Brachytherapy showtime

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briantopp
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Date Joined Sep 2010
Total Posts : 24
   Posted 9/26/2010 6:00 PM (GMT -6)   
I'm going in Tuesday for brachytherapy procedure at Princess Margaret Hospital in Toronto.

Last week was prep time with the anesthesiologist. A visit to Toronto Western Hospital to be blood tested, heart tested, listened to through instruments, and told three times to tilt my head back and open my mouth. Plus a run through the entertaining "have you ever had" questionnaire. When it was all over I briefly met the doctor himself who, pleasingly, said: "I'm used to meeting with patients who are sicker than you". I was warned that the tube to be put down my throat could cause damage to my front teeth. And, otherwise, that I was going to be aware of having a tube put into my arm; a mask over my mouth; and that I'd be missing the rest of the procedure. Which suits me just fine.

Also started in on "flomax". It made me dizzy the first day, and otherwise I don't seem to have any side-effects at all.

Today is day one of prep time for the main event. I.e. nothing to eat -- only liquids you can see through. In the morning I chose to interpret coffee as possible to look through, and am living on apple juice and chicken broth otherwise. Tomorrow it will be time for the fun purgative. Tuesday is showtime.

I'm feeling optimistic about things. Friends keep me positive by telling me stories about people they know who are doing well. I like stories like that, on this forum and in conversation. I've booked off work for the whole week and hopefully will be back in the saddle eight days from today.

Ed C. (Old67)
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Date Joined Jan 2009
Total Posts : 2460
   Posted 9/26/2010 6:30 PM (GMT -6)   
Good Luck Brian. I wish you the best results possible.
Age: 67 at Dx on 12/30/08
PSA 9/05 1.15; 8/06 1.45; 12/07 2.41; 8/08 3.9; 11/08 3.5 free PSA 11%
2 cores out of 12 were positive Gleason (4+4) and (4+5)
Negative CT scan and bone scan done on 1/16
Robotic surgery performed 2/9/09 Dr Fagin, Austin TX
Prostate weighed 57 grams size:5.2 x 5.0 x 4.9 cm
Posterior lateral lesions measuring 1.5 x 1.4 x 1.0 cm showing focal capsular penetration over a distance of 3mm in circumference.
Prostatic adenocarciroma accounts for approx. 10-20% of the hemisphere.
Gleason 4+4
both nerve bundles removed,
pT3a Nx Mx, Negative margins
seminal vesicles clean, lymph nodes: not dissected
continent after 5 months
2 months PSA test 4/7/09 result <0.1
5 months PSA test 7/9/09 result <0.1
8 months PSA test 10/9/09 result <0.1
11 months PSA test 1/21/10 result 0.004
14 months PSA test 4/19/10 result 0.005

Fairwind
Veteran Member


Date Joined Jul 2010
Total Posts : 3887
   Posted 9/26/2010 6:48 PM (GMT -6)   
Your front teeth should be fine! If you are like me, the breathing tube they stick down your throat will raise Cain with your vocal cords, I STILL have a little laryngitis..
Age 68.
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 age 66 9.0 DRE "normal", 2ed biopsy, negative, BPH, Proscar
PSA at age 67 4.5 DRE "normal"
PSA at age 68 7.0 third biopsy positive, 4 out of 12, G-6,7, 9
RRP performed Sept 3 2010

Tudpock18
Forum Moderator


Date Joined Sep 2008
Total Posts : 4271
   Posted 9/26/2010 7:16 PM (GMT -6)   

Brian, good luck...I'm sure it will go well and you will be bored by the time you get back to work!  So use some of those idle hours to check in here and let us know how it went.

