Brachy it is!!

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kuls
Regular Member


Date Joined Mar 2010
Total Posts : 57
   Posted 5/9/2010 9:12 AM (GMT -6)   
After my husband's latest PSA reading of 5.02, we met with the RO on April 29th.  He said that it was very unlikely that the PSA would rise so quickly from Pca, and feels that more likely it is a case of prostatitis.  We're going to repeat the PSA May 19th, and if it's still high (or higher) he's going recommend a course of antibiotics and a repeat PSA after the antibiotics are done.  If it's still high following the antibiotics, he feels it would be the safest bet to proceed with treatment.
 
My husband has decided that he is going to have brachy.  Initially, I would have FREAKED, but after doing literally hundreds of hours of reading and researching, I am comortable with his decision. At this point he wants to go with the least invasive option and feels that brachy would give him the best odds for a good quality of life, and the 10 year survival stats are just as good as for surgery. He has cancelled his surgery date, and Brachy is booked (tentatively) for July 20th.  If the PSA drops again, he may delay the brachy a while longer.
-Husband's 1st PSA done (age 45) at routine physical  PSA 3.8
-DRE at physical indicated no abnormality other than slightly enlarged
-Consult with urologist Jan. 2010---DRE negative, PSA 3.89
-Biopsy Feb. 10, 2010:  T1c, Gleason 3 + 3, 2/10 cores pos. (5% in one core, <5% on other core) 1% of core volume positive, gland size     38.84
-consult with "open" prostatectomy uro March 2010
-2 consults with rad. onc. for Brachy March, Apr. 2010....also discussed AS
-latest PSA reading April 8 4.63
-consult with "robotic" uro Apr. 12....tentative surgery date booked July 8
-Have also booked tentative Brachy date of July 20th.
-undecided as yet
_April 27th PSA 5.02!!  Repeat May 19th.  If still high, then a course of antibiotics and repeat.  If still high, proceed with treatment.


60Michael
Veteran Member


Date Joined Jan 2009
Total Posts : 2229
   Posted 5/9/2010 9:34 AM (GMT -6)   
Kuls,
Thanks for posting and lets hope the antibiotics does the job. If not, you all have a plan in place and that is a good idea. Take care and keep us posted.
Michael
Dx with PCA 12/08 2 out of 12 cores positive 4.5 psa
59 yo when diagnosed, 61 yo 2010
Robotic surgery 5/09 Atlanta, Ga
Catheter out after 10 days
Gleason upgraded to 3+5, volume less than 10%
2 pads per day, 1 depends but getting better,
 started ED tx 7/17, slow go
Post op dx of neuropathy
T2C left lateral and left posterior margins involved
3 months psa.01, 6 month psa.4, 6 1/2 month psa.5 on 11/28/10
Starting IMRT on 1/18/10, Completed 39 tx at 70 gys on 3/12/10
6 week Post IMRT PSA .44 a drop from .5 but maybe more
Great family and friends
Michael


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 5/9/2010 10:39 AM (GMT -6)   
Sounds like you got a well thought out plan in place. That's where all the knowledge you have learned along the way can give you comfort once think through all the options and possibilities. Good luck ahead, and please, as always, keep us well posted.

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, 4/8 .04, next one:  July
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, 3/6 Cath #13 out - 4 days, Cath #14- 27 days, Cath #15 - 26 days, Cath #16 - 4/23 put in


Tudpock18
Forum Moderator


Date Joined Sep 2008
Total Posts : 4180
   Posted 5/9/2010 11:37 AM (GMT -6)   

Dear Kuls:

First of all, hopefully the PSA will drop and you can consider the delay.  If not, I think you have made a fine decision.  The due diligence of hundreds of hours of research as well as consulting more than one doc give you peace of mind in your decision making...I know that from personal experience.  FYI, my wife was also concerned at first about brachy but was persuaded (as was I) by the research we did.

Good luck and please keep us posted on your journey.

Tudpock


Age 62, Gleason 3 + 4 = 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 4/10/10.  6 month PSA 1.4 and now 1 year PSA at 1.0.  My docs are "delighted"!

RayPat
Regular Member


Date Joined Apr 2010
Total Posts : 104
   Posted 5/9/2010 4:03 PM (GMT -6)   
Kuls, I too have chosen Brachy. Volume study scheduled for May 20. I only know three people who've had PC. Each one chose a different treatment and came through without complications and apparently successful treatment. Good luck to you and your husband. I'll post the things I go through since I'll be going before you guys.
Age 63
Frequent urination for 10 years but never saw a doctor.
01/26/10 talked to doctor who did blood work...PSA 9
Referred to urologist
Met urologist on 2/26/10....DRE normal new PSA test was 11. Taken after DRE.
Biopsy on 3/26/10. 14 samples...3 positive on right side...all 11% Gleason 3+3
Urologist said stage T-1c.
Advised treatment. Discussed surgery and set appointment with radiologist for 4/26/10
4/26/10 Met with radiologist. Confirmed urologist's opinion that it's gland confined but suspects real stage is T-2. Thinks IMRT or Brachytherapy would be good choice.


