Brachytherapy? Anyone have thoughts?

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

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.

@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?

@famcare Did you mean to ask if " Has anyone had radio active seeds implanted" in his prostate? I don't think in the heart. I believe some have had radio seeds implanted prior to prostate EBRT.

Has anyone had radio active seed implanted? Had anyone had this procedure done?

My numbers were similar to yours. I had brachytherapy and EBT 9 years ago. Apart from two episodes of painless hematuria (cystoscopies essentially negative), and some temporary ED that has passed, I have done well. No major downstream effects.

Went well!
I will be receiving HDR Monotherapy
2 sessions and hoping to start in May

@bwesty, how did your consult go? Did you discuss treatment preferences and options?

Which doctor did you see at the Mayo? I will be there this Friday for a consult with Dr Stish
Age 50 Intermediate risk favorable Gleason 7. HDR is my preference after extensive research and several consults.
Any advice?

I opted for high-dose brachytherapy. Two days of out-patient treatment a week apart. Although the procedure sounds pretty nasty, you are knocked out for it all. I had no pain ever with the procedure. I went home from the hospital (Mayo Rochester) driven by family members and took a long walk. My cancer likely started in my early 60's. My PSA was at 5.48 in 2017. A biopsy was recommended but then some health care dispute in my city caused a loss of nearly all urologists (many quit and others were fired, and leaving the city without urologists due to noncompete clauses). So, I did nothing. In Dec 2021 PSA at 7.8 sent me to an MRI, with 4 lesions at PI-RADS 5, 4, 3, 3. Did biopsy May 2022. Cancer found in 13 of 18 cores, two with PNI, most at 3+4. Surgery or radiation after talking to three doctors (my urologist, a surgeon, and a radiologist). Aug 2022 Decipher test at 0.42 (high end of low risk). I decided to wait and see. Dec 2022 PSA at 10.7. Second MRI Mar 2023 showed substantial growth of lesion pushing on capsule. Had two sessions of HDR brachy in April 2023 (16+17 needles) at Mayo Rochester at age 70. No issues. The procedure is not at all worth the worry. It is true that "Worrying is like paying a debt you don't owe." -- Mark Twain.