Brachytherapy Soon

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Tudpock18
Forum Moderator


Date Joined Sep 2008
Total Posts : 4085
   Posted 10/29/2008 7:52 PM (GMT -6)   
Hi All:
 
I will be having Brachytherapy in December.  I realize that most posters on this site are surgery survivors but I would sincerely appreciate advice from any recent brachy patients.  JustJulie's thread is great, but I'd like to know if there are guys (or wives) with other recent experience they would like to share.  I have read tons of stuff on the net as I did my research but this forum is great for first person experiences.
 
So...any commentary would be interesting, i.e. post-procedure recovery, urinary, bowel, ED side effects, etc., etc.  And, any post-procedure tips would be great.
 
Thanks!
 
Age 62
Gleason 4 +3 = 7
T1C
PSA 4.2
27cc
Brachytheraply volume study 11/14/08; brachytherapy to be scheduled in early December


RBinCountry
Regular Member


Date Joined Apr 2008
Total Posts : 270
   Posted 10/30/2008 7:00 AM (GMT -6)   
Hi Tudpock,
Your age (I will be 62 next week) and basic diagnosis is similar to mine. I don't know how many cores involved you had - I had 8 of 10. I am quite sure you have done your homework as far as examination of all the issues and I suppose that is what you are doing even now. Please don't think I am in any way questioning your judgment - I am not. I am curious though as to your reasoning for choosing brachy - everyone has their priorities, and everyone's situation is somewhat unique.

By the way, when I was struggling over what route to go, I was given the name of a CEO of a large corporation to phone and talk with as he had brachy 8 years before. This was obviously a very intelligent man who had done his homework. I did get through to him after going through several people and found him to be very open about his experience. He was about 5 years younger than I. He gave a generally positive report of his experience. His PC had been caught early. He said he had some flow problems but had worked through that with medications - he used viagra for ED and it worked for him. He was positive about his treatment, and no return of PC in 8 years.

As for me, I chose RRP because I was concerned the PC had gotten out of the capsule, and I wanted to know if it had (which is only through surgery), and be able to save radiation as a backup in case the surgery failed to get it all. For those who catch their cancer early (as the man I described above) it seems their is a good success rate from what I have read is similar to surgery.

I am sure in your study you will find that it is interesting, most people who have brachy have more residual problems with incontinence & ED later on (if they have problems), while surgery has its problems earlier (for some more than others) and surgery problems have more of a tendency to improve long term. I hope this is helpful.

Blessings.

RB

Age 61
Original data - pre-operation
PSA: 5.1
T1C clinical diagnosis, Needle biopsy - 10 cores, Gleason 7 = 3+4 in 1 core (40%), 7 cores Gleason 6 = 3+3 ranging from 5% to 12%
All scans negative
Lupron administered 4/9/2008 for 4 months (with idea I would undergo external beam radiation followed by seed implants - then I changed my mind).
Robotic DiVinci surgery - Dr. Fagin (Austin) May 19th
Post operative - pathology
pT2c NX MX
Gleason 3+4
Margins - negative
Extraprostatic extension - negative
seminal vesicle invasion - uninvolved
1st Post PSA <.04

JustJulie
Regular Member


Date Joined Mar 2006
Total Posts : 355
   Posted 10/30/2008 10:12 AM (GMT -6)   

Hello, JustJulie checking in!

I can tell you that my husband continues to make progress.  He's back to work full-time, back doing projects and coaching soccer.  He gets fatigued sometimes but I think it's more due to his work schedule than any brachytherapy side effects.  No flow or ED problems but he does keep some Levitra on hand if needed.

If you have any questions, let me know, I'd be happy to answer what I can.