All the best,

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 9/10/10. 6 month PSA 1.4, 1 year PSA at 1.0. My docs are "delighted"! My journey:
http://www.healingwell.com/community/default.aspx?f=35&m=1305643

erbob
Regular Member


Date Joined Jan 2010
Total Posts : 281
   Posted 9/26/2010 8:41 PM (GMT -6)   
Brian, you will do just fine. I had my brachytherapy on May 26th this year and drove from the Chicago area back home to Colorado just a day and a half after the procedure with zero problems. Only tiny discomfort was feeling like sitting on a sponge golf ball..... Left the facility without catheter and have experienced NO problems since the seed planting. I do take Flomax 1/2 hour after the evening meals and have yet to experience being dizzy. No trouble peeing and no ED. Just recently had my three month PSA check which turned out to be 0.12
For me, the brachy was THE way to go. Good luck and be sure to get back here soon to pass along the results of your seed implants.

briantopp
Regular Member


Date Joined Sep 2010
Total Posts : 24
   Posted 9/26/2010 9:44 PM (GMT -6)   
Thank you for these comments. Very helpful!

erbob: Wow a drive from Chicago to Colorado a day and a half after your procedure I'm impressed. I've done that drive (south from Saskatchewan to North Dakota, and then across heading east) I'm impressed you did it as an outpatient! Congrats on 0.12 you've set my target.

F8
Veteran Member


Date Joined Feb 2010
Total Posts : 3986
   Posted 9/26/2010 10:45 PM (GMT -6)   

Brian -- i also had BT in May.  i had side effects immediately -- urgency, frequency etc.  -- but they went away after a couple of days and then returned around day 10 like the doc said.  i had other side effects too (the worst of my treatment) but i was/am on lupron and i started flomax right before BT. 

six weeks after BT i began 28 doses of IGRT.  at that point i was still having frequency issues but it had gotten better.  i go for my one-month follow-up from IGRT tomorrow. the last  few nights i've only had to get up to pee once or twice and that's rare for me even pre-cancer.

the only "pain" from BT was the catheter i went home with but it was removed painlessly the next morning. i took aleve twice a day per my doctor and flomax twice a day.  good luck.  you'll do fine cool .
 
ed


age: 55
PSA on 12/09: 6.8
no symptoms, no prostate enlargement
12/12 cores positive....gleason 3+4 = 7
HT, BT and IGRT
received 3rd and last lupron shot 9/14/10

Post Edited (F8) : 9/26/2010 9:57:10 PM (GMT-6)


JoeFL
Regular Member


Date Joined Oct 2009
Total Posts : 420
   Posted 9/27/2010 12:05 PM (GMT -6)   
Brian,
 
Based on my BT experience you may be in for two surprises:
- The most discomfort you may have will be a sore throat from that breathing tube
- You're gonna feel pretty good long before you go back to work
 
Just get ready for a lot of bathroom visits for a while. That said, I think you will be pleased with your decision. It was the right choice for me.
 
Please let us know how it goes....regards,
 
Joe
 
 
Age 67 PSA 4.5 Biopsy 9/4/09 Bostwick Labs 5 of 8 sections (5 of 11 cores) positive-Gleason 3+3=6 Stage T1
BT on 12/11/09 (84 seeds of Palladium 103) Home same day/no catheter. Some burning, frequency, urgency for 6 weeks. No incontinence, mild ED. Normal activity within 3 days. 25 IGRT sessions ending 3/22/10 - some fatigue until 30 days after last treatment. PSA on 5/26 - 0.1 PSA on 9/1 - 0.1

lifeguyd
Veteran Member


Date Joined Jul 2006
Total Posts : 686
   Posted 9/27/2010 4:36 PM (GMT -6)   
 
Good luck with your procedure.  I still wish that I could have had BT.  I have two close friends that had BT the same time as my surgery.  One had some significant urinary and bowel problems during the first year and the other had no problems at all.  They both claim to have no erectile problems, though I know that guys tend to lie about that.  Maybe even some on this forum rolleyes
 
BT was my first choice and I still think that I should have gone that path.  However three urologists insisted that my Gleason 8 cancer needed to be removed with surgery. My friends both had Gleason 6 diagnosis.  I now have complete erectile failure.  shakehead I am only able to have erectile success with bimix injections.
 
