Anyone have the Pro's and Con's for either treatment option who can speak from personal experience?
A structural engineer reviewing an old building can take specimens of steel / concrete send them to the lab, break them and thus have the best assesment on the strength of materials used during construction. If not allowed to do so, there are non destructive tests that can give them some idea on the above. Same with prostate cancer. Surgery is destructive yet provides the best info of where things stand at that moment.
Non destructive testing would be perfect if it could actually tell you the strength of something thus the biopsy in PCa and most cancers. All treatments are destructive in some manner or another and patients respond differently further complicating choices.
OP needs to provide more information about his particular situation given it is his first post, is he 50 or 80?
7/2018 (66yr), PSA 4.1->5.1
8/2018-MRI PI-RADS 5, MRI guided biopsy, 8/14 cores, G7(4+3)
9/2018-CT/Bone scans clear
11/6/18-RALP Surgery
11/2018-Post-Op Path G7(4+3) Tert Gr5, pT3a pN0, Grp 3, SM, EPE, <3mm
11/2018-Decipher 0.47, Ave Risk
1/2019-Epstein-G9(4+5) Grp 5, pT2x, margin vs. incision not clear
4-6/2019 ART 37 sessions
PSA<0.10: 2019, 2020, 2021, 2022, 2023, 2024, 2025
OP needs to provide more information about his particular situation given it is his first post, is he 50 or 80?
7/2018 (66yr), PSA 4.1->5.1
8/2018-MRI PI-RADS 5, MRI guided biopsy, 8/14 cores, G7(4+3)
9/2018-CT/Bone scans clear
11/6/18-RALP Surgery
11/2018-Post-Op Path G7(4+3) Tert Gr5, pT3a pN0, Grp 3, SM, EPE, <3mm
11/2018-Decipher 0.47, Ave Risk
1/2019-Epstein-G9(4+5) Grp 5, pT2x, margin vs. incision not clear
4-6/2019 ART 37 sessions
PSA<0.10: 2019, 2020, 2021, 2022, 2023, 2024, 2025
Hello RJ and welcome. I had "radioactive pellets" inserted 18 years ago with great success (you can read my story in my signature). They were curative and left me with zero side effects except reduced ejaculate. The more technical term is Low Dose Rate Brachytherapy. At one time there were a number of posters on this site who had chosen this route but most (after their cure) have simply moved on. With the advent of other radiation alternatives, e.g. HDR Brachytherapy and SBRT as well as the fact that LDR Bracy generally isn't as profitable to providers as other alternatives, it isn't used as much these days. So, if you are considering that treatment, please make sure you pick an experienced doctor. Of course, that's true for all treatment!
LDR Brachy is optimal for normal sized prostates, cancer contained within the prostate (usually with Gleason 3 + 4 or 4 + 3) and men who prioritize sexual and urinary function along with cure. There is plenty of data to prove it's effectiveness.
Anyway, please tell us more about your specific situation and you'll get good advice and perspective from many educated folks on our site.
Jim
Forum Moderator-Prostate Cancer. Age 62 (80 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. PSA: 6 mo: 1.4, 1 yr: 1.0, 2 yr: .8, 3 yr: .5, 4/5 yr: .2, 6-15 yr: <1. My docs are "delighted"! My journey:
http://www.healingwell.com/community/default.aspx?f=35&m=1305643&g=1305643#m1
LDR Brachy is optimal for normal sized prostates, cancer contained within the prostate (usually with Gleason 3 + 4 or 4 + 3) and men who prioritize sexual and urinary function along with cure. There is plenty of data to prove it's effectiveness.
Anyway, please tell us more about your specific situation and you'll get good advice and perspective from many educated folks on our site.
Jim
Forum Moderator-Prostate Cancer. Age 62 (80 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. PSA: 6 mo: 1.4, 1 yr: 1.0, 2 yr: .8, 3 yr: .5, 4/5 yr: .2, 6-15 yr: <1. My docs are "delighted"! My journey:
http://www.healingwell.com/community/default.aspx?f=35&m=1305643&g=1305643#m1
I would not do pellets without IMRT.
Duck2 said...
I would not do pellets without IMRT.
Duck, maybe you wouldn't but one size doesn't fit all and that advice is not consistent with medical guidelines. LDR Brachy alone can be a great choice. In fact, LDR brachytherapy monotherapy remains a standard, guideline-supported treatment with excellent long-term outcomes. The men who are best suited for this as a monotherapy generally present with these cancer characteristics:
- PSA <10 (sometimes up to 15)
- Gleason Grade Group 1 or selected Grade Group 2 (3+4). Sometimes 4 + 3 if the factors below are true.
- Limited amount of Gleason 4
- Disease confined to the prostate
- Small number of positive biopsy cores
- No MRI evidence of extracapsular extension
- Prostate size that can technically accommodate implants (often <60–70 cc, although downsizing with medication is possible)
The reasons you DON'T automatically add IRMT are because adding it also increases:
- Urinary irritation
- Rectal dose
- Treatment time (several weeks)
- Cost
For men whose cancer is very likely confined to the prostate, multiple studies suggest there may be little or no meaningful improvement in cure rates from adding IMRT, while side effects may increase.
Hope this helps.
Jim
Forum Moderator-Prostate Cancer. Age 62 (80 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. PSA: 6 mo: 1.4, 1 yr: 1.0, 2 yr: .8, 3 yr: .5, 4/5 yr: .2, 6-15 yr: <1. My docs are "delighted"! My journey:
http://www.healingwell.com/community/default.aspx?f=35&m=1305643&g=1305643#m1