My Treatment Decision Is In: Single Seed Brachytherapy

I've had two sessions of HDR brachytherapy. My understanding is that it is usually done in two sessions a week apart. I chose it to avoid the removal risks of ED and incontinence. I chose it over the permanent seeds since they can move around a lot. The procedure was a piece of cake. I was up and about immediately after this out-patient procedure and was out walking the next day. I had no pain at all during or after the procedure. Looks like you have a good shop, so you should be fine. You should not have any radiation effects, other than to kill cancer cells. I understand that is the benefit of HDR brachy. Only the bad spots are subjected to radiation. I was not on any drugs after the treatment except for 30 days of tamsulosin.

As noted earlier, my treatment is only one dose of HDR BRACHYTHERAPY; and of the type that is done from the insertion of one seed but moved among 20 locations within the prostate gland for shorter periods of time and then withdrawn.
I like to say that this is "one and done" and then off to 5 weeks of EBRT, or external Radiation.
And hearin lies my problem.

I am not at all concerned about one Brachy session.
It's those 25 days of being externally radiated.
This is where things can go wrong, including some very worrisome potential side effects.
Let's just call it what it is .... There WILL BE side effects- some mild, some severe, some short term, and others of life long complications.
My tamsulosin works great.
My ADT/ORGOVYX is tolerable now in the 4th month.

Have you ever heard of anyone who is highly recommending
External beam radiation everyday for 5 or more weeks?
I haven't.
Thanks for joining in my rant!
PAUL

I’ll weigh in here because I had HDR brachytherapy in 2012. I’ve had stage four and now stage five prostate cancer since 2010. The course for me was doable because my body was strong and responded in a positive way to the treatments My Gleason were all over 10 and I had 14 of them. I immediately went on Lupron and tamsulosin and biclutamide. I had the HDR brachytherapy five months later once the cancer was a bit stabilized For me, I had 44 tubes inserted which was a huge number and I had Every problem to this procedure I had the Third worst recovery of anyone in the hospital records. But I did recover. I still have no sexual activity and still have to get up six times a night. But I am also 14 years into this cancer journey. I am currently undergoing nuclear isotope infusions to stabilize it for another year or two or three
I chose brachy therapy because it had the highest percentage of cure back when I underwent the surgery compared to having a Prosectomy
Plus, it would save my sexual function which it did not.
The only issue I would caution you about is not letting the urologist or other doctor back away from keeping a steady eye every two months or maybe three months on your PSA and your condition.
.

I might add that I have had seven different doses of radiation and tolerated them very well Minor side effects but they did control the pain for a year or two My cancer lodged in my bones, and so there was often extreme pain. And I seem to just be treated and treated and never relate get to a cure

Stage 5, Gleason 10, and 44 tubes !! WoW! Those are all numbers that I've never seen before in these discussions! And you are telling your story 14 years later!
It's horrible in one way, but amazing in another!
I was only hoping for maybe another 5 years and no radiation destruction to my rectum, bladder, colon or otherwise.
Thank you, and may you continue to survive this battle!
PAUL

Incredible story. Having a Gleason 10 and living so long has got to be memorable for many of the people in here. While I’ve had prostate cancer for 15 years (in January) I’m only a Gleason seven (4+3), though I also have BRCA2.

Your story will give hope to people in this group who have high Gleason scores and wonder how long they’re going to live.

Your latest treatment “nuclear isotope infusions” sounds very interesting. I’ve never heard of it before. How are they going to stop your cancer from proceeding? What technique do they use? How widespread are your metastasis, your whole body or are they isolated in a specific area? I would like to tell people about this treatment, more information would be really helpful..

Have you been on Pluvicto yet?

Hey Paul, YES to your question! I am beginning 25 sessions of EBRT on Nov 4 at Sloan. It is the new standard of care for recurrent PCa. It used to be 39 sessions at a lower fractional dose but they found that 25 sessions at a higher dose was equal in success rates.
Here’s the bottom line: side effects with 25 tx are a bit more pronounced than the 39tx during treatment. However, side effects for BOTH groups are the SAME in intensity/duration after 6 months.
So yes, we WILL have side effects but after 6 months they’d be the same as the group with the lower fractional doses. I am not happy about it either but my anxiety and fears have been replaced by acceptance and the understanding that I HAVE NO CHOICE IF I WANT TO LIVE!
Looking at it that way has really helped me. Sometimes having NO choice to make is the best feeling there is.
Best to you!
Phil

Phil, your knowledge and explanation of sessions and side effects is quite good, and I appreciate this!
Somebody comes up with all of this stuff, then they have to sell it to us, and all we can do is hope for the best!

In all honesty, I am not looking forward to any of it.
I would have loved HDR BRACHYTHERAPY as a monotherapy. But nope, I am not a good candidate for that. Of course, I'm not!

My brachy is the 11th of November and first EBRT is the 19th.
Best wishes to you Phil as we motor on!
PAUL

I’m sure we will be keeping each other up on our exploits! After being trussed up with my legs behind my head and my balls taped to my belly for the biopsy, very little bothers me any longer in respect to dignity or decorum.
If I lose control of my bowels or bladder on the table I won’t be the first - or last!!🤣

Interesting that they have changed how they’re doing the salvage radiation with fewer visits. I know I went through seven weeks of treatments, but felt nothing. No issues at all after each treatment.

It would be interesting to know if you actually do feel something as a result of them having a higher radiation dose. Did they tell you there would be more side effects? What did they tell you that you should expect to feel?

I got 2.5 years of undetectable tests after radiation. Hopefully yours will end in remission.