We are all three approaching four years post treatment with no reoccurence.  That is the good thing.

PSA July 2006 4.7 , Nodule found
biopsy 10/06 very agressive gleason4+4=8 identified
DaVinci surgery, Sutter Hospital, Sacramento, Ca. January 2007
Post Ob confirms, gleason 4+4=8 with no extension or invasion
no long term continence problems
post surgery PSA continues to be undetectable at 3 years
ED continues, using bimix
born 1941

briantopp
Regular Member


Date Joined Sep 2010
Total Posts : 24
   Posted 9/28/2010 10:15 AM (GMT -6)   
I'm sitting in the waiting room waiting to be called. If you would like to imagine a surreal moment, try this: the room is full of glum surgery patients; the "price isvright" is blaring on a big tv; and all the ads are about funeral cost insurance! Not improving anybody's mood and bob barker did that show better...

cooper360
Regular Member


Date Joined Jul 2010
Total Posts : 161
   Posted 9/28/2010 10:24 AM (GMT -6)   
Hope all goes well! I think everyone can identify with the waiting room scenario,sometimes that's the worst part!!

briantopp
Regular Member


Date Joined Sep 2010
Total Posts : 24
   Posted 9/28/2010 10:32 PM (GMT -6)   
Well, I'm "on the other side" of this procedure... almost.

Bit of a wait this morning before they got around to me. Then friendly, smiling staff wheeled me into the OR. I was handled a bag full of useful things like my shiny new medic alert bracelet. Talked to the anaesthesiologist and the doctor. and then wheeled into the OR. In went the tube into my hand; a mask for oxygen... and I woke up, about an hour and a half later in the recovery room.

The doctor seemed quite pleased with how things went, and in due course I was wheeled out of recovery and into the short-term stay ward. Where I have been ever since. Pains for and aft steadily went away and I feel just fine now.

Just... can't pee. And they wont let me go until I do. Have drunk lots of water. Took two showers. Was catherized to relive some pressure and open things up. But so far, no luck.

So my wife has gone home. Seems like I'm here for the night. And now we are going to try the English remedy -- a big cup of tea.

briantopp
Regular Member


Date Joined Sep 2010
Total Posts : 24
   Posted 9/29/2010 3:23 PM (GMT -6)   
...which wasn't a great idea. Two-thirds of the way through the cup of tea, I had to run to the bathroom and was violently ill. The nurse was not too concerned -- that happens sometimes after anaesthetics.

Doctor was consulted. Conclusion was that I would spend the night with a catheter and hopefully the prostate would relax.

But that was not to be. A scan revealed that, mysteriously, there was less than 100cc in my bladder even though I had been drinking gallons (litres?) of water. Another nurse came in to redo the test - same result. So conclusion was that an old-fashioned remedy would be tried. They decided to let me sleep and see what happened.

At about three in the morning I woke up and, seemingly magically, everything had sorted itself out. Perhaps the anti-inflammatory had done its work. Perhaps five minutes of throwing up had shaken things loose. The nurses were very pleased. Commented that about one in three brachytherapy patients in their experience have to spend the night to be sure everything is working, and that things almost always resolve with some walking around and some time.

700cc of mysteriously-hidden urine into the bottle in four stages over the course of the night. I think maybe their scanner was defective, which worked out well for me since it saved me from a night on a catheter.

At 800 am a smiling nurse took my vitals -- all well -- checked with the front desk and said "you can go home".

I've now home and caught up on my sleep.

If all of this is as bad as its going to get, then this is going to be just fine. I feel fine -- just a tiny bit sore sitting on this hard chair, but perfectly normal lying down or in a softer spot. Tolerating the medicine just fine. Feel normal. Everything is working.

