Brachytherapy? Anyone have thoughts?

Posted by stevenp @stevenp, Aug 9, 2024

Hi all. I have been on active surveillance for two years but psa is up to 6.49 so we did a second biopsy. Gleason 7 (3+4, 3+4, 3+3, 3+3). Just recieved Decipher score .29. I’m 65, still working and physically active. I know 2 men who did the low dose Brachytherapy with good success, but I don’t know what their numbers were. Any anecdotal experience with, or info about, that treatment path would be appreciated.

Interested in more discussions like this? Go to the Prostate Cancer Support Group.

Colleen Young, Connect Director | @colleenyoung | 5 days ago

In reply to @famcare "Has anyone had radio active seed implanted? Had anyone had this procedure done?" + (show)

@famcare, as @vircet mentions, placing radioactive sources (or seeds) in the prostate gland is called prostate brachytherapy. This type of radiation can kill the cancer cells while causing less damage to healthy tissue nearby.

I moved your message asking for the experiences of others who have had brachytherapy to this existing discussion:
- Brachytherapy? Anyone have thoughts? https://connect.mayoclinic.org/discussion/brachytherapy-anyone-have-thots/

I did this so you can read previous posts and connect with members like @stevenp @robertmizek @spino @rjw4usmc @octopuss @cstrutt52 who have had brachytherapy.

@famcare, is this a treatment option that you are considering?

robertmizek | @robertmizek | 5 days ago

In reply to @colleenyoung "@famcare, as @vircet mentions, placing radioactive sources (or seeds) in the prostate gland is called prostate..." + (show)

I used to be a big supporter of brachytherapy. I no longer am. I had brachytherapy in 2020 and it failed in 2023. The Doctor who did the procedure told me that if cancer came back, it was an easy option to have surgical removal of the prostate if the procedure failed. That turned out not to be true and I only found five doctors in the whole US that could or even would attempt to remove my prostate after LDR failed.
Other treatment modalities, such as cryo- or HIFU might be better as in the case of failure, there is a no collateral damage of surrounding tissues unlike LDR brachytherapy.

You’re a low decipher score is a positive indicator that you might have these options for sure.

Good luck. Hope everything goes well.

heavyphil | @heavyphil | 5 days ago

In reply to @robertmizek "I used to be a big supporter of brachytherapy. I no longer am. I had brachytherapy..." + (show)

Hey Bob, how are you after all that? I think you actually did have surgery, right? And then more radiation?
I reread some of your posts and it seems that you may have had some spread as well. Could you have done HIFU after LDR failure in your situation? Hope you are on the mend! Thanks,
Phil

lag | @lag | 5 days ago

My husband had brachytherapy plus external beam radiation after he was first diagnosed in 2005. His cancer did not recur until 2011; the recurrence showed that the cancer had already escaped the prostate in 2005, but of course we didn't know that at the time . I don't know how common brachytherapy is these days.

robertmizek | @robertmizek | 5 days ago

In reply to @heavyphil "Hey Bob, how are you after all that? I think you actually did have surgery, right?..." + (show)

Hi Phil. Nice to hear from you. My surgeon and I did discuss HIFU and cryo- both but I decided to have a prostatectomy since I had lymph node involvement and it was a safer path towards cure. About six weeks after surgery I had 31 sessions of external beam radiation to the pelvic lymph node basin and one lymph node that could not be reached in surgery. I’ve been on ORGOVYX and generic Zytiga for 12 months now, but the last three months have been absolutely brutal with side effects, including severe nausea, dizziness, and cognitive issues. I’ve stopped both drugs now. I’ll meet with my medical oncologist soon and we’ll discuss switching me to estradiol patches to suppress testosterone and mitigate the side effects caused by near zero estradiol.
I’ll report back in a week or two once we have a plan in place and I see how things are going.

Hope you’re doing well!

heavyphil | @heavyphil | 5 days ago

In reply to @robertmizek "Hi Phil. Nice to hear from you. My surgeon and I did discuss HIFU and cryo-..." + (show)

Oh man, sorry to hear that. But those patches are suddenly back in Vogue and they produce a lot less side effects, especially in the liver. So hopefully your liver enzymes - if already affected should calm down quite a bit.
It’s funny because yesterday a poster had a similar situation with failed brachy LDR and I suggested surgery to him, but had no idea of any surgeons who did that. Perhaps you could post his name one of these days or maybe the five that you found so he could give them a look?
It sucks when your first treatment fails and the corrective treatment is so much worse. Hope you continue to improve! Best, Phil