Galileo
Veteran Member


Date Joined Nov 2008
Total Posts : 697
   Posted 5/9/2010 4:20 PM (GMT -6)   
Sounds like a plan! Best wishes.
Galileo

Dx Feb 2006, PSA 9 @age 43
RRP Apr 2006 - Gleason 3+4, T2c, NX MX, pos margins
PSA 5/06 <0.1, 8/06 0.2, 12/06 0.6, 1/07 0.7.
Salvage radiation (IMRT) total dose 70.2 Gy, Jan-Mar 2007@ age 44
PSA 6/07 0.1, 9/07 and thereafter <0.1
http://pcabefore50.blogspot.com


kuls
Regular Member


Date Joined Mar 2010
Total Posts : 57
   Posted 5/9/2010 5:07 PM (GMT -6)   
Thanks guys!! This has really been an educational journey! Here in Calgary, they'll be doing intraoperative planning and dosimetry using loose seeds. Generally, according to the Medical Physicist, they take the volume of the prostate and multiply it by two, and that's the number of seeds they use (plus a few extra for good measure). They are also able to treat the prostatic margin with an effective dose out to 5mm beyond the prostate. Apparently, they've had an extremely low incidence of seed migration, and in the 7 years they've been doing it here, they have only had one local recurrence (early on in the brachy program), which proved to be a Gleason 8 on re-biopsy. That fellow was sent to a uro in Toronto for salvage prostatectomy, and is doing fine with no incontinence or rectal fistula.....he does however have ED (stands to reason).
-Husband's 1st PSA done (age 45) at routine physical  PSA 3.8
-DRE at physical indicated no abnormality other than slightly enlarged
-Consult with urologist Jan. 2010---DRE negative, PSA 3.89
-Biopsy Feb. 10, 2010:  T1c, Gleason 3 + 3, 2/10 cores pos. (5% in one core, <5% on other core) 1% of core volume positive, gland size     38.84
-consult with "open" prostatectomy uro March 2010
-2 consults with rad. onc. for Brachy March, Apr. 2010....also discussed AS
-latest PSA reading April 8 4.63
-consult with "robotic" uro Apr. 12....tentative surgery date booked July 8
-Have also booked tentative Brachy date of July 20th.
-undecided as yet
_April 27th PSA 5.02!!  Repeat May 19th.  If still high, then a course of antibiotics and repeat.  If still high, proceed with treatment.


erbob
Regular Member


Date Joined Jan 2010
Total Posts : 281
   Posted 5/9/2010 7:50 PM (GMT -6)   
Just three months ago, I too was diagnosed with PC and that news hit me like a dang ton of bricks. I have been a 28 1/2 year survivor of another cancer(not prostate) and have been doing just fine and have seldom even thought of it any more.
Then this came up. My PSA has been on the high side but being 73 years old, I guess this crap is catching up with me. I still feel like I am in my 40's and before this diagnosis, my Primary Doc said that I am in very good shape and should easily be good for another ten years.
I have been on the computer every day (EVERY) day for hours since the diagnosis and feel like I have really crammed a lot of good info on the subject.
Do not rush into a decision on which treatment to go with. There are a lot of them. I am hoping for Brachytherapy later this month. This is, as you already know, is the procedure where some radioactive pellets/seeds are injected directly into the prostate gland and left there to kill the dang cancer. From all I have read, this is about the least invasive treatment with great or perhaps even best results (my opinion after a lot of reading). The decision on which treatment is chosen rests with the patient and most Docs are reluctant to recommend any certain treatment. Even though most of us will have health insurance that will take care of most of the bill or a good portion of it, I have learned that Brachytherapy is supposed to be about the least expensive treatment so I won't have to worry as much about any huge co-pay etc.
Do ask a lot of questions as you will be the one to make the final decision on which treatment you want to go through. There are some drawbacks to each of the treatments but the surgery is the one that I personally do not want due to the POSSIBLE longer lasting side effects like incontinence and erectile dysfunction (yeah, even at my age of 73, I'm still kinda active) rolleyes
Keep the faith, keep a good attitude and positive thinking will help a lot. Good luck.
Bob, down in Southern Colorado

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