Decision Made: Going the Brachytherapy Route

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Michael's Wife
Regular Member


Date Joined Aug 2007
Total Posts : 150
   Posted 9/20/2007 2:10 PM (GMT -6)   
After talking with a several surgeons and radiologists, as well as a number of friends who have faced the same choice, my husband has decided on brachytherapy. We're waiting for him to get scheduled, but the procedure itself likely will be performed in early December due to a number of factors making earlier treatment difficult. He's also going to ask for another PSA test between now and then to see if anything has drastically changed in the meantime.

Thanks for all of your input. Reading about your experiences has helped us both have a better idea of what he'll be facing.

Husband Age: 58
Stage: T1c
Gleason: 6 (3+3)
PSA: 4.4
Biopsy: 12 samples, Adenocarcinoma involving 3 cores, right side only (95%, 90%, 30%, discontinuously)
Still researching options


Swimom
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Date Joined Apr 2006
Total Posts : 1732
   Posted 9/20/2007 2:31 PM (GMT -6)   
Good Choice and Good Luck. Stay with us okay?


Swim
 


Tony Crispino
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Date Joined Dec 2006
Total Posts : 8128
   Posted 9/20/2007 2:53 PM (GMT -6)   
Congrats and good luck. We hope the best and will be here if you need us.

Tony
Age 45 (44 when Dx)
Pre-op PSA was 19.8
Surgery on Feb 16, 2007
Post-Op Pathology was poor: Gleason 4+3=7, 4 positive margins, Stage pT3b (Stage III)
HT began in May, '07 with Lupron and Casodex 50mg
IMRT radiation for 38 Treatments ending August 3, '07
 
My PSA did drop out after surgery to undetectable.  It has not returned and I will continue HT until January '08.
 
My Life is supported very well by family and friends like you all.
 
STAY POSITIVE!


biker90
Veteran Member


Date Joined Nov 2006
Total Posts : 1464
   Posted 9/20/2007 4:00 PM (GMT -6)   
Hey Mike's Wife,

Its great to have the treatment decision behind us, isn't it. Now you can move ahead. Your patience has paid off...

Jim
Age 73. Diagnosed 11/03/06. PSA 7.05. Stage T2C Gleason 3+3.
RRP 12/7/06. Nerves and nodes okay.
Pathological stage: T2C. Gleason 3+4. Cancer confined to prostate.
PSAs from  1/3/07 - 7/18/07 0.00. 
T level on 4/2/07 - 48     On 7/16/07 - 613
Started Tri-Mix on 8/7/07.  .02 ml and 50 mg Viagra.  It works!!!
Next PSA and T tests on 10/17/07
 
"Patience is essential, attitude is everything."
 


Michael's Wife
Regular Member


Date Joined Aug 2007
Total Posts : 150
   Posted 9/20/2007 5:43 PM (GMT -6)   
Thanks, everyone. Yes, it's great to have the decision made. We kept going back and forth for so long, and there's definitely a sense of peace that comes in knowing the choice has been made and we're moving on to the next step.

We'll definitely be around and will keep you all posted on how things go along the way.

Ellen

P.S. I updated the signature; let's see if this works ...

Husband Age: 58
Stage: T1c
Gleason: 6 (3+3)
PSA: 4.4
Biopsy: 12 samples, Adenocarcinoma involving 3 cores, right side only (95%, 90%, 30%, discontinuously)
Brachytherapy being scheduled


jetguy
Veteran Member


Date Joined Sep 2006
Total Posts : 741
   Posted 9/20/2007 5:49 PM (GMT -6)   

Good decision.  And what a relief to have the decision making finished!  Expect the best and don't forget to keep us informed.

Regards,

Bill


August of 2006, PSA up to 4.2 from 2.7 one year ago. 
October free and total PSA 12% free and 5.0 total.
A month, or so later, 4.7.
Late in the year decide on Image Guided IMRT.
Begin 43 treatments on January 23, 2007 and finish on March 23.
Four month post treatment PSA is 1.9.  (This is a very good result.)
No side, or after effects.  None.
I have aged a year and am now 63.  How did that happen?


IdahoSurvivor
Veteran Member


Date Joined Aug 2007
Total Posts : 1015
   Posted 9/20/2007 5:52 PM (GMT -6)   

Hi Ellen,

With all of the consideration you have made, I just know you and hubby made the very best decision for your family.  I'm so glad that you can now look forward with confidence to the first step for healing.  My thoughts and prayers go out to you and your husband!   Thank you for all the support you continue to offer us as well.