Tudpock18
Forum Moderator


Date Joined Sep 2008
Total Posts : 4085
   Posted 10/30/2008 10:47 AM (GMT -6)   
Hi RP:

Thanks for your response, I appreciate your comments. In answer to your questions:

1. I had 2 of 16 cores positive.

2. I can understand your curiosity re my choice and, it was not an easy one. Certainly the points you make about the potential for radiation after surgery and the knowledge gathered from an immediate pathology report are good ones and ones that I considered carefully. But, for me, after tons of research, I think the chances for cure for me for either treatment are similar. So...it came down to the quality of life issues and I felt that the brachy side effects were better for me than the surgical ones. That quality of life conclusion was part science, referencing a recent NEJM study but also largely phychological.

Anyway, thanks again for your thoughts and response.
Age 62
Gleason 4 +3 = 7
T1C
PSA 4.2
27cc
Brachytheraply volume study 11/14/08; brachytherapy to be scheduled in early December


Tudpock18
Forum Moderator


Date Joined Sep 2008
Total Posts : 4085
   Posted 10/30/2008 10:50 AM (GMT -6)   

Hi Julie:

It was very nice to hear from you.  Your journal posting and the commentary on your threads have already been more helpful than you can possibly know.  I am delighted to hear that your husband's health continues to be good...that is very encouraging to someone who is about to "get the treatment".

And, thanks for the offer to answer further questions.  If I have specific ones, I will be sure to call on you!


Age 62
Gleason 4 +3 = 7
T1C
PSA 4.2
27cc
Brachytheraply volume study 11/14/08; brachytherapy to be scheduled in early December


JustJulie
Regular Member


Date Joined Mar 2006
Total Posts : 355
   Posted 10/30/2008 10:53 AM (GMT -6)   

I can assure you once the decision was made, it was made and we never looked back.  We've had our bumps in the road so to speak but I am thankful it was caught early - thanks to a great doctor - and we're on the road to recovery.

 


Dirtmover
Regular Member


Date Joined Apr 2008
Total Posts : 158
   Posted 10/30/2008 12:34 PM (GMT -6)   
Hi just julie, i was wondering where your signiture is ,and how long ago your husband had his brachy,just curious as brachy shows no side affects for a min of 1 yr we wish your hubby all the best and it great to hear hes doing well,........dirt

Diagnosed November 2007   (43 years old )
PSA 3.9 / Gleason 6 / TC1 6 cores 1 shows 25%
Sugery scheduled 5/29/08 - City of Hope - Dr. Mark Kawachi
 "First show of the day"
 and now for the new ive been waiting for
 FINAL PATH REPORT:gleason upgraded to 3+4 T2c bilateral disease,tumor involvment 5%
extra prostatic extention:absent
seminal vesical invasion :absent
pathological staging:pTNM pT2 ORGAN CONFINED
margins free of carcinoma
usable erections ;6-6-08 with little blue pill
continence; 1 pad a day, dry at night


JustJulie
Regular Member


Date Joined Mar 2006
Total Posts : 355
   Posted 10/30/2008 12:39 PM (GMT -6)   

Hello again - I really should be here more often but things have been busy.  In any event, with respect to timeline, my husband's brachytherapy was in April 2006 and he has shown very few, if any side effects.

I don't know how to insert a signature but, in any event, he was diagnosed at the age of 44 with a PSA of 3.74 and a Gleason 6.  Brachytherapy (91 stranded seeds) in 2006.

 


JustJulie
Regular Member


Date Joined Mar 2006
Total Posts : 355
   Posted 10/30/2008 12:42 PM (GMT -6)   

OK I think I've updated my signature so I'll post to confirm.

 


lifeguyd
Veteran Member


Date Joined Jul 2006
Total Posts : 672
   Posted 10/30/2008 6:10 PM (GMT -6)   

Mr dirtmover

Just Julie has done an extrordinary job of documenting her husband's brachytherapy experience, no profile needed.  If you have the time read it all below,

 



PSA up to 4.7 July 2006 , bump noted during DRE
Biopsy 10/16/06
stage T2A  -  Psa 4.7
Gleason  4+4=8  right side
DaVinci Surgery  January 2007
Post op confirms gleason 4+4=8
No extension or invasion found
No continence problems
PSA 90 day (-.01)  , (6 month -.01) , (9 month +.02) , (1 year +.02) ( 18 months +.02)
ED still a problem, minor succces with bi-mix
plaque buildup due to injections 
 
