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my brother in January, now me!

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User

Posted 18 Mar 2016 at 15:46

But in reality, how many have Brachy when their PSA is 13, Gleason 3+4, even when confined within just one side of the prostate (PIN in the other side) ? And how many need further treatment 'later on'? Any stats anyone?! If it works, I'm in favour, but I'm not sure it's being offered to me....so far.

David

User

Posted 18 Mar 2016 at 15:58

David,

I was not deemed to be suitable for Brachy when I asked...

Apparently the size of the prostate... the volume / extent of the disease..... together with Gleason score and PSA level are all deciding factors when considering suitability.

Maybe you should discuss this with your consultant?.... He/ she will be able to advise if you are a suitable candidate

Luther

User

Posted 18 Mar 2016 at 15:59

Hello. Did you read my post above? Consultant at Addenbrookes said if psa remains low after 2 years then 90% chance it's cleared forever Other half was told he could have brachy up to psa of 15. But it varies I think on hospital.
I know it depends on how much cancer is in the prostate.

Edited by member 19 Mar 2016 at 14:08 | Reason: Not specified

User

Posted 18 Mar 2016 at 16:51

David

By now I expect your brain is going into overload.

"""I'm really struggling here. 50-60% chance of ED with surgery. ..and I've only been married 6 years...not fair! How is ED with RT and whatever MAY be needed in a few years?

You do not need an erection to have intercourse with a women and if you are lucky the experience is out of this world.

Hopefully you spoke to one of the site nurses as I feel some information given in this convesation contradicts prostatecanceruk and cancerresearhuk information regarding RT treatments and ED.

All treatments can carry risks and not all potential side effects are guaranteed. I looked at various options before my treatment and picked surgery with the hope of cure but knowing I still had options if it failed.

I am probably the worst advert for surgery (read my profile) but 4 days post catheter I was almost dry, CJ was dry from day one so was Fozzi Bear, quite a few others have been dry within a few weeks.ED is still work in progress but it is fun trying to find the right solution.

Once you have decided on your treatment you might then wish to research your surgeon or oncologist.

I wish you well with you choice of options.

Thanks Chris

User

Posted 18 Mar 2016 at 17:36

Originally Posted by: Online Community Member

David, I should mention that the ed side effects with HT and RT are not permanent and normal service can be resumed after completing HT with a little bit of time for system to wean itself off the hormones.---

You could be lucky but for me
RT 2005 -HT 2004 to 2008 ED is still an issue

Ray

User

Posted 18 Mar 2016 at 18:14

Not sure I can figure intercourse with ED....?

User

Posted 18 Mar 2016 at 18:49

)Hello David and a belated welcome from me (was on holiday)

I see Brachytherapy has been mentioned but I don't think it was specified which kind as there are two.
) ?
Was it high dose (temporary) or low dose (permanent seeds

We can't control the winds - but we can adjust our sails

User

Posted 18 Mar 2016 at 19:10

Hi Ray, sorry to hear that about your ed, I was only quoting what others have said before me as I have no experience apart from my ed now since Feb 2015. Knowing my luck it will be an issue with me as well but being 66 now and still years to,go,before clear,of hormones I would imagine that chance will be a fine thing anyway!!

All the best, regards Chris/Woody

Life seems different upside down, take another viewpoint

User

Posted 18 Mar 2016 at 19:17

Johsan,

Well I'm not sure....I know there are two. Neither were mentioned at my diagnosis but I will see the Radiotherapy consultant on Monday and ask if it's a possibility, rather than Beam RadioT. I'm just in more confusion than I was up till yesterday, since the surgeon today said he could feel a slight hardness whereas the other 4 DREs could not, so he says one nerve will go. That I was not expecting, so I am now less keen on surgery even though it may be 'best'. Nightmare.

David

User

Posted 18 Mar 2016 at 19:30

David

Not sure where you live but you mention Addenbrookes so I'm assuming you live around that area. I noticed Man with PC mentioned HIFU - that's something they offer at Princess Alexandra Hospital in Harlow.

Could this be a treatment possibility for you?

Arthur

User

Posted 18 Mar 2016 at 19:56

Hi Arthur,

I am certainly intrigued by HIFU and need to ask about it....I live in St Ives and use Hinchingbrooke too...I am going there on Monday to discuss RT, but I want to discuss Brachy and now HIFU as I don't think either can be dismissed.

Thanks for the tip on Harlow.

David

User

Posted 18 Mar 2016 at 20:22

David

If survival rather than quality of life is the aim then go for the treatment that you feel is the best for that as no one can predict severity of side effects for each person
of whatever chosen treatment.

Chris/Woody.

As regards ED its RT nerve damage rather than HT. Feedback from long term guys I know on Zoladex seems to suggest the longer on it the greater ED issues.

However you could be lucky - I sincerely hope so.

Ray

User

Posted 19 Mar 2016 at 15:33

Originally Posted by: Online Community Member

David

Hi David

No stats but my brother had High Dose Rate brachytherapy with a PSA of 14 and a Gleason score of 9. It was contained within the capsule. He also had 20 months HT and, two weeks after the HDR brachytherapy he had 15 sessions of EBRT.