Kind regards,

Barry (Idaho)


Da Vinci Surgery July 31, 2007… 54 on surgery day
PSA 4.3  Gleason 3+3=6  T2a  Confined to Prostate

PSA 0.04 (undetectable) 9/11/2007

Web site: http://pca-info.blogspot.com

 


mvesr
Veteran Member


Date Joined Apr 2007
Total Posts : 823
   Posted 9/20/2007 7:34 PM (GMT -6)   
Dear Mike's wife. It is a real relief when you make that decision. Now, don't look back and move forward with the rest of your life. Best of luck to you and let us know how you are doing.

Mika

Michael's Wife
Regular Member


Date Joined Aug 2007
Total Posts : 150
   Posted 9/21/2007 6:33 AM (GMT -6)   
Thanks to you all. :-) I feel like we've made the first step towards healing. It's funny how although nothing really has changed, it feels so much better already.

JustJulie
Regular Member


Date Joined Mar 2006
Total Posts : 355
   Posted 9/21/2007 12:06 PM (GMT -6)   

Mike's Wife:

Welcome to the Brachytherapy Club!  We're on that journey now, please, Ellen, if you have ANY questions about the pre-op, procedure or post-op, call on me.  My husband's surgery was over a year ago and he's really progressing well :)

Best wishes to you and your husband as you begin the next step of your journey, and please, keep posting.

 

JustJulie


Michael's Wife
Regular Member


Date Joined Aug 2007
Total Posts : 150
   Posted 9/21/2007 12:30 PM (GMT -6)   
Will do, Julie. Thanks for the offer. It's much appreciated.

Ellen

Michael's Wife
Regular Member


Date Joined Aug 2007
Total Posts : 150
   Posted 9/21/2007 3:29 PM (GMT -6)   
I've not seen the particular study you seem to be referencing with the associated statistics you cite. Do you have a particular reference? You seem to be lumping in physical effects of radiation in general as if there's only one type. In any event, to us, issues of incontinence and other factors with surgery far outweigh other potential side effects we've read about. As has been posted over and over, the decision is a personal one. I'm glad the decision you made was right for you.

All of our research fed into the decision that's been made. Overall, we felt more comfortable with what we considered to be lower side effects and risks associated with seed radiation as opposed to either open or DaVinci surgery. Since my husband's cancer is early stage and he's in excellent health otherwise, we felt he was an ideal candidate for brachytherapy.

As I've said and per the title on this thread, the decision has been made and we're not looking back, particularly without any serious new information. Thanks.

Husband Age: 58
Stage: T1c
Gleason: 6 (3+3)
PSA: 4.4
Biopsy: 12 samples, Adenocarcinoma involving 3 cores, right side only (95%, 90%, 30%, discontinuously)
Brachytherapy being scheduled


Michael's Wife
Regular Member


Date Joined Aug 2007
Total Posts : 150
   Posted 9/22/2007 8:06 AM (GMT -6)   
I woke up this morning thinking about this thread and something you said that people often use as an argument for surgery:

chas036 said...
One thing that really scared me alot about radiation is there no way to really know if the cancer is gone. If it does come back in the future, you do not have the option to remove the prostate because of all the damage done buy the radiation. At least with surgery, you will have a pretty good idea what to expect, and to know if it looks good that you will be cured.


The fact is that even with surgery, you never really know whether the surgeon has left cancer cells behind. All it would take is one. With seed radiation, the prostate will be imaged to see if there are any 'cold spots' after treatment. If there are, the area will be re-seeded. Also, if cancer returns after surgery, other treatments such as radiation are the usual next step. This is the same case for seed radiation. Once the prostate is radiated, there really isn't a prostate per se to try to remove, so I'm not sure what the point would be of removing an organ that has already been radiated. If the cancer is determined to have spread, other treatments will be evaluated, just as with surgery.

Again, each person should learn the facts and evaluate the risks in terms of their own priorities.

Ellen

Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 9/22/2007 11:23 AM (GMT -6)   
Hi Ellen,
The biggest key is to go with what makes you feel best. Your point about the surgery after radiation is mostly correct. One good reason for surgery after RT is seminal vesicle involvement. And for me however, this procedure, brachytehrapy, would have likely not worked. My decision for surgery was based on the what if it is advanced? And indeed I had the indicators. High PSA, both sides involved, and borderline aggressive disease. I could only find a few RO's that would argue against surgery and all surgeons argued against RT in my case. Good thing I did have surgery as the likelyhood of distant spread was discovered. I might have waited years for further adjuvant therapy with radiation as a primary treatment and that could have proved deadly. By removing the prostate and checking the pathological margins it was clear that I needed HT as well. Eventually I did have radiation, but I knew the positive margins meant more local disease could be treated with it. At 45, I have an 8% chance of no recurrance in ten years. I would never have been comfortable not knowing if it was possible that the disease was still present after RT. After surgery I know it is. Sounds backwards, I but I'd rather know than wonder. At this time I am presently attacking back and have the upper hand at this point. Good luck on your husbands treatment. We will pray for your success and good health.

