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bedamed
Regular Member


Date Joined Mar 2010
Total Posts : 31
   Posted 3/20/2010 10:22 PM (GMT -6)   
hi room thank u al 4 ur help my name bedamed   means be damed if it gona get the beta of me  i need some info if possible on wat its like to have brachy treatment is like and wat sideeffects if any one can help thank u very much hard here in nz to get al u need

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25393
   Posted 3/20/2010 11:24 PM (GMT -6)   
Hey friend, you need to talk to JohnT or Tudpock about seeding. THey are both doing well with it, and can tell you all about it. Hopefully they will answer you soon.
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, no problem post SRT
Post Surgery  PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA: 1/10 .12
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 - 11/27 IMRT SRT 39 sess/72 gys ,cath #8 33 days, Cath #9 35 days, 12/7 - Cath #10 43 days, 1/19 - Corr Surgery #4,  Caths #11 and #12  same time, 2/8-Cath #11 out - 21 days, 3/2- Cath #12 out - 41 days, 3/2- Corr Surgery #5, Caths #13 & #14 same time, 3/6 Cath #13 out - 4 days


Tudpock18
Forum Moderator


Date Joined Sep 2008
Total Posts : 4274
   Posted 3/21/2010 7:07 AM (GMT -6)   

Dear bedamed:

I have copied and pasted from one of my earlier posts to someone who asked a similar question.  You can also read my "journey" by selecting the link in my signature.  While most of the posters on this site are surgery patients, there are a few of us here who chose brachytherapy and are doing well.  I thnk I made a good choice for my case and am now 1 1/2 years out with no side effects.  I realize you are in NZ but a good site for brachytherapy info is www.dattoli.com

 

Good luck and keep us posted,

Tudpock

A typical poster-boy candidate for brachytherapy will have Gleason 6 or less, a prostate size of 50cc or smaller, Stage T1-T2, and PSA less than 10.  With G-7, brachytherapy alone may also be used if all of the other criteria are met plus cancer found in only a few cores and with a small %.  Otherwise, the doc will typically use HT to lower the prostate size and/or supplement the brachytherapy with a 4-5 week course of additional radiation therapy.

The cure rates for brachytherapy are similar to those for surgery.

Brachytherapy as a procedure is pretty non-invasive and is typically done on an outpatient basis.  There is very little pain involved and the patient pretty much returns to normal activities within 48 hours.  Besides the aforementioned curative power of seeds, the urinary effects are much different than surgery.  There is rarely any incontinence, but a patient may experience some frequency and/or urgency during the first couple of months.  Most docs put men on Flomax for 3 months to assure normal urinary activity.  Pre-procedure, most patients take a written test about their urinary activities.  If things are pretty normal pre-procedure, they are more likely to be normal post. 

The same can be said for ED in brachytherapy patients.  A patient performing well before seeding is more likely to perform well afterward.  In any case, most of the “performing” patients return to sexual activity within a couple of weeks of the procedure.  However, if and when ED occurs in brachytherapy patients, it is likely to be a couple of years down the road.  If that happens, the same little blue pills that help surgery guys will likely do the trick for seed guys.  In general, brachytherapy patients show somewhat less ED than do surgery patients when normalized for age, diagnosis, etc.

While “radiation after surgery” is generally available (but not highly successful) if the cancer returns for surgery patients, “surgery after radiation” is not usually an option for brachy patients.  There are only a few docs who will do salvage surgery after radiation and personally, I would not recommend it.  So, if cancer returns to a brachytherapy patient, the options are likely to be hormone therapy, cryosurgery, HDR radiation, re-seeding with a different isotope or maybe even HIFU…there ARE options…unlike what some surgeons will imply.

 


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 12/09.  6 month PSA 1.4 and now 1 year PSA at 1.0.  My docs are "delighted"!