User

Posted 19 Mar 2016 at 17:07

When it comes to RT, from stats I have seen and previously posted, it seems that brachytherapy of whichever form for suitable candidates is more effective than external beam and is therefore becoming increasingly the RT of choice. However, EBRT is still the most widely form of RT given and is likely to be so for some time, not least because there would not be the capacity to treat many men who would have EBRT with Brachytherapy instead. Also, EBRT can be an option where the patient's prostate is not so suited to Brachytherapy or there is a need to treat beyond the Prostate. Sometimes Brachytherapy is supplemented with EBRT. Whether the Brachytherapy is High Dose or seeds the RT is delivered to or very close to the cancer in the Prostate. EBRT deposits radiation all along it's route to the cancer target and also beyond it - more collateral damage and less RT applied to the cancer, so this is part of the reasoning for preferring Brachytherapy where this is a suitable option.

I believe the statement attributed to a consultant that the chance of a man with PSA of under 2 some 18-24 months after RT is 90% unlikely to have the cancer return is a sweeping one and does not accord with the risk I have read about, lectures I have listened to or my personal experience. My PSA two years after RT and with no benefit from HT after the radiation was 0.06 but gradually increased to 1.44 over several years at which point it was agreed I have an MRI scan. A new tumour was indeed found and I had salvage HIFU in July 2015 when my PSA immediately before the op was 1.99. Click on my avatar for more details.

Information on my HIFU experience can assessed here. http://community.prostatecanceruk.org/posts/t10960-HIFU--my-experience#post133611

http://www.ahamm.co.uk/prostate/blogdetails.htm Scroll down to video 2 for HIFU

One of the good things about HIFU is that it does not involve radiation and can be repeated in need. However, it is not widely available in the UK and agreeing to have it as part of a trial may be a good way to have it.

Edited by member 19 Mar 2016 at 21:41 | Reason: Not specified

Barry

User

Posted 19 Mar 2016 at 18:33

David I have replied to your PM

Barry

User

Posted 19 Mar 2016 at 19:02

Yes man with PC. I listened to our consultant tell my other half that if psa is still low and under 2 in 18 months time then there is 90% chance it is completely cured. My other half was very pleased. But I told him that's not what I have read online. I read more like 30% chance of it returning (same statistics with all treatment for low grade cancer) I know the return risks are higher if you have a higher Gleason etc.
But that is what the consultant said. I'm not sure how long brachy has been around to compare to the other treatments. I know it is newer that EBRT.
I am sure the consultant must have got his statistics from somewhere.

User

Posted 19 Mar 2016 at 19:17

In my opinion most of the statistics and success rates we read or look up from various sources are flawed anyway...

You have to remember that fewer people are deemed suitable for Brachy in comparison to EBRT and possibly have less disease progression?

Likewise the same can be said of RT as opposed to EBRT ..... RP is mainly deemed suitable for what is assumed to be contained PCa as opposed to EBRT which is used with HT in some cases for a more advanced diagnosis ...

Luther

Edited by member 19 Mar 2016 at 19:48 | Reason: Not specified

User

Posted 21 Mar 2016 at 17:49

Well today it was the turn of the radiotherapy man to talk to me. Brachy is on my option list as finally I saw my mri report and it's within the gland. I insisted on being referred to Harlow for consideration of HIFU which has to be my favoured option if I am accepted. Hope so, ad options are open if it fails.
Thanks for everything so far.
David

Edited by member 21 Mar 2016 at 18:39 | Reason: Not specified

User

Posted 30 Mar 2016 at 10:13

I hope all had a good Easter...a few days break for me from all this...back to it now.

So, I have a meeting with the potential Brachy man on Monday, then with a HIFU man on Wednesday. Lastly, I am hoping to get referred to the surgeon at the Lister Hospital in Stevenage as I have had good reports about him, as a second opinion on possible RP.

It will then be up to me to put all the pieces of the jigsaw together. You guys have helped so far!

My fear is choosing the wrong option: I am 56 so if I don't have RP there is longer for it to return. Stage 2a, one side only, all contained(hopefully), no symptoms etc, Gleason 3+4, but PSA 13. If I do have RP, then having certain side-effects so 'young' seems harsh. Balanced against maybe HIFU/Brachy doing the job...or NOT doing the job enough for the future, and maybe preventing surgery later.

Very tough call.....

User

Posted 30 Mar 2016 at 15:58

Hi. When I read statistics of the cancer returning, they were similar with the 3 main treatments. (RP, EBRT and brachy) but obviously if you a radiotherapy type treatment and it returns then you cannot have more radiotherapy. Whereas with prostate removal there is radiotherapy to fall back on. Though the brachy man didn't actually tell us that if the cancer returned then no more radiotherapy can be done. I have read it since. All he said was "it won't return"'got to look on his positive side I guess.
It is a hard decision to make. All the best.

Edited by member 30 Mar 2016 at 19:48 | Reason: Not specified

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