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,
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"!