why surgery after radiation?

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gralestel
New Member


Date Joined Dec 2006
Total Posts : 11
   Posted 12/28/2006 7:09 PM (GMT -7)   
hello all,
many people on this forum have commented that surgery after radiation is difficult or impossible. could someone explain why surgery might be necessary after brachytherapy? does anyone know of cases where the brachytherapy didn't kill all the cancer and then the prostate needed to be removed (or some other scenario)??

thank you!

Izzyblizzy
Regular Member


Date Joined Oct 2006
Total Posts : 411
   Posted 12/28/2006 7:18 PM (GMT -7)   
that is a good question.
 
we just met with the radiologist yesterday and I didn't think to ask that.  I guess I assumed because radiation therapy might not kill all the cancer cells in the prostate?
Signficant Other diagnosed: 10/30/06 (age 63)
PSA: 3.7 (up from 3.4 prior year)
Gleason: 3+3
Biopsy: 1/10 positive, 5% cancerous, right apex.
Treatment:  Undecided


aus
Regular Member


Date Joined Sep 2006
Total Posts : 211
   Posted 12/29/2006 2:09 PM (GMT -7)   

Usually Brachytherapy is regarded as an appropriate treatment for low risk patients, not for those with agressive cancers or any  high risk elements.

Like any treatment it can have failures.  Salvage surgery can be done, but it is more difficult than usual surgery.

John

 


spinbiscuit
Veteran Member


Date Joined Apr 2006
Total Posts : 818
   Posted 12/29/2006 3:43 PM (GMT -7)   

Hi gralestel,

The radiation thearapy (brachytherapy) in this case statisticly is every bit as sucessful as any of the surgical techniques. The difference is even if there is a very small chance that a surgical procedure was unsucessful there would always be radiation, or hormone therapy to have as back-up treatments. This may not be possible if a radiation technique is the first treatment. Although it would not entirerly exclude surgery as a fall back option; many surgeons believe that the tissue in and around the treated area would have been too greatly compromised. Then hormone therapy would be the remaining option.

I know swimom has done extensive research in this matter, and I'm sure will soon explain in greater detail what I have left out or missed. 

Glen


Diagnosed at age 60
PSA went from 2.2 to 3.8 in 14 months
2 of 14 cores positive at 10%
Gleason 6(3+3), negative DRE, neg. boundaries
DaVinci surgery on 02/23/06
 


Tamu
Veteran Member


Date Joined Oct 2006
Total Posts : 626
   Posted 12/29/2006 5:37 PM (GMT -7)   
Gralestel,

My surgeon told me that he does 4 or 5 surgeries a year on men that have had radiation first. I guess it depends on the circumstances whether or not he would do it and I am not knowledgable enough to know what those may be. He did say that the complications are considerably worse in those cases.
So to say that surgery after radiation is not an option is not absolutely true but it is a very rare occurance.

Tamu
Diagnosed 7/6/06
1 of 10 core samples, 40%
Stage T1c, Gleason 3+3
Da Vinci on 11/01/06
56 Years Old
Post Op Path
Gleason 3+3
Approx. 5% of prostate involved
Prostate Confined, margins clear
Undetectable PSA on 12/18/06


Swimom
Veteran Member


Date Joined Apr 2006
Total Posts : 1732
   Posted 12/29/2006 5:52 PM (GMT -7)   
Gralestel,

I'm not sure whether you mean a prostatectomy following brachy for cancer or for another reason. The one major reason I can see the as cause for a prostatectomy following successful seeds/radiation would be in the event of severe urinary complications. The prostate is so large or damaged for whatever reason that a man has his prostate removed to relieve symptoms.

Tamu is right...second attempts at a cure for PCa using a prostatectomy is possible. The incontinence risk is about 50% and the impotence rate is 80+. Each man weighs his options and what is most valuable to him in that case.

Swim

Izzyblizzy
Regular Member


Date Joined Oct 2006
Total Posts : 411
   Posted 12/29/2006 9:55 PM (GMT -7)   
ahhhhh, that makes sense, swim.
Signficant Other diagnosed: 10/30/06 (age 63)
PSA: 3.7 (up from 3.4 prior year)
Gleason: 3+3
Biopsy: 1/10 positive, 5% cancerous, right apex.
Treatment:  Undecided


Izzyblizzy
Regular Member


Date Joined Oct 2006
Total Posts : 411
   Posted 12/29/2006 9:55 PM (GMT -7)   
ahhhhh, that makes sense, swim.
Signficant Other diagnosed: 10/30/06 (age 63)
PSA: 3.7 (up from 3.4 prior year)
Gleason: 3+3
Biopsy: 1/10 positive, 5% cancerous, right apex.
Treatment:  Undecided


Izzyblizzy
Regular Member


Date Joined Oct 2006
Total Posts : 411
   Posted 12/29/2006 9:55 PM (GMT -7)   
ahhhhh, that makes sense, swim.
Signficant Other diagnosed: 10/30/06 (age 63)
PSA: 3.7 (up from 3.4 prior year)
Gleason: 3+3
Biopsy: 1/10 positive, 5% cancerous, right apex.
Treatment:  Undecided

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