 
 


divo
Veteran Member


Date Joined Jul 2008
Total Posts : 637
   Posted 10/30/2008 6:40 PM (GMT -6)   
I did not read Just julies update signature with date of Brachy, but, I (we) have a different perspective from a few years back...We were so happy after four. almost five years of brachy, external radiation, and lupron, but when the cancer returned , there was only salvage surgery!!!??? or hormone therapy...Looking back now, (which we do not do...except maybe rarely)..how we wish we would have chosen surgery in the beginning ...it is OUT....! When the cancer came back...we had two choices. hormone therapy or salvage surgery. Salvage surgery is NOTHING like ...open surgery or Da vinci........It is TAKE NO PRISONERS! I can tell you first hand...If your doctors give you a choice between nerve sparing surgery and radiation in the beginning....take surgery......If it does return, you can ALWAYS do the radiation...Divo
Husband Pete
dx Jan 2001 age 67 gleason 4 + 3 PSA 16.5
seed implant and conformal radiation Lupron from Jan 2001 to Jan2002
2005 Dec PSA began to rise from .5 to 8 within 6 months
Salvage surgery at MSK 9/06
Fistula operation 2/07 MSK
Many cystoscopies and ER visits with strictures
catheter for one year....Catheter taken out Sept 07..
Total Incontinence since then....
PSA .52 3/07
AUS Operation at MSK Sept 8. Dr. Sandhu
Activated Oct 28th Dr. Sandhu..MSK


JustJulie
Regular Member


Date Joined Mar 2006
Total Posts : 355
   Posted 10/31/2008 6:31 AM (GMT -6)   

The best advice I can offer is  to do your investigation and make an informed decision.  Many feel surgery is the only way to go.  For some, like my husband, he felt the risks were too high.  Because of the location of the cancer, there were risks of damaging other organs and he felt those risks were too high - specifically, he did not want to have to wear a bag for the rest of his life -he was only 44.  While I'm sure everyone would like to have a "golden" answer, there are risks to every treatment which is why you need to explore all your options and the make the decision that is right for YOU under YOUR circumstances because every single case is different.

For those of you with any additional brachytherapy queries, I'm always here to help.

 


Husband diagnosed in December 2005
PSA of 3.74
Gleason 6
Brachytherapy (91 stranded seeds) April 2006
 


wiggyann
Regular Member


Date Joined Apr 2007
Total Posts : 171
   Posted 11/2/2008 2:50 AM (GMT -6)   
Hello Tudpock,

My husband had brackytherapy in April of 2007. He had 25 IMRT
(radiation) treatments first and then a 90 seed pallidium seed implant.
He had no side effects from either treatment, except some urination urgency (meaning if you have to go, you better be close to a restroom )
for some months after the seed implant.

Wiggyann

Husband diagnosed in December of 2006, at 68
PSA 7.3
8 out of 12 cores positive for adenocarcinoma
Gleason 3+3 on seven cores, 3+4 on one
psa in May 2008 was 0.5
next one due this month

Johnny Canuck
Regular Member


Date Joined Jan 2008
Total Posts : 88
   Posted 11/2/2008 9:13 PM (GMT -6)   
Hi Tudpock,
I haven't checked in in a bit, but here is my thread about brachy. I hope it helps, and I'll provide some current info shortly...but so far, so good.
JC
Age: 54
Gleason Score: 3+3=6
PSA: 3.33
Biopsy:7/8 Positive
Stage: "Bulky" T1c
Prostate Size: 27cc
 
Diagnosed: December 05, 2007
Brachytherapy: February 26, 2008
68 seeds, (Iodine 125). 
 
