Anyone had Permanent prostate brachytherapy? How was your experience?

https://www.mayoclinic.org/tests-procedures/prostate-brachytherapy/about/pac-20384949#dialogId60141876
No experience, but I'll be watching for the comments

desertfalcon1954:

The Prostate Cancer Research Institute (PCRI) has several good videos on this subject. Their website is pcri.org and you could also go to YouTube and type in “pcri brachytherapy”

They also have well-informed volunteers that you can contact via email or by phone and they will talk to you and answer your questions.

You might know that there are two types of brachytherapy: low-dose-rate (LDR) and high-dose-rate (HDR).

LDR is where they place tiny radioactive seeds in your prostate and they stay there “permanently” —emitting radiation from within the prostate for some months; they eventually lose their radioactivity.

HDR is where they use highly radioactive seeds and place them in the prostate (where they previously mapped them out by computer) for a number of seconds, then withdraw the seed.

So LDR emits a relatively low amount of radiation constantly for several months, whereas HDR admits a much higher dose of radioactivity for just a few seconds for each seed.

I want to stress that I am not a medical professional, and that these are just my understandings and opinions. Prostate cancer patients are encouraged to have a big say in what kind of treatment they get. It’s called “shared decision making.”

My wife and I spent about three months after diagnosis reading books and articles, watching videos, etc to learn as much as possible about all of our options before landing on one most appropriate for my situation. My biopsy showed me to be Gleason 3+4 = 7, “favorable intermediate”, so I had many treatment options available to me.

Thanks for your question, and welcome to our brotherhood! The people on this website are kind and giving, and it is well moderated, so it’s a good place to learn things as well.

By the way, I am scheduled for HDR brachytherapy in late January—it is two procedures within two weeks.

Good luck to you!

Jim (jamesharrison)

Like Jim, I am just an individual who has experience with low level brachytherapy. It was done 2017 when my Gleason was like yours, 3+4.
I also in conjunction, has 23 low dose radiation treatment.
Those procedures has given me almost 6 years of symptom free like.
Recently I had a PET scan and while my prostate was cancer free, a couple of lymph nodes had been infected. We are dealing with that now. But, to me that in no way reflects badly on the Brachytherapy.
Your other question about how; I assume you have had a prostate biosy by now. It is just like that but takes just abit longer. Like the biopsy, leave your modesty at home. Great luck and God Bless.

A few other things I wanted to mention. Along with Gleason score and stage level, other important factors are your age, health condition, whether you presently have had urinary problems, and what is important to you for erectile function.

I’ll also mention that many will tell you it’s important to get second opinion on biopsy and to interview more than one physician. We got a second opinion from Johns Hopkins on the Mayo biopsy pathology report. We are glad we did, as it came up with a few things that were not on the Mayo report.

After speaking with a urology oncologist, and with 2 radiation oncologists at Rochester MN Mayo Clinic, we decided to go with the second radiation oncologist because he is well experienced in brachytherapy, is known to be very picky and careful about his procedures, and we felt at ease and comfortable with him.

Also, very important that you find a physician who has done lots and lots of the type of therapy you are seeking, and has a track record of good results. This is especially important with brachytherapy, as it is a treatment that is declining in use in the USA (but increasing in use in Canada, Europe and other countries around the world).

Blessings to you on your journey. Happy Holidays!

Jim

Thanks for you all for your very helpful comments and replies I really appreciate it very much.
Wishing you all a Very Merry Christmas and a Very Happy New Year

