Brachytherapy? Anyone have thoughts?

Interstitial radio therapy ['seeds'/ LDR], may cost as little as 5K, HDR ?$, SBRT (5 visits ) maybe 25K, IMRT may be 35K.Is it any wonder that it is difficult to find an (RO) relatively low tech solution for many,...maybe most in the early diagnosis PSMA PET CT scan negative for ECE. Dr Kishan at UCLA is using SBRT for even HIGH Risk 'early birds' As CMS (taxpayers) pays for the graduate training of radiation oncologists maybe a little leverage can be exerted to require competency in cheaper solutions? Just saying.

I had LDR Brachytherapy in Dec 2019. Gleason score was 4+3. All 12 cores cancerous with 4 aggressive cancer. PSA of 10.7. After LDR B, my PSA never went below 1, then over the next 2 years it was back up to 9.7. PET Scan showed cancer had spread to my right pelvic lymph nodes. Did SBRT Radiation and 8 months of Lupron Depot. Since then my PSA has been undetectable at 0.13. I'm getting my PSA checked this week so we'll see what happens next. Fingers crossed.

That's fantastic! For context, what were the detailed results of your biopsy and, if you had it done, your Decipher score?

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Bill

My husband had brachytherapy with seeds plus external beam radiation when he was first diagnosed, way back in 2005. His PSA stayed low for six years, when it rose substantially and he had his first recurrence. Twenty years and many and varied treatments later, he is still here and doing OK. Brachytherapy treatment may well have changed a lot since 2005, but I know other men who have recently been treated with it, so it is still in the arsenal of weapons used against prostate cancer.

I had brachytherapy in 2006. I haven't had a detectable PSA since.
However, I had a lot of radiation damage in the surrounding tissues.

I had brachytherapy done in 2020 and my PSA has been undetectable for 5 years.

Has anyone had Brachytherapy/Seeds nd was it successful?

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

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!

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.