Sex after Brachy

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New Member

Date Joined Jun 2010
Total Posts : 10
   Posted 8/5/2010 10:28 PM (GMT -6)   
I have some questions about sex and Brachytherapy. I am 62 and have some sort of sexual activity each week. I have some ED but we have gotten around that with some oral sex and other types of stimulation. How long after Brachy can I have sex? Is oral sex safe for my wife? Will my climax be significantly changed without semen? I apologize for the bluntness and nature of these questions, But I need some direct answers to these questions from folks who know. Waitman.

John T
Veteran Member

Date Joined Nov 2008
Total Posts : 4268
   Posted 8/5/2010 11:01 PM (GMT -6)   
You should use a condom for at least 2-3 months after Brachy just to be on the safe side as you may expell a radioactive seed. This is rare and shouldn't hurt anything, but I would play it safe. I think you could have sex within a week or two of Brachy. The Climax is just the same and you do have ejaculate, but not as much.

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.


Regular Member

Date Joined Jan 2010
Total Posts : 281
   Posted 8/5/2010 11:11 PM (GMT -6)   
Hi Waitman. On the reverse side of the little information card that was provided at the time of my Brachy (11 weeks ago) it states:
"You may resume normal sexual activity when ready, providing you use a condom for two weeks following implant". It also states, "The implanted radioactive seeds are sealed in a titanium casing: there are no contamination problems. Your breath, sweat and body fluids do not contain any radioactivity and will not contaminate anything".
Since I took the Biculatamide and Lupron, I have had extremely little interest in ANY sexual activity. In fact, the interest in "IT" has dwindled down to zero ever since receiving my PC-DX last February. Although I'm 73 years old, I was still pretty active up until all this PC crap arose. cry
Bob, located in Southern Colorado

Age 73 Retired Railroader.
Dx Jan 2010, Volume 51.345
Gleason 3+4=7, second opinion 4+3=7 (Don't know which to believe)
2.6 4/96.......... 3.7 4/07
1.9 5/97.......... 3.2 1/08
2.3 4/98.......... 6.1 4/09
2.2 10/99......... 5.3 5/09
2.4 8/00......... 5.3 8/09
2.3 6/01......... 6.9 10/09
2.9 2/03......... 7.3 12/09
3.6 4/04......... 6.1 1/10
3.0 5/05......... 5.0 3/10
4.7 4/06......... 0.7 5/10 (Lupron/Bicalutamide)
Volume study at CPCC (Westmont, IL) Feb 15, 2010 = 55.7cc
On Feb 15, 2010 put on 90 days of Bicalutamide
Got LHRH Lupron shot on Feb 29,2010
Another Volume study May 24, 2010 = in mid-40cc
BRACHYTHERAPY received May 26, 2010
Received 80 I-125 (Iodine seeds)
Activity per seed (mCi) 0.373
Total activity implanted (mCi)29.80
Measured exposure @ 3 feet (mR/hr) 0.06
Received the Brachytherapy at the Chicago Prostate Cancer Center from Dr. Brian Moran
Walked in the facilty and just a few hours later walked right out.
No after effects other than just a little sore from the needle sticks but NOT serious
enough to take ANY meds for pain.
PSA to be taken in three months (Aug 2010).

Forum Moderator

Date Joined Sep 2008
Total Posts : 4272
   Posted 8/6/2010 8:00 AM (GMT -6)   
Dear Waitman:
Specifically in answer to your questions....based on directions from my physicians and my personal experience:
1.  Wait two weeks after brachy before sex.
2.  Wear a condom for two months.
3.  Sex is exactly the same after the brachy except for reduced level of ejaculate...but you should not feel any difference in your experience.
Tudpock (Jim)
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"!

Regular Member

Date Joined Feb 2011
Total Posts : 49
   Posted 2/2/2011 5:00 PM (GMT -6)   
I know this is a very sensitive subject for guys but I would much appreciate feedback from anyone who has had brachytherapy about how orgasm feels now for you versus how it was before brachtherapy. I know BT can cause some ED problems and dry ejaculations but Im also concerned with the experience of orgasm. I'm a 63 year retired writer Gl 7 3+4 4.8 psa athletic with a much younger partner. Sex is very important to me in all its forms and the wonderful "oceanic" feeling of orgasm in all of its varieties is a great joy! And I also value the intimacy and relationship aspects of sex. I will do seeds or HDR bracytherapy in the next few weeks and would like to know how guys feel sexually now after bracytherapy. My doc says I want to have my cake and eat it too and its true, I dont want my sexuality to change but I'm thinking it will. I just want to have an idea what might happen. The docs with stats really do not present much of a picture of how a guy is afterwards. Do you feel the wonderful release and joy or is the dry organism a major downer or do you think its all in the mind? All opinions are welcome and many thanks for sharing so intimately! blush
Best wishes