They are both permanent so I assume you mean either HDR or LDR. I had HDR (two sessions a week apart) in April 2023. So, I'm 8 months after the procedure. I had 16, then 17 hollow needles inserted over the two sessions. There was never any pain in the process. You administer a small fleet enema to clean out the rectal area so they can make best use of an ultrasound unit. You are a little tender for some weeks (no bike riding or sliding down a banister). I had a little stinging for the first pee's but not really rising to the level of pain. I managed some pushups after the first procedure but sit-ups were uncomfortable. I did a short 1.2 mile walk the next day. There was no sting after the second procedure. I had a few pink drops at the start of every pee for a few days. I had bloody chunks in ejaculation that slowly went away and were gone in about two months. No standard ejaculation (since no more semen) but my Cowper's glands (bulbourethral) was (and is 8 months later) still active, producing perhaps a quarter teaspoon of pre-ejaculate fluid. I'm told that will eventually stop. I was on Flomax (Tamsulosin) for 52 days. I was on a double dose for about three days. I don't like to take a drug the rest of my life so I tried to get off as soon as possible. My flow is less than it was before procedure. I used to be a standard 21-second guy (the average for Earth mammals) but I now take about 45 seconds to pee. Erection levels the same as before. I had some problems with latchkey urgency for a couple decades before the procedure. I drink a lot of iced tea and urgency seemed to get a little worse (but only when I knew that I could use a toilet if one was near); mostly a problem with shutting down the urge to pee after the procedure, but that has improved. But never had to wear pads or diapers. I think maybe the tubes weakened the muscles in that area and I had to rebuild them. This made things a little more urgent. My PSA had hit a high of 10.7 and was at 3 at five months after the procedures. I'm told it will take more time to drop to zero. So generally, it was a painless procedure, though some tenderness. No other big lifestyle changes except for some temporary bloody discharges during ejaculation, slower stream, and no more semen (I had a vasectomy decades ago so haven't had sperm most of my life). I guess I missed your question about how it was done. From your point of view, you do a small enema. They wheel you to the operating room. You chat with the health-care folks and go to sleep. You wake up hours later in recovery. They wheel you back to your room to find you have a cath in. They pump some liquid into your bladder, take out the cath, and ask you to pee. If you can, then you go home. No pain, no overnight stay. While you are out they put the ultrasound unit up your rectum, insert the cath, push in the hollow tubes, and the computer pushes in the radioactive material and decides how long to leave it in place (5-15 minutes).

P.S.
Cstrutt52, would you mind sharing your age and Gleason score? (And staging number, if you know it..) Those statistics help put your story in context for others.

FYI, my Gleason was 3+4 = 7, stage 2.
Also, 2 of 16 biopsy samples were cancerous. I’m 71 years old. All indications are that none of the cancer has escaped my prostate.

My Gleason score indicates that I am “Intermediate Favorable.” However, I got a second opinion on the Mayo biopsy from Johns Hopkins and they additionally found some “cribriform morphology,” which is not well understood but studies indicate it might increase the aggressiveness somewhat. (Apparently, experts are split on whether or not cribriform should be included on pathology reports.)

I had the permanent brachytherapy {BT} in late 2007. I have been extremely pleased with the results. At the time I was 62 years old, in excellent health and the cancer was diagnosed early. After all the preliminaries, diagnosis tests, etc the implantation was done on an outpatient basis. If memory serves me correctly the radiation seeds we implanted manually per a computer generated map. I had some very minor discomfort and bleeding as of the results of the procedure which cleared up totally in two weeks or less. Since then my PSA which is checked yearly has steadily declined and as of may 2023 was less than .04. I have available a prostate supplement I can take as I have issues with frequentcy, stream and or bladder emptying which are rare.
I just recently developed a reason to have an MRI. A question on the paperwork was, "have you had radiation seeds implanted as a prostate treatment", answer yes. The staff doing the test had not done anyone with seeds before and we are log jammed until they get and answer if there is any special considerations to be taken. Has anyone encountered this situation ?

Hi @jasmith, I see you have a question about getting an MRI (for a non prostate cancer reason), but having permanent brachytherapy (radioactive seeds). I'm tagging @robo45vt @al2 @ronc320403 @hodagwi @tedalmon, who I believe also have permanent seeds planted as treatment. They may have some experience with imaging studies.

Were you able to get the MRI?

I don’t have seeds implanted. My father did and had problems later on in life. I have had two MRI s for prostate cancer. Going to have RP surgery on February 15th