Seeds as a treatment

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Charlierobert
Regular Member


Date Joined May 2009
Total Posts : 24
   Posted 4/11/2010 9:04 PM (GMT -6)   
As you can see by my signature, this question is not for me personally, but for my friend. He has selected the seed treatment for his prostate cancer. We have discussed the need to stay a distance from the grandchildren (he is the other grandfather in the family),, but he tells me that he is going to have only one cycle of implanting of the seeds and after 40 days he will be clear of radiation and that the one treatment will get rid of the cancer (as rid as any of us ever get)

Could I have some comments from guys who have had the seed treatment? The entire family is questioning the "ease" of the treatment and the rapid dispersement of the radiation. We have small grandkids.

Obviously I can't ask his doctor!

Thanks for any info you might be able to give me.
71 year old male
PSA of 5.1

3/9/09 robotic surgery
non nerve sparing surgery
5/5/09 PSA Non detectable
5/24/09 slowly regaining bladder control.
6/8/09 graduated to thinner liners at night and most of the day. Pads when doing physical work, or going out of house for short trips.
8/18/09 PSA Non detectable at <.03
8/27/09 PSA redone by Mayo Clinic at my request - Non-detectable at <.0.01
11/20/09 PSA Non detectable using the super sensitive method.
3/4/2010 PSA Non detectable using the super sensitive method. Still have to use pantiliners a good deal of the time for stress drips.
Tried Calias. Had no effect.


JoeFL
Regular Member


Date Joined Oct 2009
Total Posts : 420
   Posted 4/12/2010 7:42 AM (GMT -6)   
Charlierobert,
 
I had the seeds and also a small grandchild (and a pregnant daughter) so I was also interested in this question. Here is my contribution to your question (based on what I was told by my radiologist and some additional research):
  • Maintain a distance of at least 4 feet from small children and pregnant women for 40 days after the procedure.
  • Do not let small children sit in your lap.

The type of seeds used (iodine, palladium, other) determines the strength and duration of the radiation emitted. Iodine has a half-life of 17 days. This basically means that after 17 days you can be 2 feet away with no problem. You should google these two agents for more specifics on the half-life properties of iodine and palladium. (I asked my radiologist why he used palladium rather than iodine and his answer was that he had used both sucessfully but had come to believe over time that his patients had milder side effects with palladium)

I also asked about pets....we have 3 cats...and the doc said not to worry about them. Since they are "small children" to us, I took the precaution of ordering a lead lap pad (universalmedicalinc.com) and used it for a month when the cats and granddaughter got close. I probably didn't need to do this....but it made me feel better.

I finally came to believe that the risk was slight. Hope this helps. Regards,

Joe

 

 

 


Age -67 PSA - 4.5

Biopsy  (9/4/09) - Positive in 5 of 8 cores. In those 5 cores, 5 of 11 samples were positive. Gleason 3+3=6. Stage – T1C  Ct and Bone scans negative.

 

BT performed on 12/11/09. 84 seeds of Palladium 103. Surgery at 7:30 - Home at 12:30 same day with no catheter. Blood in urine for a week. Side effects as expected -  some burning, frequency, urgency.   Resumed daily  1 ½ mile walk after 3 days. 

 

BT followed with 25 IGRT treatments beginning Feb 15 (4500 Gy's). After third week, experienced some fatigue.

 


Charlierobert
Regular Member


Date Joined May 2009
Total Posts : 24
   Posted 4/12/2010 7:48 AM (GMT -6)   
Joe, I am not familar with the term IGRT. I am assuming this is some type of addition radition treatment. Can you clarify for me?
71 year old male
PSA of 5.1

3/9/09 robotic surgery
non nerve sparing surgery
5/5/09 PSA Non detectable
5/24/09 slowly regaining bladder control.
6/8/09 graduated to thinner liners at night and most of the day. Pads when doing physical work, or going out of house for short trips.
8/18/09 PSA Non detectable at <.03
8/27/09 PSA redone by Mayo Clinic at my request - Non-detectable at <.0.01
11/20/09 PSA Non detectable using the super sensitive method.
3/4/2010 PSA Non detectable using the super sensitive method. Still have to use pantiliners a good deal of the time for stress drips.
Tried Calias. Had no effect.


lifeguyd
Veteran Member


Date Joined Jul 2006
Total Posts : 672
   Posted 4/12/2010 9:38 AM (GMT -6)   

I am a big fan of brachytherapy.  If my diagnosos had been less than Gleason 8, I would have opted for that treatment.  I have two friends who had the 'seeds' at the same time as my surgery. They suffered far fewer ED problems than me, and three years later are healthy and 'cured'.

Any danger to others is easily handled.  I have never heard of radiation transfer to a family member actually happening.  Though I am sure it is possible.