What's next? A month from now an intensive day for MRI and other tests to make sure everything is where it's supposed to be. Three months from now the first PSA test and hopefully (give or take the scripted "bounce") the first of a series of declining numbers.

I respect the therapy choices made by everyone on this board. I learned a great deal here, and made my final decision to try brachytherapy in good part after reading the stories about experience with that therapy that I read here. So here's one more voice saying that -- so far, fingers crossed -- this therapy is worth considering in the right circumstances.

Many thanks again for the encouraging notes above. All the best bt

Tudpock18
Forum Moderator


Date Joined Sep 2008
Total Posts : 4271
   Posted 9/29/2010 6:53 PM (GMT -6)   
Brian, sounds like you had a little hiccup but all in all everything went ok.  I'm also one of those who barfs with anesthesia and I do understand it's quite common.  I also have "Groundhog Day Symptom" with anesthesia...which my wife finds terribly amusing as I continually ask the same questions over and over...LOL.
 
I can't explain the delay in urination except that "all men are different".  Or...did you start the Flomax before your procedure?  That helped me and is pretty common but some docs start it afterward.
 
Anyway, I'm sure you're glad it's done and all should go smoothly from here on...
 
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 9/10/10. 6 month PSA 1.4, 1 year PSA at 1.0. My docs are "delighted"! My journey:
http://www.healingwell.com/community/default.aspx?f=35&m=1305643

briantopp
Regular Member


Date Joined Sep 2010
Total Posts : 24
   Posted 9/29/2010 7:10 PM (GMT -6)   
My wife said i was pretty funny coming out of anesthesia but I apparently didn't say anything too outrageous for which I am grateful. I did start the flomax a week ago. I think there was just a bit of swelling that resolved over the course of the night.

John T
Veteran Member


Date Joined Nov 2008
Total Posts : 4268
   Posted 9/29/2010 9:04 PM (GMT -6)   
Brian,
some tips if you need them. Lay off caffine and alcohol for a couple of months.
Take your flowmax and if there is any swelling or constriction take high dose, 800mg or Ibubropin for no more than 8 days.
JT

briantopp
Regular Member


Date Joined Sep 2010
Total Posts : 24
   Posted 9/29/2010 10:15 PM (GMT -6)   
very keen to hear any advice. i asked one of the nurses about taking a higher dose of flomax (the written materials i was given talk about going to two pills a day). she said that was not a great idea because it might lead to low blood pressure. have you been told this?

F8
Veteran Member


Date Joined Feb 2010
Total Posts : 3986
   Posted 9/29/2010 10:25 PM (GMT -6)   
i took two pills and they made me dizzy.  but i am also on lupron and BP meds.  so who knows.  did they tell you to take aleve 2x a day?  there's a likelihood side effects will return in a week or so and be more persistent.
 
ed
 
 
age: 55
PSA on 12/09: 6.8
no symptoms, no prostate enlargement
12/12 cores positive....gleason 3+4 = 7
HT, BT and IGRT
received 3rd and last lupron shot 9/14/10

Tudpock18
Forum Moderator


Date Joined Sep 2008
Total Posts : 4271
   Posted 9/30/2010 5:40 AM (GMT -6)   
Brian, I have seen a number of posts of this forum re Flomax and some lightheadedness so I would be careful with upping the dosage...hopefully you will not need it...I didn't.  But, I did need to take it for 3 months.  I had some urgency and frequency but not too bad.  I also avoided alcohol, caffeine and spicy foods.  The once or twice I had my Diet Cokes for a pick-up it made me go like crazy so I went back to avoiding that stuff and all was well.
 
Tudpock (Jim)

briantopp
Regular Member


Date Joined Sep 2010
Total Posts : 24
   Posted 9/30/2010 9:38 AM (GMT -6)   
Here's the regime they prescribe at the Princess Margaret:

Tamsulosin (generic "flomax") 0.4 mg a day, at bedtime. The written material says "after your brachytherapy procedure, the dose may be increased to 2 capsules at bedtime" but I havent discussed this with anyone yet.

