My first HDRB treatment

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Regular Member

Date Joined Oct 2009
Total Posts : 32
   Posted 12/2/2009 4:24 PM (GMT -6)   

It was a real experience!

Got there at 6:30AM and they started the prep.
 Anesthiologist came in and talked about the spinal and the anesthesia.  I told him I would prefer to just be sedated and he and the nurses said "No you don't".  I said I knew the placement of a few needles would be unpleasant but it would be OK.  At that point they said it was going to be 18 needles and the placement had to be precise and I had to be under.  That convinced me.
I woke up around 10:45 as they were removing the tubes that connected to the needles.  I could see the reflection from a screen and it looked  lke a bunch of  spaghetti coming from my perenial area.  They then moved me to a post-op area and said we would do the second zap around 2:30.  I had to remain very still to avoid causing the needles to shift.  The spinal started wearing off and they asked me to try to flex my toes and ankles.  No problem with that but as expected I got some pretty uncomfortable lower back pain. 
They took me back in and I got to watch the reflection as they reconnected the tubes.  The actual radiation treatment took about 30 minutes and then another disconnect session.  Still no major problems until the doc said "OK, this will be unpleasant, please stay as still as possible."  When he pulled the needles out it felt like my testicles had been hammered.  I casually mentioned that to him and he said that was pretty normal.
Then it was back to postop and waiting for my legs to start working again.  We finally got out of there @ 5:30 (with a cathater still attached) and told me to come back the next morning to get it out.
Everything went pretty well until about 8:30 and then I started  having bladder spasms.  I tried to tough it out but by around 9:30 I chickened out and called him.  He said the only thing to do was take it out but if I could not pass urine I would have to get another put in.  He talked me through removing it and said keep  him informed.  I had to go to the bathroom about every 30-45 minutes all night long and could pass small amounts but it was not fun.
I am VERY sore but it gets better as time progresses.
I get to do it again next Monday and now that I know what to expect,  I really dread it.  I talked to the doc earlier this afternoon and he said they would use a drug to try to avoid the spasms this next time.  I can only speculate on how sore I will be this time next week.
Now that I have vented.........I know it will be worth it.  It IS going to work.
Age: 63
Gleason: 8 (5+3) Biopsys ranged from 90% to 100%
Refused surgery and hormone therapy. Doctor really made an argument for benefits of hormone therapy, I could not accept the consequences.
28 IMRT treatments.  Originally scheduled to get seed implants but doc decided that due to my prognosis High Dose Rate Brachythrapy was a better path to attempt.
PSA: 13
Let the chips fall where they may.

John T
Veteran Member

Date Joined Nov 2008
Total Posts : 4268
   Posted 12/2/2009 4:52 PM (GMT -6)   
Doesn't sound like a very pleasant experience. I thought it would be painless, like a regular brachy, but only a longer procedure. Thanks for describing it; it was informative. Let us know how it goes next week.

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.


Elite Member

Date Joined Oct 2008
Total Posts : 25393
   Posted 12/2/2009 4:59 PM (GMT -6)   
Bill, sorry you had a hard time with that. I think its important to post the unpleasant with the pleasant, things don't always go by the book and everyone is different.

As a long term cath user, couldn't tell you how many hundreds of bladder spasms I have had, the med they keep me on is Ditropan, cheap and easy to get. They usually dose 3-4 a day, depending on the severity. I still get the spams daily even on the med, starting to wonder if I have grown immune to the med.

Hope it goes better for you at the next juncture. I feel for you, brother. That's a lot of hurt to deal with.

David in SC
Age: 57, 56 dx, PSA: 7/07 5.8, 7/08 12.3, 9/08 14.5, 10/08 16.3
3rd Biopsy: 9/08 - 7/7 Positive, 40-90% Cancer, Gleason 4+3
Open RP: 11/08, Rht nerves saved, 4 days in hospt, on catheters for 63 days, 5th one out 1/09
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos margin
Incontinence:  1 Month     ED:  Non issue at any point post surgery
Post Surgery  PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Latest: 7/9 met 2 rad. oncl, 7/9 cath #6 - blockage, 8/9 2nd corr surgery, 8/9 cath #7 out  38 days, 9/9 - met 3rd rad. oncl., mapped  9/9, 10/1 - 3rd corr. surgery - SP cath/hard dialation, 10/5 - began IMRT SRT - 39 sess/72 gys cath #8 33 days, 11/2- SP Cath #9 in place

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