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Brachytherapy ?

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User
Posted 19 Oct 2015 at 18:35

Hello

 

I have been diagnosed with Prostate Cancer, about 2 weeks ago, I've been getting up 3 or 4 times a night for a wee for some time but put it down to getting older - I'm now 60

 

I feel very fortunate that the Rotary Club offered a mass screening for PC - I wouldn't usually even think about attending such an event, but luckily I did, the result was a slightly higher PSA reading than normal, I was told to see my doctor after 3 months for another test, after this test showed a high PSA things have moved quickly.

 

Its added to the stress I was under with problems starting a new business, but it could have been worse, the bone scan shows it hasn't spread from the prostate.

 

I would appreciate any feed back to help decide what to do, I have the option of Prostate Brachytherapy or Da Vinci

 

My info

 

Gleason score 3+4=7, maximum cancer length 8mm, PSA4.3 ng/ml, prostate volume 37 cc on MRI, clinical stage T1 or T2

 

Best wishes

 

Richard

User
Posted 19 Oct 2015 at 22:54

Hi Richard,

With G7, T2, you have a wide range of options, not just brachytherapy or prostectomy but other treatments and watchfull waiting, therefore you should resist the perfectly natural urge to make a quick decision and take the time you require to satisfy yourself that you have explored all options. 

There was a Horizon programme on BBC 2 last August ('Should I Test My Health', on BBC Two Wednesday 12 August).

You can find it's written version on the Internet

Dr Vincent Gnanapragasam, who runs a watchful waiting programme at Addenbrokes hospital in Cambridge, tells me: "There was a study which took men with all kinds of prostate cancer and randomised them to having nothing done or radical surgery and at the end of 10 years there was actually no difference in the overall survival. Most importantly the men with low risk cancer had absolutely no evidence of benefit from radical treatment."

So take your time and don't be rushed into a decision.

:)

Dave

User
Posted 20 Oct 2015 at 06:00

Hello Richard and welcome

My husband was diagnosed at around 72. His PSA was 6.3 with Gleason 3+4. He opted for active surveillance which he was on for the first year, then he had to make a decision and opted for low dose seed Brachytherapy implants.

(Brachytherapy comes in two versions low dose where the seeds are implanted and remain forever and High Dose where "rods" are inserted for a minimum time and removed. Which version were you thinking of?

As Mjl says, click on the avatar and you can follow my husband's journey. His PSA is now down to 0.5

You do appear to have time to ponder your options and I would think very carefully before you make a decision. In other words don't be rushed by anyone into taking a route you may regret further down the line.

I wish you well with your journey. Ask anything you like. Somebody will know the answer or point you in the right direction to find it.

Sandra

We can't control the winds - but we can adjust our sails
User
Posted 21 Oct 2015 at 10:11

Based on the data collected by surgeons and oncologists, brachy is as successful as external beam RT or surgery but with less side effects. It would have been my husband's first choice but it wasn't available to him because at our hospital it isn't given to 'young' men (he was 50). Generally, brachy is not offered to men if their Gleason is 8 or above, if their PSA is 10 or above, if they have a large prostate gland and/or if they already have urinary problems such as hesitancy or difficulty emptying their bladder. Having said that, some hospitals will offer brachy if the man has only one or two of the contraindications.

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 21 Oct 2015 at 10:34

Hi Richard,

Sorry, I don't know much about brachy as I didn't qualify for it but I just wanted to welcome you to the site.

I hope your treatment goes well when you decide.

You've join a great group of people here.

All the Best

Steve

User
Posted 17 Nov 2015 at 19:42
Hi Richard

I haven't been on the site for a while as my hubby was having a break between his radiotherapy and his planned brachytherapy - which is happening tomorrow so I'll probably post an update at the weeken. Brachy was just one part of his treatment plan, 25 sessions radiotherapy done and he'll hopefully have his last 3 month hormone injection in December.

All the best

M

"You're braver than you believe, stronger than you seem and smarter than you think." A A Milne
User
Posted 18 Nov 2015 at 09:03

Wish him luck from me M.

Hope all goes well for him (and you !)

We can't control the winds - but we can adjust our sails
Show Most Thanked Posts
User
Posted 19 Oct 2015 at 20:30
Hi Richard

My husband opted for the brachytherapy route, he had a choice, if you click on my avatar you will be able to see his history, I also have posted a thread "start of radiotherapy" , updated earlier today, which gives a summary of his radiotheraphy treatment prior to his planned brachytherapy (not everyone has both) you may find these useful.

If you haven't already done so phone PCUK for a copy of the "toolkit", the specialist nurses are brilliant.

All the best

Maureen

"You're braver than you believe, stronger than you seem and smarter than you think." A A Milne
User
Posted 19 Oct 2015 at 22:54

Hi Richard,

With G7, T2, you have a wide range of options, not just brachytherapy or prostectomy but other treatments and watchfull waiting, therefore you should resist the perfectly natural urge to make a quick decision and take the time you require to satisfy yourself that you have explored all options. 