Mobicox (meloxicam) 7.5 mg, twice a day with meals -- an anti-inflammatory. They say this will continue for a month unless stomach is irritated or black stool occurs.

Cipro (ciprofloxacin) 1000 mg, an antibiotic and the size of a horse tranquilizer.

JoeFL
Regular Member


Date Joined Oct 2009
Total Posts : 420
   Posted 9/30/2010 10:18 AM (GMT -6)   
Brian,
 
I started with one flowmax, went to 2 during my IGRT treatments (which you are not doing) on the advice of my Radiologist, and went back to one after those were completed. My blood pressure is somewhat low but I was taking medication for BP anyway....hard to figure that one for me. I have asked my uro if I can stop the flomax and he says "give it a try" whenever I am ready. He did tell me that some of his patients who stop become symptomatic again. I am going to continue to take 1/day for a couple of more months, stop, and see what happens.
 
Cipro was another story altogether. It was prescribed for me for a flu-like infection that was unrelated (I think) to my PC. I had a terrible reaction to it and will never take one again. It may have no adverse effect for you at all....I sincerely hope so.
 
One thing the Uro/Rad team that did my BT did not tell me was to expect some major brusing of the scrotum. I was pretty "black and blue" for about 10 days. No pain....just a lot of discoloration. It sure looked like it should have been sore...but it never was.
 
There are several of us here that admit to being biased toward BT if it is a viable option based on your "numbers/pathology". You are finding out right now why. Glad you are doing well.....regards,
 
Joe
Age 67 PSA 4.5 Biopsy 9/4/09 Bostwick Labs 5 of 8 sections (5 of 11 cores) positive-Gleason 3+3=6 Stage T1
BT on 12/11/09 (84 seeds of Palladium 103) Home same day/no catheter. Some burning, frequency, urgency for 6 weeks. No incontinence, mild ED. Normal activity within 3 days. 25 IGRT sessions ending 3/22/10 - some fatigue until 30 days after last treatment. PSA on 5/26 - 0.1 PSA on 9/1 - 0.1

briantopp
Regular Member


Date Joined Sep 2010
Total Posts : 24
   Posted 9/30/2010 11:14 AM (GMT -6)   
i'm tolerating the cipro well so far -- apparently it is something some folks are allergic to.

Ditto to the bruising. Looks like a bar fight morning after, but doesnt hurt.

I'm sharing the bias as well, to date. All depends on the outcome, but all plumbing is working perfectly so far -- not bad for day two post surgery.

Tudpock18
Forum Moderator


Date Joined Sep 2008
Total Posts : 4271
   Posted 9/30/2010 11:28 AM (GMT -6)   
Brian/Joe...you guys must have bigger b*lls than I do since mine weren't bruised at all...
 
Tudpock (Jim)

erbob
Regular Member


Date Joined Jan 2010
Total Posts : 281
   Posted 9/30/2010 4:44 PM (GMT -6)   
lifeguyd, you mentioned that one of your friends, who went through BT, had some bowel problems during his first year. Do you recall exactly what those bowel problems consisted of and how severe were those particular problems?? Thanks.

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25393
   Posted 9/30/2010 4:48 PM (GMT -6)   
brian, good luck on your recovery from your seeding. glad you got that urinary retention issue worked out

david in sc
Age: 58, 56 dx, PSA: 7/07 5.8, 10/08 16.3
3rd Biopsy: 9/08 7 of 7 Positive, 40-90%, Gleason 4+3
open RP: 11/08, on catheters for 101 days
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos marg
Incont & ED: None
Post Surgery PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA: 1/10 .12, 4/8 .04, 8/6 .06 11/10 ?
Latest: 6 Corr Surgeries to Bladder Neck, SP Catheter since 10/1/9, SRT 39 Sess/72 gy ended 11/09, on Catheter #21, will be having Ileal Conduit Surgery in Sept.
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