Tony
Age 45 (44 when Dx)
Pre-op PSA was 19.8
Surgery on Feb 16, 2007
Post-Op Pathology was poor: Gleason 4+3=7, 4 positive margins, Stage pT3b (Stage III)
HT began in May, '07 with Lupron and Casodex 50mg
IMRT radiation for 38 Treatments ending August 3, '07
 
My PSA did drop out after surgery to undetectable.  It has not returned and I will continue HT until January '08.
 
My Life is supported very well by family and friends like you all.
 
STAY POSITIVE!


Michael's Wife
Regular Member


Date Joined Aug 2007
Total Posts : 150
   Posted 9/22/2007 12:38 PM (GMT -6)   
Thanks for your response, Tony. I understand completely and agree with you. I think the biggest argument for surgery is that you get to see the *true* pathology of the prostate afterward. In my husband's case, all factors point to early stage, confined, non-aggressive disease. This has played a huge part in his decision. To us, he seems the perfect candidate for brachytherapy. (Even his surgeon urged us from the start to seriously consider it.)

I'm glad to hear things are going well for you. It certainly sounds like you've had quite the fight but are doing well at winning! It's encouraging to read about people like you who have much more advanced/aggressive disease and are doing well against the cancer.

Take care.

Ellen

JustJulie
Regular Member


Date Joined Mar 2006
Total Posts : 355
   Posted 9/25/2007 12:17 PM (GMT -6)   

Ellen:

Was Mike offered the option of stranded seeding for his Brachytherapy?  That's the route my husband took - all 91 were stranded.

Julie


Michael's Wife
Regular Member


Date Joined Aug 2007
Total Posts : 150
   Posted 9/25/2007 12:25 PM (GMT -6)   
Hi, Julie.  Yes, the plan is for stranded seeding.  We're still anxiously waiting for scheduling.  I know we'll both feel better to have some dates set.
 
Ellen

JustJulie
Regular Member


Date Joined Mar 2006
Total Posts : 355
   Posted 9/25/2007 12:33 PM (GMT -6)   

Patience sure is a virtue isn't it?  Good luck to you.  Speaking from the stranded experience, we've had nothing to complain about.

Best wishes to both on you on your next step down the road to recovery.

Julie


Michael's Wife
Regular Member


Date Joined Aug 2007
Total Posts : 150
   Posted 9/25/2007 1:36 PM (GMT -6)   
Thanks! Yeah, patience is something I'm not normally good at. I'll keep you posted as things get lined up. (And thanks for the feedback re: stranded seeding.)

Ellen

Husband Age: 58
Stage: T1c
Gleason: 6 (3+3)
PSA: 4.4
Biopsy: 12 samples, Adenocarcinoma involving 3 cores, right side only (95%, 90%, 30%, discontinuously)
Brachytherapy being scheduled


creed_three
Veteran Member


Date Joined Jan 2007
Total Posts : 762
   Posted 9/27/2007 4:31 PM (GMT -6)   
Hi Ellen,

All the best with your husband's decisions and now treatment. I really hope it goes well for you both. My husband chose surgery but due to the aggressiveness of the Gleeson 7 mainly. Brachytherapy seems to have some excellent results overall.

Anyway, now that you have decided, it is all focus on recovery. We took 4 months to make our final decision after considering all options. It is a hard decision whatever path, but glad you are both on the road to planning now. There is a wealth of info about brachytherapy here and great outcomes from those who have chosen this too. Good luck with everything. Just thought I'd say hello. Take care. Lana


Creed_three
Lana posting for husband CJ (49 years). First PSA 3.5 (Nov 06). Open Radical Prostatectomy on Tuesday 17th April 2007. Gleeson 3 + 4 = 7. Confined to prostate. PSA 0.01 (June 07).


Michael's Wife
Regular Member


Date Joined Aug 2007
Total Posts : 150
   Posted 9/28/2007 5:23 AM (GMT -6)   
Thanks very much, Lana. My husband had another pathologist review his slides to confirm the Gleason and will be having another PSA test prior to seeding just to make sure it doesn't look like we're dealing with something that is any more aggressive than originally anticipated. I understand completely about your husband's choice of surgery, as my husband would do the same if it seemed more aggressive and possibly not contained. (Of course, anything is possible, we just hope for the best with all of this. I guess that's what makes all of this so hard.)

I'm glad to see someone else took a long time, too, to decide. We found out about the cancer at the beginning of August, and only recently made the firm decision on treatment. I do feel, though, that we've really evaluated all of the alternatives and are knowledgeable about our choices, so there's a real comfort in that. Now to wait until December when we'll finally be able to fully focus on recovery. Hopefully we'll have a cancer-free Christmas and New Year. :-)

Thanks for saying hi and for the words of support.