PSA up to 4.7 July 2006 , nodule noted during DRE
Biopsy 10/16/06 ,stageT2A
Very Aggressive Gleason 4+4=8  right side
DaVinci Surgery  January 2007
Post op confirms gleason 4+4=8 with no extension or invasion
no long term continence problems
Post surgery PSA continues to be "undetectable"
One side nerves spared
Bi-Mix for ED 
born in 1941


John T
Veteran Member


Date Joined Nov 2008
Total Posts : 4188
   Posted 4/12/2010 10:32 AM (GMT -6)   
Your friend is correct. The procedure is a breeze, about an hour, and you are completely functional in about 2 hours. It is as effective as any other treatments and some studies indicate it is more effective.
As a precaution children should not sit on one's lap for an extended period of time. I have never heard of seeding affecting a secondary person in any way. Radiation from a seed radiates approximately 1mm and beyond that is ineffective in killing cells. This is why it takes 60 to 100 seeds to cover a normal prostate.
Side affects are minimal, with urinary frequency and urgency for about 4 to 6 weeks. that do not interfer with daily activities or work. Your friend can return to work the next day with no issues.
JT

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


Tudpock18
Forum Moderator


Date Joined Sep 2008
Total Posts : 4080
   Posted 4/12/2010 10:45 AM (GMT -6)   

I will echo what JT said about ease and cure.  Transferring radiation is not likely but I was advised not to have extended close contact with small children or pregnant ladies for a couple of months, i.e. hugs and brief lap time  (5 minutes) was ok but longer time should be avoided.

Tudpock


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"!

Jstars
Regular Member


Date Joined Oct 2005
Total Posts : 489
   Posted 4/12/2010 2:00 PM (GMT -6)   
JohnT is right -- the effective distance for radiation from a pellet is on a millimeter or two (beta particles).

It is not like you have a unlicensed nuclear reactor in your crotch there (although lots of guys would think that might be a good pickup line for a gal to use....

"Is that an unlicensed nuclear reactor in your pocket or are you just glad to see me?" ..

I am sure the Docs mention caution just to be overly cautious about any causalities however implausible they may be.
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.
04/09, 07/09, 10/09, 01/15/10 PSA <0.1
03/2009 Levitra@20mg / Viagra@100mg/Cialis@20mg -- (nocturnal stirrings started 02-03/2010).
08/09-09/09,02-03/10 MUSE@1000mcg 80-90% (with some ache )
10/09-11/09 TrimixGel@(500/300/100mcg): 60,70,80%,
02/10-03/10 TrimixGel@1000/300/100mcg - 80-90% - just @ usefulness.
Gel + MUSE 500mcg -- 100% for 30-60 mins and 80-90% for hours after that).


JoeFL
Regular Member


Date Joined Oct 2009
Total Posts : 420
   Posted 4/12/2010 2:31 PM (GMT -6)   
Charlierobert,
 
IGRT is Image Guided Radiation Therapy. An ultrasound is done before each treatment to make sure that the beam is directed at the prostate as closely as possible (it can move around to some degree). This helps avoid treating other areas that don't need to be zapped but does treat a small margin around the prostate.
 
With my stats and the benefit of more informed hindsight at this point, I'm not totally sure that I needed the IGRT boost....I might could have done the seeds alone. Others on HW have had seeds only and are fine. I opted for some additional "insurance" and am very happy with my decision up to this point. I do not have a post-treatment PSA reading yet but feel optimistic  that it will be good.
 
I have updated my profile with an email address that can be used if you want to contact me.
Best Wishes,
 
Joe

Age -67 PSA - 4.5

Biopsy  (9/4/09) - Positive in 5 of 8 cores. In those 5 cores, 5 of 11 samples were positive. Gleason 3+3=6. Stage – T1C  Ct and Bone scans negative.

 

BT performed on 12/11/09. 84 seeds of Palladium 103. Surgery at 7:30 - Home at 12:30 same day with no catheter. Blood in urine for a week. Side effects as expected -  some burning, frequency, urgency.   Resumed daily  1 ½ mile walk after 3 days. 

 

BT followed with 25 IGRT treatments beginning Feb 15 (4500 Gy's). After third week, experienced some fatigue.

 


zufus
Veteran Member


Date Joined Dec 2008
Total Posts : 3149
   Posted 4/12/2010 3:08 PM (GMT -6)   
Just to be more precise on any therapy with PCa.....cured....does not always equate with 2 or 3 years out and ultra low or safe psa level. You may know with more certainty towards 10 years, and at 15 yrs. come to believe it is more towards certain. There are patients whom have failed PCa even around 10 years post treatments and looking safe all that time prior. I am only the messenger...but hey 10 yrs. is long time and who says you cannot battle it with drugs for another 10 or whatever. Just so we don't give people the wrong impressions about PCa, one should remain vigalent watching psa numbers over the years, maybe 1 or 2 tests a year, but keep watching is likely your best bet.
Youth is wasted on the Young-(W.C. Fields)

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