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Question for the brachy guys

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Prostate Cancer
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Question for the brachy guys  
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jym62
Regular Member
Joined : Apr 2013
Posts : 154
Posted 9/25/2013 7:45 AM (GMT -7)
I have somewhat of a weak stream especially at night and some frequency & urgency already. Is brachy still an option for me?
62
60 at 1st biopsy 11/22/11 one of 12 pos <5% gleason 6(3+3) psa 5.0
active surveillance 15 months
2nd biopsy 2/26/13 3of 24 pos <5% gleason 6(3+3)
psa 3/14/13 5.6
psa 6/13/13 2.5 ( after Avodart for over a year)
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Tudpock18
Forum Moderator
Joined : Sep 2008
Posts : 4427
Posted 9/25/2013 8:09 AM (GMT -7)
Jym, if you are considering LDR brachytherapy your urologist and/or RO should check your AUA Symptom Score www.prostatechicago.com/forms/aua-symptom-score.pdf

If you have a score much above 15 or if you have significant retention post-voiding, then you may not be a good candidate for LDR brachy. However, I'm not sure about the constraints for HDR brachy so perhaps one of the HDR guys will chime in as well.

Hope this helps.

Jim
Forum Moderator-Prostate Cancer. Age 62 (66 now), G 3 + 4 = 7, T1C, PSA 4.2, 2/16 cancerous, 27cc. Brachytherapy 12/9/08. 73 Iodine-125 seeds. Everything continues to function normally as of 7/13/13. PSA: 6 mo: 1.4, 1 yr: 1.0, 2 yr: .8, 3 yr: .5, 4 yr: .2. My docs are "delighted"! My journey:
https://www.healingwell.com/community/default.aspx?f=35&m=1305643&g=1305643#m1
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Steven D
Regular Member
Joined : Apr 2013
Posts : 367
Posted 9/25/2013 8:22 AM (GMT -7)
I know they used the same scoring method before my HDR.
Age 52
11/4/05 - PSA: 1.44
5/11/11 - PSA: 4.1
11/11/11 - PSA: 3.0
4/13/13 - PSA: 6.4
4/24/13 DRE normal
5/16/13 ultrasound but no biopsy due to bleeding
5/23/13 Biopsy 3+4=7
4 cores positive 3+3
1 core positive 3+4
9/19/13 HDR Brachy
IGRT Soon
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overthepond
Veteran Member
Joined : Apr 2011
Posts : 648
Posted 9/25/2013 8:26 AM (GMT -7)
Hi Jym,
First thing Jeff had to do when he had his initial consult with the Brachytherapist was a ‘flow test’; had to pee into a contraption that measured his flow etc.
We are in the UK so not sure if this would be the same protocol for you but definitely something to check with the specialist.
All the best to you.
Susan
x
Husband's age 64, excellent health
First PSA test – 7. Two months later – 11
Biopsy results: Gleason 3+3 in two cores (right medial 30% and right apex 90%).
Feb 2011 – Brachytherapy – Iodine 125
Post Brachy PSA results:
3 months 3.83 - 6 months 3.18 - 9 months 1.78 - 12 months 2.77 - 17 months 2.31 - 24 months 3.73 - 27 months 2.2 - 30 months 1.1
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jym62
Regular Member
Joined : Apr 2013
Posts : 154
Posted 9/25/2013 8:37 AM (GMT -7)
Tud, thanks for the reply. My AUA score is around an 8 to 10 and my post void residual was 85ml last time and has been as high as 146 ml. It's a concern to me because I had an acute retention episode 10 years ago after an ureterscopy. Still fresh in my mind. I was more interested in LDR brachy.
62
60 at 1st biopsy 11/22/11 one of 12 pos <5% gleason 6(3+3) psa 5.0
active surveillance 15 months
2nd biopsy 2/26/13 3of 24 pos <5% gleason 6(3+3)
psa 3/14/13 5.6
psa 6/13/13 2.5 ( after Avodart for over a year)
profile picture
Tudpock18
Forum Moderator
Joined : Sep 2008
Posts : 4427
Posted 9/25/2013 9:44 AM (GMT -7)
Jym, post-void retention of less than 100 and AUASS of 8-10 should be just fine for LDR. Given that you have had over 100ml in the past you should definitely talk that issue over with your uro-RO combination who might be doing the procedure. They may want you on specific meds to reduce the possibility of any retention issues.

Other than that you should be a great brachy candidate....of course, you may want to stay on AS also since you seem to be doing great.

Jim
Forum Moderator-Prostate Cancer. Age 62 (66 now), G 3 + 4 = 7, T1C, PSA 4.2, 2/16 cancerous, 27cc. Brachytherapy 12/9/08. 73 Iodine-125 seeds. Everything continues to function normally as of 7/13/13. PSA: 6 mo: 1.4, 1 yr: 1.0, 2 yr: .8, 3 yr: .5, 4 yr: .2. My docs are "delighted"! My journey:
https://www.healingwell.com/community/default.aspx?f=35&m=1305643&g=1305643#m1
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jym62
Regular Member
Joined : Apr 2013
Posts : 154
Posted 9/25/2013 3:13 PM (GMT -7)
Overthepond, thanks for the reply.
I did that once and had a peak flow rate of 10ml/sec down to 3. Low side of normal the way I understand it. Did they give your husband any idea of what the minimum flow rate needed to be?
62
60 at 1st biopsy 11/22/11 one of 12 pos <5% gleason 6(3+3) psa 5.0
active surveillance 15 months
2nd biopsy 2/26/13 3of 24 pos <5% gleason 6(3+3)
psa 3/14/13 5.6
psa 6/13/13 2.5 ( after Avodart for over a year)
profile picture
overthepond
Veteran Member
Joined : Apr 2011
Posts : 648
Posted 9/26/2013 3:09 AM (GMT -7)
Hi Jym,
No we weren't told what it should have been, only that he had passed it and was suitable for the Brachy procedure.
Susan
x
Husband's age 64, excellent health
First PSA test – 7. Two months later – 11
Biopsy results: Gleason 3+3 in two cores (right medial 30% and right apex 90%).
Feb 2011 – Brachytherapy – Iodine 125
Post Brachy PSA results:
3 months 3.83 - 6 months 3.18 - 9 months 1.78 - 12 months 2.77 - 17 months 2.31 - 24 months 3.73 - 27 months 2.2 - 30 months 1.1
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jym62
Regular Member
Joined : Apr 2013
Posts : 154
Posted 9/26/2013 11:52 AM (GMT -7)
Susan
Thanks for the reply!
62
60 at 1st biopsy 11/22/11 one of 12 pos <5% gleason 6(3+3) psa 5.0
active surveillance 15 months
2nd biopsy 2/26/13 3of 24 pos <5% gleason 6(3+3)
psa 3/14/13 5.6
psa 6/13/13 2.5 ( after Avodart for over a year)
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