HDR Brachytherapy treatment recovery process?

When are you scheduled ? What is your Gleason Score ? How many liasons in your gland ?
Finally . What after effects did your Radiation Oncologist cover with you , if any , and does he/ she plan to put you on any post treatment madication ?
Thank you .

66 & no post treatment drugs with the exception of 30 days of flomax following the procedure.

I had HDR brachy, one week apart beginning in April 2023 at Rochester Mayo. Sixteen hollow needles the first one and 17 the next one. There was no pain or discomfort immediately after either procedure, only a feeling of "tenderness" in the perineum for about an hour, then only when pressed (stay off a bike and no sliding down banisters). There was a slight sting during pee for about 18 hours but barely noticeable after the second procedure. I walked 1.3 miles at a slow pace the afternoon after the first session with no issues. Did some pushups okay, but sit-ups felt like they could be pulling on the wrong bits, so stopped. You will pee pink with some clots or debris for a while. On day 8 (after procedure) I started a double dose of Flomax but only did that for about three days. My pee time went from normal 20 seconds to 90 seconds. Doctor put me on ibuprofen for inflammation for a few days. Stopped Flomax on Day 51. Ejaculate will be ruddy brown with occasional debris for 90 days or so. Eventually, there will be no emissions. The Cowper glands will still work for a while longer, but I'm told they will eventually dry up too. I'm 71 and not working but I would have probably headed to my desk job the same afternoon after both procedures. Overall, the only real limitations after the procedure are waking up from the anesthesia (should give yourself a day before signing legal documents) and no biking for a while.

Urine flow improved with meds.
What meds ?

How many lesions ?
How many cores were taken at your Biopsy ?
How many cores were positive ?
Were you on active surveillance prior to the HDR Brachytherapy ?
Thanks .

Two lesions, one left 3+3=6 , one right 3+4=7. 16 cores, 5 cores with carcinoma, no perineual invasion or lymphovascular invasion. PSA 7, Polaris score of 3.1, Decipher score of 0.50. Haven’t been on active surveillance, process with insurance (denials) has taken forever. But that’s another story. My first Brachytherapy is scheduled at end of month, then second two weeks later.

My stats are similar to yours, @ngus44, except my Decipher is .29. I’m curious why you chose Brachytherapy over a prostatectomy?

Tamsulosin 0.4 MG, which I understand is generic Flomax. I was on that drug for 51 days. After HDR brachytherapy, there will be some swelling for a bit that can press on the urethra through the burned-out prostate (bad design idea there).

I met with the oncology team and they discussed my situation thoroughly. I did a ton of research on my own, everybody’s different but for me brachytherapy was the best option. HDR brachytherapy offers a quicker recovery and a generally better long-term quality of life due to fewer severe side effects. Radical prostatectomy involves a longer recovery period and may have more significant impacts on quality of life, particularly concerning urinary and sexual health. Time will tell, I went through my first treatment yesterday. Feeling surprisingly well this morning.

Let me step in and explain why I considered HDR Brachytherapy as an alternative to surgery.

When I was diagnosed at Moffitt Cancer Center in Tampa, Florida with low risk Decipher, intermediate Gleason 7 cancer confined to the prostate, I was offered surgery, various photon therapies and HDR Brachytherapy. Moffitt's Proton therapy won't be available until 2026, so they never discussed it. If I had stuck with Moffitt, I would have chosen HDR Brachytherapy, trusting in their ability to deliver it accurately. The way I understood it, they would sew a temporary plate to my perineum with guide holes for the many delivery tubes that would be inserted into my prostate at predetermined locations. This would be done under a spinal block of some sort. Once tube placements were confirmed by imaging I would be taken to a treatment delivery room where a computerized machine would insert, retract, and repeat the process for all inserted tubes. The radiation seed would be precisely exposed for a predetermined time at the end of each tube and then retracted to be inserted into the next tube, etc. When finished, the plate and tubes would be removed and the whole process repeated one more time a couple weeks later. So with this therapy, you expose nothing outside the prostate to radiation, as you would with both photon therapy and to a lesser extent, proton therapy. If accurate (and you have to trust the science here), this treatment should leave you with fewer side effects than surgery, where you risk the dangers of anesthesia and surgery, snipping out the prostate and other tissues, including a section of your urethra that must then be stretched and reattached to the bladder neck, etc. So it only takes two days of treatment with HDR Brachy, two weeks apart. But I did some further research and went with proton therapy in Jacksonville, FL at UFHPTI instead. So far, so good.