Brachytherapy? Anyone have thoughts?

I was scheduled for HDR Brachytherapy as "boost" radiation to EBRT. Days before the procedure, I met with a Urologist friend who talked with me confidentially. He related two cases of his personal friends who had serious and permanent rectal damage as a result of the procedure. The Dr. is still closely aligned with the instituion and supports it wholeheartedly, however, he cautioned against the HB for me. I then met Dr. Roach at UCSF who a is renowned RO and has published a study showing Cyberknife to be equally effective as boost radiation. Of course, Cyberknife is far less invasive and does not require a catheter. I made a last minute switch away from Brachytherapy and am now hopeful that my 'remission' is for life.

I don't have any experience with LDR Brachytherapy, but, I would also not want any procedure that leaves radiation in my body. I love to hug my grandchildren and my wife told me that was at risk...whether true or not, not one that I'd take.

I've had LD Brachy and have done a ton of research into it and I wouldn't go any other way with my Gleason 9,..... PSA 50, cancer. I also had 25 external Beam treatments and 19 months of Lupron. My cancer is either cured or in remission. Brachy concentrates the radiation in the prostate at a much higher dose than they can deliver from the outside without burning the other areas, like your colon. The survival rates are close to 100 percent at 10 years with my treatment. My psa at 2 years post treatment is .02 !!! Don't listen to your Radiologist unless he offers you Brachy. The payment to the Radiation oncologist is only about 10 percent for brachy as for Proton or External Beam because they have to radiate you 40 times, whereas the brachy is done on an outpatient basis. One and done...

I’m glad that you had good success with LDR brachytherapy. I formerly was a member of a local prostate cancer support group and I know a number of other men like yourself had low-dose brachytherapy in combination with external beam radiation and ADT. I also know other men who had Brachytherapy as solo primary treatment for low risk prostate cancer, and sadly a third of them, including myself had recurrences of higher risk disease that were difficult to treat because the “radiation card” had already been played.

Best wishes to stay cancer free!

... Of course there are the 25 external beam squirts, but that's a lot less than the 40 or 45 external beam treatments. If you think about it, you will realize that Brachy radiates the cancer cells 24 hours a day, 7 days a week, so that when the cancer cells attempt to divide, the radiation is there to kill it when it is weakest. It's that simple! After the implantation, you will swear that they didn't do the procedure, it's that painless!!! My oncologist showed me the post procedure x-ray so I would believe he had done it! I was a Gleason 9 and pretty worried but now I know I got the most effective treatment there is. My cancer is no longer a part of my life. ( Do Your homework and check me out. Start with "prostatecancerfree.org" and contact me here for more info. )

I'm sorry to hear that. I'm not recommending Brachy as a solo treatment. In conjunction with Lupron and external beam it is the most effective treatment there is and gives an overall survival statistic that is far and away better than all the other regimen.

Robert, was there a study published in conjunction with the "Brachytherapy only treatment"? I have a friend who is in the same boat as we are and is considering going without ADT.

I respectfully disagree with that statement. That may have been the best solution for your situation and I am genuinely happy for you, but advanced prostate cancer is a complex disease and treating it is not a one size fits all solution.

When my 2020 LDR brachytherapy treatment for prostate cancer failed in 2023 I hoped I could be treated with more Brachytherapy, EBRT, and ADT. I met with two different care teams at two nationally recognized centers of excellence for prostate cancer and both told me that it was the wrong solution for me.

I think we can share our success stories with other men facing prostate cancer, and should stop short of recommending the treatment we received for others when we don’t know all the facts.

Best wishes for success on your journey.

It was my 1st choice but I ran k to a complication with a stricture and they pulled Brachy as an option and I ended up with 44 fractions of Proton - finished Aug 1. Still on ADT. I was 3 of 12 positive. 2 were 3+4and 1 was 4+3
Good Brachy techs are getting more difficult to find. The hospitals make way more $ on some of the other treatments. Sad but true.

Was your solo treatment ( Monotherapy ) HDR or LDR ?

LDR