Brachytherapy? Anyone have thoughts?

Posted by stevenp @stevenp, Aug 9, 2024

Hi all. I have been on active surveillance for two years but psa is up to 6.49 so we did a second biopsy. Gleason 7 (3+4, 3+4, 3+3, 3+3). Just recieved Decipher score .29. I’m 65, still working and physically active. I know 2 men who did the low dose Brachytherapy with good success, but I don’t know what their numbers were. Any anecdotal experience with, or info about, that treatment path would be appreciated.

Interested in more discussions like this? Go to the Prostate Cancer Support Group.

groundhogy | @groundhogy | Aug 11, 2024

Here is a good website to compare odds of cure for the major treatment paths. You have to determine your stage, low risk, intermediate, or high risk (risk of recurrence). So if you are intermediate, pull up the intermediate chart and you can see the odds of 10-20 yr survival, etc. based on the treatment you pick.
https://www.prostatecancerfree.org/compare-prostate-cancer-treatments/
It is best viewed on computer or just print it on paper. Not so viewable on phone.

To make the graphs easier to read, i drew a dot on the endpoints of the elipses, and then drew a line through the dots. This turns the elipses into lines.

Also be aware the the graphs don’t show any salvage radiation benefit. This would boost the surgery odds up a bit.

And, this is a very dysfunctional industry from my view. Loads of bad info mixed in with the good info. Same with the docs. Many of them are more dangerous than the cancer.

clandeboye1 | @clandeboye1 | Aug 10, 2024

Dr Morton at Sunnybrook Hospital in Toronto, Canada . ( A Center of Excellance for Cancer Treatment ) is one of the worlds foremost experts on HDR & LDR Bracytherapy . I personally would consider Monotherapy HDR Brachytherapy . 2 doses - 2 weeks apart . Minimal to Zero side effects .
Discuss this with your Radiation Oncologist AFTER viewing Dr. Mortons video and other background at :
Google : Dr. Morton Brachytherrapy Video .
Good luck .

robertmizek | @robertmizek | Aug 9, 2024

Hi Steve. Welcome to the forum and the club no one wants to join. I’m a two-time prostate cancer patient who had Brachytherapy in 2020. My comments are not medical advice, just my personal opinion based on my experience.

The fact that you have “favorable” Gleason 7 PCa is good news because you have a myriad of viable options. I hope you explore them. Brachytherapy has a good track record for treating prostate cancer while avoiding problems with incontinence and erectile dysfunction. I’ll attest to that. i had zero problems with urinary urgency and no issues with ED. The problem in my case was that I was under-diagnosed and my cancer was more aggressive than appropriate for brachytherapy alone. Prostate cancer returned with a vengeance in 2023. It returned as Gleason 9 Stage 3 with local lymph node involvement. I’ve had to undergo Salvage Robotic Prostatectomy, 31 sessions of radiation, and have to be on First and Second Generation Androgen Deprivation Therapy for 2 years. It’s been a rough 8 months all because brachytherapy was the wrong choice for me.

I used to be an advocate for brachytherapy and used to speak publicly singing its praises at the local Prostate Cancer Support Group. I believe that I influenced other men with Prostate cancer to choose brachytherapy. I hope things worked out OK for them.

If I had favorable intermediate risk PCa today I would investigate whether or not I was a good candidate for cryotherapy, a treatment where the cancer is frozen within the prostate. If that failed it would’ve been easier to determine that it failed earlier and I believe that I could’ve been treated with surgery or radiation while it was easier to treat and cure.

Good luck to you on your journey. Please keep us posted. We’re here for you.