Veteran Member

Date Joined Jul 2009
Total Posts : 504
   Posted 2/2/2011 5:29 PM (GMT -6)   
I can see a CSI episode now that deals with the clue being a seed found post sex sans condom

"You should use a condom for at least 2-3 months after Brachy just to be on the safe side as you may expell a radioactive seed"

Forum Moderator

Date Joined Sep 2008
Total Posts : 4272
   Posted 2/2/2011 8:03 PM (GMT -6)   
Richard, please see my answer on the other thread you started.
Tudpock (Jim)
Age 62 (64 now), G 3 + 4 = 7, T1C, PSA 4.2, 2/16 cancerous, 27cc. Brachytherapy 12/9/08. 73 Iodine-125 seeds. Procedure went great, catheter out before I went home, only minor discomfort. Everything continues to function normally as of 12/8/10. PSA: 6 mo 1.4, 1 yr. 1.0, 2 yr. .8. My docs are "delighted"! My journey:

Veteran Member

Date Joined Dec 2010
Total Posts : 3886
   Posted 2/3/2011 10:41 AM (GMT -6)   
If you have HDR there are no seeds left behind, so no worry about expelling them or migrating to other parts of the body. I had sex two weeks after my HDR and everything was fine but the semen was dark. The darkness went away after about 3 weeks. The volume was down by maybe one-third. I am now about 7 weeks after my HDR was completed.

Veteran Member

Date Joined Dec 2008
Total Posts : 3149
   Posted 2/3/2011 11:41 AM (GMT -6)   
In case others missed that JNF....HDR are high dose removable and taken back out, not left in and not the long term type. I think some missed that last time posted.
Dx-2002 total urinary blockage, bPsa 46.6 12/12 biopsies all loaded 75-95% vol.; Gleasons scores 7,8,9's (2-sets), gland size 35, ct and bone scans look clear- ADT3 5 months prior to radiations neutron/photon 2-machines, cont'd. ADT3, quit after 2 yrs. switched to DES 1-mg, off 1+ yr., controlled well, resumed, used intermittently, resumed useage

John T
Veteran Member

Date Joined Nov 2008
Total Posts : 4268
   Posted 2/3/2011 12:05 PM (GMT -6)   
Sex and orgasim are eactly the same as before treatment. Ejaculant is there but in much less quantity.
65 years old, rising psa for 10 years from 4 to 40; 12 biopsies and MRIS all negative. Oct 2009 DXed with G6 <5%. Color Doppler biopsy found 2.5 cm G4+3. Combidex clear. Seeds and IMRT, no side affects and psa .1 at 1.5 years.

Regular Member

Date Joined Feb 2011
Total Posts : 49
   Posted 2/4/2011 12:52 AM (GMT -6)   
JNF why did you choose HDR over LDR seeds? I have been weight the two approaches.

Veteran Member

Date Joined Dec 2010
Total Posts : 3886
   Posted 2/4/2011 2:18 PM (GMT -6)   
HDR is a more advanced and refined verson of brachytherapy. It delivers radiation that is more conformal to the cancer and away from the areas that should't be radiated. The catheters are positioned under ct scan before the radiation is given resulting in greater accuracy than the ultrasound guidance of seeds. I understand that ultrasound images can be off several mm which is the difference of a seed toucing the bladder wall or missing a tumour spot entirely.

The HDR dose is given on a dwell time basis. In other words, if in one of the catheters you need twice as much radiation to one spot than another, the after loader leaves the radiation there longer to increase the dose. So within each of the 15 catheters they can deliver different doses every mm or so. This improves the conformal radiation.

Since the radiation doesn't stay in the body it can't mmigrate or change the radiation dose and cloud as happens with the permanent seeds. Over the 90 day period of time that the seeds give off the radiation the body changes quite a bit and as the body changes the seeds may not deliver the radiation in the exact places planned and may radiate places that were not planned. I understand that HDR has far less side effects to the urethea and bowel than seeds.

Several studies have also shown that PCa can be better killed by much higher dose fractions. Thus the HDR delivers more dose in a 30 minute period than can be delivered any other way. A hard quick hit from HDR rather than a low slow dose from the permanent seeds.

The HDR can also be done as salvage wheras you can't reseed the area at a later time. I had the customary 2 HDR sessions and understand that I can have more if need be.

In the end I liked the fact that nothing was left behind and bought in to the better accuracy of delivery. My medical oncologist said it best when he summed it up as..."pemananent seeds was last century....HDR is 21st century treatment". I hope he was right and I hope this helps. If there is more I can help with, I will.
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