Tony is correct that IMRT is better with high risk patients. For low risk patients there is no difference in cure rates between IMRT and BT.
For intermediate risk patients a combination of BT and IMRT is recommended because it can give a higher does with minimal side affects than either treatment alone.
Be careful what your read about
all the new stuff on Brachy; most of it is just marketing hype in order to differentiate a doctor's practice from all the others. Dattoli is a master at it.
There is little difference in Iodine 125 and Paladium 105; Iodine's half life is longer so the side affects last longer, but the dose is the same. It's the doctor's preference and how he was trained.
Find a doctor that has done at least 500 procedures, a thousand is better. Be sure a urologist is on hand during the procedure so the bladder can be scoped for any stray seeds as this is common and won't hurt if the seeds are removed. The most important factor is the CT quality control scan 2 weeks after the procedure to insure all the seeds are properly placed.
64 years old.
PSA rising for 10 years to 40, free psa 10-15. Had 5 urologists, 12 biopsies and MRIS all neg. Doctors DXed BPH and continue to get biopsies yearly. 13th biopsy positive in 10-08, 2 cores of 25, G6 less than 5%. Scheduled for surgery as recommended by Urological Oncologist.
2nd Opinion from Dr Sholtz, a Prostate Oncologist, said DX wrong, pathology shows indolant cancer, but psa history indicates large cancer or metastasis. Futher tests and Color Doppler confirmed large transition zone tumor that 13 biopsies and MRIS missed. G7, 4+3, approx 16mmX18mm.
Combidex MRI in Holland eliminated lymphnode mets. Casodex and Proscar reduced psa to 0.6 and prostate from 60mm to 32mm. Changed diet, no meat and dairy. All staging tests indicate that tumor is local and non agressive. (PAP, PCA3, MRIS, Color Doppler, Combidex, tumor reaction to diet and Casodex, and tumor location in transition zone). Surgery a poor option because tumor is located next to the urethea and positive margin is very likely; permanent incontenance is also high probability with surgery.
Seed implants on 5-19-09, 3 hours door to door, no pain, minor side affects are frequency and urgency; very controlable with Flowmax and lasted 4 weeks. Daily activities resumed day after implants with no restrictions. Gold markers implanted with seeds to guide IMRT.
25 treatments of IMRT 6 weeks after seed implants. No side affects at all.
PSA at end of treatment 0.02 mostly the result of Casodex. When I stop Casodex next week expect PSA to rise. Next PSA in November. Treatments and side affects have greatly exceeded my expectations. Glad to have this 11 year journey finally conclude.