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Brachytherapy AFTER failed radiation?

Posted by bluegill @bluegill, Feb 7 1:45pm

That's what my oncologist wants to try. Has anyone heard of this strategy?

5 years ago: PSA of 28, Gleason 9, radiation + 3 years Eligard. At first it appeared to work, but as soon as I stopped ADT my PSA shot up from .0 something to over 2.

My urologist says just keep taking Eligard for the rest of my life. Oncologist says do the brachytherapy, and maybe that will cure me.

??

How can I get a tie-breaking thrid opinion, like from Mayo?

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jeffMar | @jeffmarc | Feb 7 5:50pm

Have you had genetic testing? There might be a genetic reason why your cancer came back.

I have a problem like you described and cannot get off the drugs without my PSA rising quickly, but I have a genetic problem

The thing is with the Gleason nine you’re almost guaranteed to have relapses. Staying on the drugs for a lifetime is really about the best that you can do. I stayed on ADT for eight years, l’m off it now because my testosterone is not likely to come back, If it does, I have to start back up again.

It’s possible Brachytherapy could make a long term difference, it is not unusual to combine The two types of radiation.. Have you had a PSMA PET scan to see If cancer is visible anywhere in his body? I would think that should be the minimum that should be done before doing anything further. If it’s outside the prostate then brachytherapy is not gonna work.

Your urologist should be out of the picture by now, to get the best advice find yourself a Genito Urinary oncologist. Those are the ones that specialize in prostate cancer, unlike medical oncologist, which specialize in everything. Mayo can get you that type of specialized treatment.

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bluegill | @bluegill | Feb 7 7:31pm

Thanks for the comments. It's interesting that here and in another group many people suggest getting genetic testing. Both of my doctors (urologist and oncologist) say I don't need one, because we already know my cancer is aggressive and high grade.

Yes, I recognize the value of ADT, but someday my cancer will evolve and ADT won't work anymore. My urologist says that could happen in 20 years, and my oncologist says it will happen in a year or two (I already did 3 years of ADT).

The recent PSMA shows no evidence of spread outside the prostate. The oncologist wants another MRI before the brachytherapy.

I would like an appointement at Mayo. How do I go about making one? I may wait until I turn 65 (next month) to get Medicare.

Anyway, if I can get 2 or 3 more years of life and longer breaks from ADT, they can stick whatever they like up my butt.

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2 replies
heavyphil | @heavyphil | Feb 8 9:33am
In reply to @bluegill "Thanks for the comments. It's interesting that here and in another group many people suggest getting..." + (show)
@bluegill

Thanks for the comments. It's interesting that here and in another group many people suggest getting genetic testing. Both of my doctors (urologist and oncologist) say I don't need one, because we already know my cancer is aggressive and high grade.

Yes, I recognize the value of ADT, but someday my cancer will evolve and ADT won't work anymore. My urologist says that could happen in 20 years, and my oncologist says it will happen in a year or two (I already did 3 years of ADT).

The recent PSMA shows no evidence of spread outside the prostate. The oncologist wants another MRI before the brachytherapy.

I would like an appointement at Mayo. How do I go about making one? I may wait until I turn 65 (next month) to get Medicare.

Anyway, if I can get 2 or 3 more years of life and longer breaks from ADT, they can stick whatever they like up my butt.

Jump to this post

My friend had SBRT at Sloan one year ago - no ADT. His RO told him that if he had a recurrence, no worries, seeds can be done with a high degree of success.
For myself, I would try anything before going on ADT for life for all the reasons you mention. Best
Phil

REPLY
jeffMar | @jeffmarc | Feb 8 11:01am
In reply to @bluegill "Thanks for the comments. It's interesting that here and in another group many people suggest getting..." + (show)
@bluegill

Thanks for the comments. It's interesting that here and in another group many people suggest getting genetic testing. Both of my doctors (urologist and oncologist) say I don't need one, because we already know my cancer is aggressive and high grade.

Yes, I recognize the value of ADT, but someday my cancer will evolve and ADT won't work anymore. My urologist says that could happen in 20 years, and my oncologist says it will happen in a year or two (I already did 3 years of ADT).

The recent PSMA shows no evidence of spread outside the prostate. The oncologist wants another MRI before the brachytherapy.

I would like an appointement at Mayo. How do I go about making one? I may wait until I turn 65 (next month) to get Medicare.

Anyway, if I can get 2 or 3 more years of life and longer breaks from ADT, they can stick whatever they like up my butt.

Jump to this post

Your doctors, missed one major thing when talking about genetic testing. If you happen to have BRCA2 In your hereditary or somatic test, you can use a PARP inhibitor to give you more time. If you go to the right center of excellence, they require you have a hereditary test. You should also ask about getting a somatic test at this point.

As long as you live in the USA, you can get one for free from this site.

Prostatecancerpromise.org

They will send a spit tube which you could spit into and just send back in in 2 to 3 weeks a Geneticist will call you To discuss your results. Do not pick the option that you want your doctor involved.

You should wait until next month because everything will be a lot cheaper. Take a look at Medicare advantage plans or regular Medicare with supplementals, Be prepared do it all ahead of time.

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