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25393
   Posted 3/21/2010 10:26 AM (GMT -6)   
Thanks, Tud, for coming to the rescue
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, no problem post SRT
Post Surgery  PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA: 1/10 .12
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 - 11/27 IMRT SRT 39 sess/72 gys ,cath #8 33 days, Cath #9 35 days, 12/7 - Cath #10 43 days, 1/19 - Corr Surgery #4,  Caths #11 and #12  same time, 2/8-Cath #11 out - 21 days, 3/2- Cath #12 out - 41 days, 3/2- Corr Surgery #5, Caths #13 & #14 same time, 3/6 Cath #13 out - 4 days


John T
Veteran Member


Date Joined Nov 2008
Total Posts : 4269
   Posted 3/21/2010 12:05 PM (GMT -6)   
Bedamed.
I'm 10 months out from seeding and also had IMRT. The seeding took about an hour, about 4 hours from the time I left my house to the time I got back home. No pain, just frequency and urgency for about 4 weeks. I have no side affects, no ED, no urinary issues, ( in fact stream is better than before treatment). PSA is 0.2 down from 40.2
JohnT

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.

JohnT


Jstars
Regular Member


Date Joined Oct 2005
Total Posts : 489
   Posted 3/21/2010 8:58 PM (GMT -6)   
Yo Bedamed,

Looks like you got some great advice to start you off.

Now we have to get down to some even more important business.

You just cannot go along being Damed -- it is just not Manly.

Dame Judy Dench is Damed, ... Dame Judith Anderson was Damed -- YOU can't be damed.

You are just going to have to Man Up and become BE D A M N E D .. but never DAMED.

However, JamesC the Mod here might end up making you 'BEDARNED' but that will still work.

Go Give either a try -- ControlPanel -> Edit Profile -> DisplayName and all will be well and we can all call you Sir if you become Knighted even ...

Hope your healing path goes well too -- seriously.
Age 59, 57 at DX, PSA Aug2008 7 4 ... June2007 4.7 (BPH + LUTS)
11/2008 Biopsy: 1 of 12 cores 5%, Gleason 3+3 - Sona showed size 140+ cc (110 grams post op).
02/03/09 open RRP surgery ,Nerve sparing, 1 day in hospital.
02/18/09 Cath out -- passed 1 cm oblong bladder stone (not kidney!).
Pathology Report: All margins clear - No Invasive spread - no change in Gleason score.
03/06/09 Started Levitra@20mg / Viagra@100mg / (04/01) Cialis@20mg -- (some tumescence 02-03/2010).
04/01/09, 07/07/09, 10/01/09, 01/15/10 PSA <0.1
08/09-09/09,02-03/10 MUSE@1000mcg (very little ache ) 80-90%
10/09-11/09 TrimixGel@(500/300/100mcg): 60,70,80%,
02/10-03/10 TrimixGel@1000/300/100mcg - 80-90% - (with cialis) - just @ usefulness.


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25393
   Posted 3/21/2010 9:17 PM (GMT -6)   
JohnT, always glad when you and/or Tud show your Seed Story. I am glad to have good examples of how well that can work as a primary treatment for PC, and that's its not just about surgery. I sincerely hope that both you guys, and the other seeded ones, continue to do well long term, it will be a good testimony
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, no problem post SRT
Post Surgery  PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA: 1/10 .12
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 - 11/27 IMRT SRT 39 sess/72 gys ,cath #8 33 days, Cath #9 35 days, 12/7 - Cath #10 43 days, 1/19 - Corr Surgery #4,  Caths #11 and #12  same time, 2/8-Cath #11 out - 21 days, 3/2- Cath #12 out - 41 days, 3/2- Corr Surgery #5, Caths #13 & #14 same time, 3/6 Cath #13 out - 4 days


bedamed
Regular Member


Date Joined Mar 2010
Total Posts : 31
   Posted 3/21/2010 10:41 PM (GMT -6)   
thanks al 4 your help it has put some light on the subject and now i feel comfortable with the tretment option i intend to take or at least lok more carefully at still a lot to learn yet and get my head round but now i feel a lot more informed i was loking at my urology report today took a bit to get a copy of it dont really understand it al my psa is 12 up from 11 in a month and gleason is at 8 wateva that means

