Faced with a treatment decision: Brachytherapy vs high dose radiation?

why wouldn’t your doc give you the option of surgery ( perhaps you told him no surgery no how)

Which form of Brachytherapy are you referring to? High Dose Radiation (HDR) brachytherapy or the seeds? I had 2 sessions of HDR where they insert wires in the prostate and radiate the tumor for 8-12 minutes. This procedure has been around for several years and has a very low cancer recurrent rate. Unfortunately few radiation oncologists are trained in this procedure and hospitals do not have the facilities for HDR. The Prostate Cancer Research Institute has a couple of good videos on HDR.

I was diagnosed with Gleason 8 PC in 2017. I was treated at a specialized clinic in Sarasota FL starting with hormone/Androgen deprivation therapy followed by about 40 sessions of direct beam radiation, a break of a few weeks, and then brachytherapy. Over 100 radioactive seeds were implanted and then another break of several months with just testing. I have been closely monitored for 5 years this November and remain cancer free with a PSA still undetectable. Brachytherapy is considered an outpatient surgery but in most cases does involve an overnight stay in the hospital. Good luck to you.

According to the youtube channel PCRI (I think), brachytherapy requires skilled surgeons and at the end of the day while offering a slightly better cure rate doesn't provide much bang for the buck for the institutions involved.

The economics of treatment herd most punters into traditional radiation methods, hence the lack of real world stories here.

That’s shameful of an institution to not offer it or obtain skilled doctors to perform this procedure based on economics what ever happen to giving the best care possible aligned with the hypocratic oath

I would recommend getting second opinions. Your medical records can be sent to another provider to review and not have to do same test again.

I got two opinions on mine. We are all novices here not doctors so just know when I say you just being given just to procedures does not sound like the norm and should have been a lot more than just two options. Perhaps your provider can't offer all the different procedures that are out there. Procedures are many and involve different ways to do them, precautions, side affects, post affects, and what is your specific case as well as your feelings of what you want and willing to do.

Good luck but my advise get second opinion.

Where did you have HDR done? What were side effects?
Thanks.

@erkbiz, using search "brachytherapy" as a keyword in the prostate cancer support, you will find these discussions about prostate cancer and brachytherapy:
https://connect.mayoclinic.org/group/prostate-cancer/?search=Brachytherapy+&index=discussions
Did you make your decision?

I had SBRT Proton at Mayo Phoenix which is the high dose radiation given in five fractions in a two-week period for my prostate confined Gleason 4-3. I have had no side effects and even questioned the radiation oncologist on the patient portal as to whether he was sure they gave me enough radiation. My three-month follow up PSA was undetectable. Hope this helps. Good luck.

Did you choose Androgen Deprivation Therapy as well to go along with the radiation?