There was a Horizon programme on BBC 2 last August ('Should I Test My Health', on BBC Two Wednesday 12 August).

You can find it's written version on the Internet

Dr Vincent Gnanapragasam, who runs a watchful waiting programme at Addenbrokes hospital in Cambridge, tells me: "There was a study which took men with all kinds of prostate cancer and randomised them to having nothing done or radical surgery and at the end of 10 years there was actually no difference in the overall survival. Most importantly the men with low risk cancer had absolutely no evidence of benefit from radical treatment."

So take your time and don't be rushed into a decision.

:)

Dave

User
Posted 20 Oct 2015 at 06:00

Hello Richard and welcome

My husband was diagnosed at around 72. His PSA was 6.3 with Gleason 3+4. He opted for active surveillance which he was on for the first year, then he had to make a decision and opted for low dose seed Brachytherapy implants.

(Brachytherapy comes in two versions low dose where the seeds are implanted and remain forever and High Dose where "rods" are inserted for a minimum time and removed. Which version were you thinking of?

As Mjl says, click on the avatar and you can follow my husband's journey. His PSA is now down to 0.5

You do appear to have time to ponder your options and I would think very carefully before you make a decision. In other words don't be rushed by anyone into taking a route you may regret further down the line.

I wish you well with your journey. Ask anything you like. Somebody will know the answer or point you in the right direction to find it.

Sandra

We can't control the winds - but we can adjust our sails
User
Posted 20 Oct 2015 at 10:11

Hi Maureen

 

Thank you for your message, I will phone PCUK for a copy of the ''toolkit''

 

So pleased I found this site - it really is a great help.

 

Best wishes

 

Richard

 

 

User
Posted 20 Oct 2015 at 10:22

Hi Dave

 

Thank you for your message, its given me a lot to think about.

 

I remember watching a few minutes of the Horizen programme you mention but because I had no problems then, and I'm very squeamish didn't watch, unfortunately it not on iplayer.

 

Best wishes

 

Richard

 

User
Posted 20 Oct 2015 at 10:36

Hello Sandra

 

Thank you for the information, its good to know I don't have to rush to decide what to do next.

 

The Brachytherapy low dose seeds were suggested, unfortunately there are side effects with every option.

 

Best wishes

 

Richard

 

 

User
Posted 20 Oct 2015 at 12:25

Hi Richard,

I had a gleason 3+4 and was told l could not have brachytherapy because the MRI scan indicated that the cancer was aggressive on the left side and looked as though it was breaking out of the capsule. As already discussed the tool kit is a valuable source of information. I had meetings with a surgeon and an oncologist who both explained the treatment, the side effects and the expected outcomes. I opted for a laparoscopic RP. 

You need to gain a much information as you can, ask many questions, agonise over a decision and then decide the way forward that suits you.

 

Paul

THE CHILD HAS GROWN, THE DREAM HAS GONE
User
Posted 20 Oct 2015 at 12:35

When I was having a blood test recently I was speaking to the nurse and I know her reasonably well. We discussed my prostate cancer and she told me her hubby had had the low dose brachytherapy. She was open enough to explain that he got most of the side - effects including ED , but that he was totally fine now. So there's some good news if you pick that
Chris

If life gives you lemons , then make lemonade

User
Posted 21 Oct 2015 at 09:50

Hi Paul

Thank you for your message, I have asked for the toolkit; really need to get as much information as possible.

Were you offered Da Vinci surgery, my cousin had this and recommended it - however his Gleason and PSA were much higher than mine, I feel the alternatives are probably better I would appreciate your views on this.

Its really uplifting to hear the successful outcomes on this site.

Best wishes

Richard

User
Posted 21 Oct 2015 at 09:55

Hi Chris

Thank you for your message - what a great site this is! its so helpful getting messages like yours.

Best wishes

Richard

User
Posted 21 Oct 2015 at 10:11

Based on the data collected by surgeons and oncologists, brachy is as successful as external beam RT or surgery but with less side effects. It would have been my husband's first choice but it wasn't available to him because at our hospital it isn't given to 'young' men (he was 50). Generally, brachy is not offered to men if their Gleason is 8 or above, if their PSA is 10 or above, if they have a large prostate gland and/or if they already have urinary problems such as hesitancy or difficulty emptying their bladder. Having said that, some hospitals will offer brachy if the man has only one or two of the contraindications.

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 21 Oct 2015 at 10:34

Hi Richard,

Sorry, I don't know much about brachy as I didn't qualify for it but I just wanted to welcome you to the site.

I hope your treatment goes well when you decide.

You've join a great group of people here.