Sephie
Veteran Member


Date Joined Jun 2008
Total Posts : 1804
   Posted 3/22/2010 6:56 AM (GMT -6)   
Bedarned, glad you finally have your biopsy pathology report. I'm not very good at explaining Gleason score except to tell you that the cells under the microscope are assigned a number from 1 to 5. The higher the number, the more aggressive. The pathologist assigns a number for the largest group of cells, then for the next largest group. A Gleason score is then assigned based on these two values. The Gleason score can be 4+4, 3+5 or 5+3. You need to speak with your doctor about your path report to determine what your Gleason score means. Not sure of your age but PSA of 12 is kind of high - again, get a meeting set up with the doctor to discuss the findings and best options.
Husband diagnosed in 2/2008 at age 57 with stage T1c. Robotic surgery performed 3/2008. Stage upgraded to T3a (solitary focus of extraprostatic extension). Perineural tumor infiltration present. Apex margin, bladder neck and SVs negative. Final Gleason 3+4. PSA: 0.0 til July 2009. August 2009 - 0.1, September 0.3, October back to 0.0, December 0.0, March 2010 0.0. Next PSA in 6 months. Thank you God!


Wigs
Regular Member


Date Joined Mar 2009
Total Posts : 89
   Posted 3/22/2010 7:53 AM (GMT -6)   
Bedamed, as you can see by my signature, I had the brachytherapy at age 47. Ten years later I underwent a salvage prostatectomy. Tupock's posting concerning the better candidates for brachytherapy is dead on. You do need to get a better handle on your Gleason score, as Sephie stated. I do know this first hand. When you have had bracytherapy and if the cancer does return, the salvage prostatectomy is a difficult surgery with extenuating circumstances. Since you don't have a signature, I don't know your age. As Tudpock stated, the cure rates for brachytherapy are the same for surgery. That being said, I was cancer free for about 10 years and it returned. While I did have the salvage procedure, I can't say that I would recommend it for anyone. My first doctor told me that if my cancer would return, the surgery would be a difficult procedure. Unfortunately, I didn't ask him what he meant by difficult. If I had, I may have chosen a different solution the first time around. As I mentioned earlier, I think your age should play into this decision. Ask your doctor, what would be the course of action if the cancer were to return.
Diagnosed @ age 47 - September 1997
PSA 5 / Gleason 3+3
Seed Implant - January 1998 @ Trident Hospital, SC
PSA 2.4 - July 2007
PSA 2.7 - July 2008
PSA 3.0 - November 2008
Diagnosed @ age 57 - December 2007
Gleason 4+3
Salvage Prostatectomy & Colostomy - March 2008 @ MSKCC, NY
Urethral-Rectal Fistula Repair - August 2008 @   Cleveland Clinic, OH
PSA < .03 - Aug 2008
Colostomy Reversal - January 2009 @ Cleveland Clinic
PSA < .03 - Jan 2009
AUS implant - May 2009 @ Cleveland Clinic
PSA < .03 - May 2009
AUS activated - July 2009
PSA < .03 - July 2009
Penile Implant - December 2009 @ Cleveland Clinic
PSA < .03 - December 2009
Penile Implant activated - February 2010
 
 


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25393
   Posted 3/22/2010 9:20 AM (GMT -6)   
Wigs, I am sorry for what has happened in your own journey, you have been on a rough path. I think your testimony of the problems and difficulty of having had salvage surgery needs to be told, and told loud and clear, especially for any new brothers.

When one chooses their primary treatment for PC, of course we all hope that it will work 100%, but on the other hand, logic says what if it fails? So you have to think through carefully what you will do next in case of that primary failure.

I think the subject would make a good seperate thread sometime. I know what my own surgeon has told me about salvage surgery, so I can only imagine what it was like for you as the patient.

I hope you continue to do well.

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, no problem post SRT
Post Surgery  PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA: 1/10 .12
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 - 11/27 IMRT SRT 39 sess/72 gys ,cath #8 33 days, Cath #9 35 days, 12/7 - Cath #10 43 days, 1/19 - Corr Surgery #4,  Caths #11 and #12  same time, 2/8-Cath #11 out - 21 days, 3/2- Cath #12 out - 41 days, 3/2- Corr Surgery #5, Caths #13 & #14 same time, 3/6 Cath #13 out - 4 days

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