Various side effects experienced from seeds (brachytherapy).

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erbob
Regular Member


Date Joined Jan 2010
Total Posts : 281
   Posted 8/22/2010 2:18 PM (GMT -6)   
Note F8 said, in another thread, "my last shot of lupron is past its peak and the side effects from the IMRT are milder than those from the seeds". If F8 wouldn't mind, hope he will share with us just what side effects he experienced with seeds that he considered to be worse (for him) than those with the IMRT. Many thanks.
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)
PSA
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).

F8
Veteran Member


Date Joined Feb 2010
Total Posts : 3987
   Posted 8/22/2010 3:12 PM (GMT -6)   

Bob -  i don't mind at all.  i got my first 3-month shot of lupron two months before getting the implant of 40 cesium seeds.  just before BT i started having very slight sexual dreams tho my libido was still non-existent.  i felt at the time that the first lupron injection had peaked and the side effects were lessening just a bit. i started feeling a bit better too.

then i got the seeds implanted followed by my second shot of lupron a couple days later.  my wife and i rode our bikes a couple days after the implants and i became fatigued after a few miles, very weak and shaky.  my neck, hands and shoulders were already aching from the lupron as were my hips but i felt terrible all over and i was gasping for breath.

i'm an electrician but i work very little these days.  for awhile i thought i would have to quit work for awhile.  i got fatigued and sweaty very easily and dizzy when i stood up.  i'd be winded after a single flight of stairs and my quads would ache.  i still suffer from all these side effects (as well as others) to some degree but they were at their very worst after BT and lasted for weeks.  i began to feel much better going into IGRT two months later but again i was on the downside of my second shot of lupron and the seeds had already done their thing.

also, my urine stream was very weak after BT and for a couple days  it was painful to pee at times because it didn't seem like the urine would come out fast enough.  also, for a few days i felt like i was crapping base rock.  i didn't  have the razor pee because i began flomax before BT. just like i didn't have severe hot flashes because i began taking celexa before lupron. i did gain 20 lbs. tho but i also eat more  mad .  one thing i remember is there were times i couldn't get comfortable anywhere.  in my office.  on the couch etc. a nap would pretty much take care of that, and i've never really been a napper until starting treatment. 

okay, i now have 23 treatments of IGRT down and five more to go.  so far the side effects have been much milder. my doctor says IGRT is easier by a factor of 10.   i recently quit riding my bike because it became a chore bordering on torture.  i now ride a recumbent bike in the gym.  the bike i use is right under the air conditioning and i can get a much better workpout without killing myself because i can control my temperature and there is no weight on my hands, neck and shoulders.

i also weight train a couple of days a week.  doing so was absolute misery when the lupron was peaking especially after BT.  my shoulders and other joints constantly ached like i was way overtrained and for many days i went with very light weight, reduced the number of sets, and just went through the motions.  since starting IGRT my strength and endurance are much better.  but i do get my third (and supposedly last) shot of lupron in two weeks so i figure i'll be feeling funky at least until thanksgiving.

urinary frequency has been an issue throughout treatment but with IGRT my flow is much better. 

treatment has not been that bad but i also have plenty of time to rest and recuperate.  sorry if i rambled but i have a lot of thoughts on what i've been going through. in general it just hasn't been that bad for me. 

F8


age: 55
PSA on 10/09: 6.8
no symptoms, no prostate enlargement
12/12 cores positive....gleason 3+4 = 7
ADT, brachy and IMRT

Post Edited (F8) : 8/22/2010 8:01:49 PM (GMT-6)


Fairwind
Veteran Member


Date Joined Jul 2010
Total Posts : 3889
   Posted 8/22/2010 3:22 PM (GMT -6)   
I also thank you for taking the time to post that well written account of your journey.. I found it very helpful..
Age today: 68. Married, 6', 215 pounds, active, no health issues.
PSA at age 55: 3.5, DRE negative. Advice, "Keep an eye on it".
PSA at age 58: 4.5
PSA at age 61: 5.2
PSA at age 64: 7.5, DRE "Abnormal"
PSA at age 65: 8.5, DRE " normal", biopsy, 12 core, negative...
PSA at age 66 9.0 DRE "normal", BPH, Finesteride. (Proscar)
PSA at age 67 4.5 DRE "normal" second biopsy, negative.
PSA at age 67.5 5.6, DRE "normal" U-doc worried..
PSA at age 68, 7.0, third 12 core biopsy positive for cancer in 4 cores, 3 cores Gleason 6, one core Gleason 9. Finesteride discontinued, still no urinary symptoms, never had any..From age 55 to 65 I had no health insurance.

I have a date with the robo surgeon on Sept 3 but I'm keeping my options open. I'm also looking at seeds combined with IGRT which seems to be having good results with high-risk patients..