Ellen

Husband Age: 58
Stage: T1c
Gleason: 6 (3+3)
PSA: 4.4
Biopsy: 12 samples, Adenocarcinoma involving 3 cores, right side only (95%, 90%, 30%, discontinuously)
Brachytherapy being scheduled


JCL
Regular Member


Date Joined Jul 2007
Total Posts : 242
   Posted 9/28/2007 6:33 AM (GMT -6)   
Sounds like you've made a very informed decision as to the path you've chosen. Good luck. Each of our situations are different, and unfortunately there's no one panacea. In my case I had been studying and staying informed on the different treatments for the past ten years since my father was diagnosed in 1997, and chances were that sooner or later I'd be dealing with prostate cancer (turns out it was sooner). I chose surgery because of my age and the fact that my tests showed that it was very well possible I had an aggressive cancer. My father's biopsy and pathology scores were lower than mine, and he was diagnosed and had surgery at age 67, while I was diagnosed at age 49.

Again, good luck!


Age: 49
Diagnosed: March 25, 2007
PSA: 3.0
Biopsy: Gleason 6, 5 out of 12 core samples positive for cancer with <5% on all 5. Staged at T1c
DaVinci Surgery: May 21, 2007 at Florida Hospital, Orlando. Surgery took 1 hour and 45 minutes. According to my surgeon, prostate peeled away nicely and everything went text book. Nerves spared.
Pathology Report: Upgraded to Gleason 7 (3+4), Negative margins, seminal vesicles negative, no capsular penetration, lymph nodes left intact, 15% of prostate involved by cancer.
1st Post-op PSA: <0.01
2nd Post-op PSA: Scheduled September 27, 2007.
Continence: Out of pads 5 weeks post-op. Still have some minor stress incontinence from time to time but it's not an issue.
Erections: Yes! With the assistance of Cialis.
Family History: Father diagnosed with prostate cancer in 1997 at age 67. Prostate removed and has had a <0.1 PSA ever since.


Michael's Wife
Regular Member


Date Joined Aug 2007
Total Posts : 150
   Posted 9/28/2007 11:14 AM (GMT -6)   
Thanks, JCL. You are so right about each situation being different. Also, since my husband had similar anticipated outcomes with different treatment choices, we were left feeling that our challenge was to pick the treatment with the most personally palatable (or, rather, the fewest non-palatable!) side effects and risks.

My husband's father had prostate cancer as well, but the family didn't share that with him until he was diagnosed this year. sad We've already discussed with my husband's son about the importance of early screening.

From your signature, it looks like you're doing quite well. That's terrific! Hope the recent PSA test results come out as great as the first.

Ellen

bluebird
Veteran Member


Date Joined May 2006
Total Posts : 2542
   Posted 9/28/2007 12:13 PM (GMT -6)   

tongue  Hi ~ Ellen & Michael,

 

Once again… I feel the following touches a cord with all of us…

 

 

KNOWLEDGE    IS    POWER  ...  and  POWER conquers  fear

 

YOU MAKE THE DECISIONS… YOU HAVE OPTIONS…

~ and ~

Your decision will be the right decision for you!!!

 

The sharing of our own personal  “Journeys” allows each of us to pull the stepping-stones we want onto our path to help with our personal fight against this cancer.  I know from my own journey over the past 18 months… ~ I have grown in knowledge about other “treatments”… and I am no longer afraid of them.  Why?  Because ~ forum friends are taking the time to Share ~ their experiences… and this is so important.  Would we change our decision due to the extra knowledge we have gained.  No ~ but it’s nice to have the fear dissipate so if the time comes where we have to move onto a new path… we can move with knowledge.  And it’s due to forum family members ~ continuing to share their Journeys with all of us.  Thank you!!! (I won’t name individuals…because I’m likely to leave someone out… “You Know Who You Are!”)  yeah  

 

Thank you for staying close and sharing “Your Journey” with all of us. 

Sending Warm Hugs and Special Thoughts to you as you move forward… 

In Friendship ~ Lee & Buddy

 

Helping to keep this journey together… for future readers/members 

(Direct Link ~ just click on the title below and a new window will open!  

Reminder … click on the REFRESH icon once you get there) 

 

08-08-07  New here  started by Ellen *Michael’s Wife


mama bluebird - Lee & Buddy… from North Carolina

 

v          We invite you to visit our personal thread:  Click Here:  “Our Journey” ~ Sharing is Caring 

April 3, 2006  53 on surgery day

RRP / Radical Retropubic Prostatectomy

PSA 4.6   Gleason  3+3=6    T2a   Confined to Prostate

3rd PSA 08-07-2007 Less than 0.1 Non-Detectable :)

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