in my penis just at the beginning of urination. I had seed implants 15 months ago. I had this sensation for awhile after the implants, then eventually it went away. But it has come back again. I too believe it is a long term side effect from the seed implants but haven't seen my urologist yet to confirm this. Has anybody found out anything new on their situation or this topic since these posts were first written? I would be interested to hear about it if you have. Thanks.

F8
Veteran Member


Date Joined Feb 2010
Total Posts : 3177
   Posted 10/31/2013 12:51 AM (GMT -6)   
could be the beginning of radiation cystitis which for me came on like a UTI and later I starting passing clots of blood.  this began for me about two years after treatment and persisted for a few months but has been completely gone for more than a year. 
 
ed
 
 
age: 58
12/09 -- PSA 6.8
G7 -- 3+4 (12-12 cores pos)
HT, BT and IGRT
9/11/13 -- 3-year post treatment PSA 0.2
(PSAs .2, .3, .2, .3, .2, .1, .2)

John T
Veteran Member


Date Joined Nov 2008
Total Posts : 3620
   Posted 10/31/2013 10:54 AM (GMT -6)   
The most likely cause is radiation prostititis. I had a flare up after a year of no symptoms that lasted a few weeks. RO prescribed FlowMax and all symptoms disappeared in a few days and have never returned.
JT
68 years old, rising psa for 10 years from 4 to 40; 12 biopsies and MRIS all negative. Oct 2009 DXed with G6 <5%. Color Doppler biopsy found 2.5 cm G4+3. Combidex clear. Seeds and IMRT, 4 weeks of urinary frequency and urgency; no side affects since then. 4 years of psa's all at 0.1.

RobertMcC
New Member


Date Joined Oct 2013
Total Posts : 2
   Posted 11/6/2013 6:28 PM (GMT -6)   
As a follow up to my recent posts.....As some have suggested, it is not uncommon with in the first two years for men to experience a "rebound" sensation of burning/aching when first beginning to urinate (which was a common side effect post implants). I saw my urologist yesterday and told him 15 months later, I was experiencing this sensation again. He said it is common and will happen once or twice over 2 years after implants and not happen again. Some thing to do with injury to the urethra caused by the radiation.

jct2011
New Member


Date Joined Sep 2011
Total Posts : 15
   Posted 1/1/2014 10:20 AM (GMT -6)   
Hello All,

Have not been here in awhile. New symptoms brought me back.

Had BT in December 2011. Had typical short term effects which went away after a month.

My PSA's since then have averaged .40 with one 2.0 spike.

In the last few months have experienced buring urination, frequency, urgency, sore testicles.

My Urologist did a CT scan, check for infection and prescribed Uribel, Flomax and Baclofen. Wants to do a Cystocopy to take a look. He says these symptoms are not unusual and usually go away on their own.

Anyone else experience these symptoms?

Also had blood in stool recently and the Doctor found vascular malformation due to radiation. He cauterized it and have been OK since then.

Thanks in advance for your thoughts and replies.

Happy? New Year!

John

GOP
Regular Member


Date Joined Dec 2010
Total Posts : 438
   Posted 1/1/2014 12:10 PM (GMT -6)   
Twoyears, I'm working on 5 years and have never had what you describe. Hopefully it is something very simple.
Diagnosed in October, 08. One sample of needle biopsy showed Gl 6. Watchful waiting for 18 months. PSA went fro 4.3 to 6.1. Surgery scared the heck out of me. Had a mapping biopsy where 60 samples are taken. 15 were GL6, 1 was GL7. Had LDR brachy on 10/ 4, 2010
First PSA post brachy on Jan. 6: 0.24
7/ 7, '11: PSA: 0.20
1/ 5, '12: PSA: 0.25
7/ 7, '12: PSA: 0.2
1/ 7, '13: PSA: 0.1
7/5, 13: PSA: 0.1

Tall Allen
Veteran Member


Date Joined Jul 2012
Total Posts : 1752
   Posted 1/2/2014 12:18 PM (GMT -6)   
John,

It's very common with brachy to experience a late term urinary flare like you describe. Almost half the guys who have seeds will experience such a flare within 5 years (median 2 years). The good news is it's typically transient. Let your Uro know if those meds aren't doing the trick. There are a host of available meds and some work better with some guys than others. Doctors usually get free samples from the drug companies that the patients can try for free.

- Allen

Jax47
New Member


Date Joined May 2014
Total Posts : 1
   Posted 5/4/2014 5:23 PM (GMT -6)   
Just like to drop in a line about the urinary tract discomfort.
Two years after my brachytherapy I was complaining about severe burning pain and urinating urgency.
Was tested for UTI and found to be negative.
Next step was cystoscopy and was diagnosed with inflammation of the bladder wall and urinary tract.
Thereafter was prescribed a sustained release anti-inflammatory (Proxen SR 750) for 1 month and all cleared up.
So far so good.
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