Walk my path at:
 
 


Tudpock18
Forum Moderator


Date Joined Sep 2008
Total Posts : 4085
   Posted 11/3/2008 7:22 PM (GMT -6)   

Johnny:

Thanks...I had not been to your thread and it was very helpful.  I'll look forward to hearing about your current status.


Age 62
Gleason 4 +3 = 7
T1C
PSA 4.2
27cc
Brachytheraply volume study 11/14/08; brachytherapy to be scheduled in early December


wiggyann
Regular Member


Date Joined Apr 2007
Total Posts : 171
   Posted 11/5/2008 1:06 PM (GMT -6)   
Just Julie,

Hello, I know that your husband had brackytherapy in April of 2006 and just wondered what his psa's have been since then?

My husband had brackytherapy in April of 2007 and he has a
psa coming up this month. His last one in May of this year was
0.5. I have read about a "bounce" that sometimes hits at around 18 months, and this month will be 18 months since he had the seed implant. However, only some men have a bounce.

Also, did you ask the person who performed your husband's seed implant his success rate? We were told by several men who had brackytherapy to do this, but we never did. I did phone and speak to his nurse and ask how many seed implants he did and she told me sometimes two a month sometimes three and sometimes none. He also does regular prostate surgery.
His radiation oncologist who did his IMRT treatments and worked with his urologist on the seed implant has a very good reputation as a doctor. Many men told us to go to Dr. Dattoli's in Florida as he is supposed to be an excellent brackytherapist, however our health insurance would not pay for treatment out of this area. We have an HMO and we have to use the doctor's, etc. listed in their book. I don't think my husband had the stranded seeds. If he had, I think we would have been told.

Thanks Just Julie,
Wiggyann

Husband 68 at diagnosis
psa 7.3
eight out of twelve cores positive for adenocarcinoma
one 3+4 and seven were 3+3
25 IMRT January and February 2007
90 seed palladium (sp?) seed implant April 2007
last psa in May 2007 was 0.5

JustJulie
Regular Member


Date Joined Mar 2006
Total Posts : 355
   Posted 11/5/2008 1:16 PM (GMT -6)   

Wiggy Ann:

My husband's PSAs have been going down except for the (apparently) normal "bounce" where it went from 0.9 to 1.8 and I literally gasped at the reading.  The Brachytherapist looked at my like I had two heads and simply said - perfectly normal - and carried on.  My husband trusts her and threw me the old "I told you so" look and carried on.  I specifically asked her again on our way out if the score was anything to worry about and she said no.

If you get a spiked PSA please don't get yourself all wound up like I did.  I have to learn that things happen and the experts know when to worry and when not to - I have to try to learn that but it's not easy for a spouse to do.

You may be surprised to learn that my husband's Brachytherapist is a woman - and apparently very well known in her field.  She was the first choice of his urologist and my husband is very comfortable with her.  I can't remember how many surgeries she's performed but I seem to recall she was very experienced.  The stranded seeds were a new procedure the year he had surgery - not all hospitals offer it and not all patients opt for it - the guy in the next bed decided to go with the traditional "free fall" seeding.

I hope your 18-months reports are favourable and I wish your husband well on his continued road to recovery.

JustJulie

 


Husband diagnosed in December 2005
PSA of 3.74
Gleason 6
Brachytherapy (91 stranded seeds) April 2006
 


wiggyann
Regular Member


Date Joined Apr 2007
Total Posts : 171
   Posted 11/8/2008 2:53 PM (GMT -6)   
Dear Just Julie,

Was your husband's 1.8 psa bounce at 18 months? May I ask
what his next psa was?


Thanks, Julie
Wiggyann

JustJulie
Regular Member


Date Joined Mar 2006
Total Posts : 355
   Posted 11/20/2008 1:43 PM (GMT -6)   

Wiggyann:

I am thrilled to report that my husband's most recent PSA score was 0.39!  I believe the bounce was around the 18-month mark so hang on for the ride, it can be a wild one!


Husband diagnosed in December 2005
PSA of 3.74
Gleason 6
Brachytherapy (91 stranded seeds) April 2006
 

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