John T
Veteran Member


Date Joined Nov 2008
Total Posts : 4268
   Posted 8/22/2010 5:12 PM (GMT -6)   
If you use Casodex instead of Lupron in order to shrink the prostate you will have about 20% of the side affects of Lupron and get just as much shrinkage.
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


F8
Veteran Member


Date Joined Feb 2010
Total Posts : 3987
   Posted 8/22/2010 5:50 PM (GMT -6)   
do you mean 20% of the side effects not caused by lack of testosterone?  my understanding is the lack of testosterone causes most side effects, which can vary widely from person to person.
 
F8
age: 55
PSA on 10/09: 6.8
no symptoms, no prostate enlargement
12/12 cores positive....gleason 3+4 = 7
ADT, brachy and IMRT

Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 8/22/2010 6:07 PM (GMT -6)   
Mind you I am susceptible to error...
An anti-androgen will produce the same side effects of an LHRH agonist sometimes worse, sometimes better. Bicalutimide, an anti-androgen at the cellular level, is only intended to supplement the effects of an LHRH agonist in prostate cancer, not replace it. Bicalutimide works at a different level to decrease androgen absorption. LHRH or GnRH is effective in suppressing the male sex hormone, testosterone, LHRH agonists prevent the body's production of testosterone through the pituitary gland. It's a nuero-blockade.

They are not interchangeable in the effects of decreasing mass or side effects that I know of, and at least that was not my experience. (Cancer will eventually use bicalutimide as a surrogate to testosterone and dihydrotestosterone, but never the other way around, that is why many believe that Casodex can be counter-productive). In no study I know of is bicalutimide an adequate substitute for a GnRH or LHRH agonist.

Does it "shrink the prostate"? Probably to some degree. Is it better than Lupron?

John can you post more information on that?

Tony
Disease:
Advanced Prostate Cancer at age 44 (I am 48 now)
pT3b,N0,Mx (original PSA was 19.8) EPE, PM, SVI. Gleason 4+3=7

Treatments:
RALP ~ 2/17/2007 at the City of Hope near Los Angeles.
Adjuvant Radiation Therapy ~ IMRT Completed 8/07
Adjuvant Hormone Therapy ~ 28 months on Casodex and Lupron.

Status:
"I beat up this disease and took its lunch money! I am in remission."
I am currently not being treated, but I do have regular oncology visits.
I am the president of an UsTOO chapter in Las Vegas

Blog : www.caringbridge.org/visit/tonycrispino

Post Edited (TC-LasVegas) : 8/22/2010 5:18:34 PM (GMT-6)


F8
Veteran Member


Date Joined Feb 2010
Total Posts : 3987
   Posted 8/22/2010 8:46 PM (GMT -6)   
Fairwind -- i have been wondering what you will decide. good luck in whatever you choose wink .  BTW, i am receiving radiation via IGRT, not IMRT.
 
F8
age: 55
PSA on 10/09: 6.8
no symptoms, no prostate enlargement
12/12 cores positive....gleason 3+4 = 7
ADT, brachy and IMRT

Post Edited (F8) : 8/22/2010 8:02:49 PM (GMT-6)


Fairwind
Veteran Member


Date Joined Jul 2010
Total Posts : 3889
   Posted 8/22/2010 9:07 PM (GMT -6)   
I'm going to have to get real serious over the next few days...Basically, it will boil down to what is available to me in the Denver area. My medical insurance does not allow me to go wandering around all over the country..There must be a good seed man there, I have to ferret him out...I'm comfortable with the surgeon..Young, smart, skilled and aggressive..It's liable to be a coin flip...
Age today: 68. Married, 6', 215 pounds, active, no health issues.
PSA at age 55: 3.5, DRE negative. Advice, "Keep an eye on it".
PSA at age 58: 4.5
PSA at age 61: 5.2
PSA at age 64: 7.5, DRE "Abnormal"
PSA at age 65: 8.5, DRE " normal", biopsy, 12 core, negative...
PSA at age 66 9.0 DRE "normal", BPH, Finesteride. (Proscar)
PSA at age 67 4.5 DRE "normal" second biopsy, negative.
PSA at age 67.5 5.6, DRE "normal" U-doc worried..
PSA at age 68, 7.0, third 12 core biopsy positive for cancer in 4 cores, 3 cores Gleason 6, one core Gleason 9. Finesteride discontinued, still no urinary symptoms, never had any..From age 55 to 65 I had no health insurance.

I have a date with the robo surgeon on Sept 3 but I'm keeping my options open. I'm also looking at seeds combined with IGRT which seems to be having good results with high-risk patients..

F8
Veteran Member


Date Joined Feb 2010
Total Posts : 3987
   Posted 8/22/2010 9:12 PM (GMT -6)   

i'm fortunate that in san jose there are plenty of good choices close by.  it's only a 5-minute drive to the radiation clinic, which is new and state of the art,  and 10 minutes to my urologist.  good luck to you cool .

 

F8


age: 55
PSA on 10/09: 6.8
no symptoms, no prostate enlargement
12/12 cores positive....gleason 3+4 = 7
ADT, brachy and IMRT
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