All the Best

Steve

User
Posted 22 Oct 2015 at 21:01
Hi Richard

My 54 year old husband had Brachytherapy 8 weeks ago, 72 seeds were planted and although the 8 weeks hasn't been easy for him, it hasn't been anywhere near as bad as what we expected. Hasn't needed time off work, except a few days after the treatment and has still been able to play squash & golf. Main issues, constant need to urinate & stinging day & night, fatigue, pain on ejaculation a few times & ED all of which have been manageable with Tamsulosin & ibroprofen.

At six weeks his PSA level was down from 10.5 to 5 so heading in the right direction. Was also prescribed viagra to help with the ED, which has been rather interesting! So far only one out of the three tablets has worked with one to go....but it is early days so not giving up hope.

He was also offered the Da Vinci surgery and had made his mind up that was what he was going to have, however consultant felt that Bracytherapy would be the better option for him as he already had 50% ED and felt that surgery could potentially make this worse, so we went with the consultant and have been extremely pleased with how things have gone and seem to be heading.

Hope it all works out well with you.

Andrea xx

User
Posted 23 Oct 2015 at 09:03

Hi Richard,

It's a very personal choice as to which option to go for. I agonised for ages between brachytherapy and surgery, choosing surgery in the end (daVinci). Questions I asked myself were: what were the side effects of each treatment, what was the risk of the treatment failing to get rid of all the cancer, how 'good' was the follow up treatment if the first line treatment were to fail etc.  I think the clincher for me was that I couldn't convince myself (even though the radio-oncologist tried his best) that every brachy seed would be placed accurately enough to kill every cancer cell.

Post surgery, my cancer was found to be "all over the place" (the surgeon's words), so I was happy with my choice. This is me though!

The only word of advice I would give is check the experience of your surgeon/ radiologist.

Flexi

 

 

User
Posted 28 Oct 2015 at 21:05

Hi Richard

The problem you will find it that there is plenty of information available and plenty of advice from others but in the end you have to make the decision.

I was in a very similar situation as you. Gleason 3+4 , T2, 35cc , PSA6.3 etc.

After researching I decided brachytherapy low dose seeds wsa best for me as every report I read indicated that the long term side effects were less than other options.

I had the op at the Guilford specialist brachytherapy unit at Guildford hosptal on 14th August 2015. ( 11 weeks ago )

I went in in the morning and came out the following morning . I have had no really bad effects other than difficult to pee. I was back down the gym and playing tennis 2 weeks after the op. My PSA 1 week ago was 2.3.

There are many others on this site with far more knowledge than me but for me it seemed a clear cut choice. Please do not forget that brachy is only suitable for those with earl;y stage local cancer and not long ago was mainly for private patients. The NHS has now approved the procedure and the cost to the NHS is approx £20,000.

Kind regards

Ray

User
Posted 29 Oct 2015 at 00:02

You will make your own decision, but having seen my dad die of PCa last month, I would never contemplate doing nothing. I had da Vinci surgery, and although I have to wear pads for mainly minor leakages, although some days are worse, and erections dont happen naturally, I have no regrets. As it turned out, my PCa was aggressive. I feel I can look forward with confidence to lots of important family events I might otherwise have missed.

Paul

Stay Calm And Carry On.
User
Posted 11 Nov 2015 at 11:10

I haven't been on the site for a while but reading as much as possible which has been helpful.

 

Also at my meeting with the second Oncologist to discuss possible treatment she said I would be suitable for Brachytherapy but said she would review my MDT and discuss with the first Oncologist - my hope was less seeds may be used and less side effects.

 

The results of the review are still not with my first Oncologist after 4 weeks She said she would do this within days, I have asked the nurse to chase this a twice and have just phoned the second Oncologist.

 

I've just received a copy of a letter the second Oncologist wrote after our appointment, before any review, She said the clinical stage was possible stage T3a, this came as a shock as the first Oncologist put it at T1/T2 !!! also Brachytherapy may be a suboptimal treatment.

User
Posted 15 Nov 2015 at 14:01

Hi Richard ,

The info that you give would shock anyone . Your MRI and needle template biopsy must surely be able to distinguish betweeb T2a,b or c and T3a.

The tumour(s) may well be right at the edge of the prostrate capsule. A friend of mine who had a similar situation was put on hormone tablets for a short while prior to having brachytherapy. He had the op. approx 6 months ago and is now almost fully recovered.

T3a indicates,of course, that the tumour has spread through the capsule on one or both sides. I hope that is not the case  for you .

Kind regards

Banjoman

User
Posted 17 Nov 2015 at 19:42
Hi Richard

I haven't been on the site for a while as my hubby was having a break between his radiotherapy and his planned brachytherapy - which is happening tomorrow so I'll probably post an update at the weeken. Brachy was just one part of his treatment plan, 25 sessions radiotherapy done and he'll hopefully have his last 3 month hormone injection in December.

All the best

M

"You're braver than you believe, stronger than you seem and smarter than you think." A A Milne
 
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