1. < Prostate Cancer

My Treatment Decision Is In: Single Seed Brachytherapy

Posted by paul28 @paul28, Oct 12 10:37pm

I had never heard of it, and since agreeing to this course of treatment, not much is found online to offer much of value.
I am thinking that some folks here know all about it.
So here's what I do know.

Because of my particular prostate cancer, other options were eliminated as viable options and it came down to this.

My treatment plan begins on November 11 at MD ANDERSON INDIANAPOLIS.

It has been described and referred as an HDR BRACHYTHERAPY, utilizing 20 needles, aka, tubes, and wires, followed by the placement of one single seed as the radiation source.
That seed is guided throughout the prostate gland to make contact with the individual tube wires.
A short while later, those tubes or needles, are retracted and the seed is also removed.
And that's it ... all in one single procedure. One and done!

Over the course of the following two weeks thereafter, my perineum has some time to heal, and I will then begin 5 weeks of daily EBRT.
I have been on ADT with ORGOVYX for 4 months, and I will remain on ORGOVYX for up to 2 years.

That's what I know.
Any BRACHYTHERAPY was always going to involve my perineum and side effects to urinary tract, etc.
I was definitely not a candidate at 74 for PROSTATECTOMY or LDR options.

Iam Gleason 9, RAD 5, 14 of 16 positive tubes, and in surveillance after Stage 4 Colon and Lung surgeries of 29 months ago. I am also on meds for Graves Disease and hyperthyroidism over a year. Other than that, I'm in good shape!
Seriously.

I am much more concerned about the 5 week EBRT than the Brachy by far!
I fear that my rectum and/or colon could suffer from radiation. After sigmoid colon resection and near the rectum, well, this is not good!

Maybe somebody can tell me something good ... or not.
Thanks much!!
PAUL

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

paul28 | @paul28 | Oct 19 10:33am
In reply to @heavyphil "I’m sure we will be keeping each other up on our exploits! After being trussed up..." + (show)
@heavyphil

I’m sure we will be keeping each other up on our exploits! After being trussed up with my legs behind my head and my balls taped to my belly for the biopsy, very little bothers me any longer in respect to dignity or decorum.
If I lose control of my bowels or bladder on the table I won’t be the first - or last!!🤣

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Well, I guess that sums it up!
I had not looked at it from that perspective....
I could have gone all day without that visual!
LoL!! Too funny!!

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heavyphil | @heavyphil | Oct 20 5:56am
In reply to @jeffmarc "Interesting that they have changed how they’re doing the salvage radiation with fewer visits. I know..." + (show)
@jeffmarc

Interesting that they have changed how they’re doing the salvage radiation with fewer visits. I know I went through seven weeks of treatments, but felt nothing. No issues at all after each treatment.

It would be interesting to know if you actually do feel something as a result of them having a higher radiation dose. Did they tell you there would be more side effects? What did they tell you that you should expect to feel?

I got 2.5 years of undetectable tests after radiation. Hopefully yours will end in remission.

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Hey Jeff, they just gave the usual gamut of side effects: diarrhea, weak urinary stream, inability to urinate, leakage, urgency, fatigue…
Or maybe nothing.
I would imagine it’s very similar to the side effects of cyberknife since the doses are not quite that high but higher than your 7 week stint. Will let you know…

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mark1952 | @mark1952 | Oct 20 7:12am
In reply to @paul28 "As noted earlier, my treatment is only one dose of HDR BRACHYTHERAPY; and of the type..." + (show)
@paul28

As noted earlier, my treatment is only one dose of HDR BRACHYTHERAPY; and of the type that is done from the insertion of one seed but moved among 20 locations within the prostate gland for shorter periods of time and then withdrawn.
I like to say that this is "one and done" and then off to 5 weeks of EBRT, or external Radiation.
And hearin lies my problem.

I am not at all concerned about one Brachy session.
It's those 25 days of being externally radiated.
This is where things can go wrong, including some very worrisome potential side effects.
Let's just call it what it is .... There WILL BE side effects- some mild, some severe, some short term, and others of life long complications.
My tamsulosin works great.
My ADT/ORGOVYX is tolerable now in the 4th month.

Have you ever heard of anyone who is highly recommending
External beam radiation everyday for 5 or more weeks?
I haven't.
Thanks for joining in my rant!
PAUL

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Hello, Paul,
I will be getting 40 sessions of image guided radiation therapy (IGRT)--5 days a week for 8 weeks. My radiation oncologist tells me this way she can lower the dose to minimize side-effects. We'll see... Glad to hear Orgovyx is tolerable for you. I am coming up on three weeks of Orgovyx and the worst side-effect so far is Restless Leg Syndrome, which is surprisingly uncomfortable and makes it hard to sleep. Sometimes it seems like getting up from bed and jogging in place a little bit helps quiet it, but that could be coincidental. Wishing you the very best.

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1 reply
paul28 | @paul28 | Oct 20 9:11am
In reply to @mark1952 "Hello, Paul, I will be getting 40 sessions of image guided radiation therapy (IGRT)--5 days a..." + (show)
@mark1952

Hello, Paul,
I will be getting 40 sessions of image guided radiation therapy (IGRT)--5 days a week for 8 weeks. My radiation oncologist tells me this way she can lower the dose to minimize side-effects. We'll see... Glad to hear Orgovyx is tolerable for you. I am coming up on three weeks of Orgovyx and the worst side-effect so far is Restless Leg Syndrome, which is surprisingly uncomfortable and makes it hard to sleep. Sometimes it seems like getting up from bed and jogging in place a little bit helps quiet it, but that could be coincidental. Wishing you the very best.

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All the best to you, also, Mark!
I get what you're saying about more sessions/ lower dose rate. I dread the everyday drive. Originally, I was set for 6 weeks, then for whatever reason, it was changed to 5. I was excited to learn of 1 week less!

I'm just not looking forward to any of it. I'll be happy when it's over.

My hot flashes are the worst. Some days more than others. I too get some restless legs. It's aggravating!
I'm thinking that the "golden years" are overrated!!
Let us know how you make out!
PAUL

REPLY
1 reply
jeffmarc | @jeffmarc | Oct 20 11:11am
In reply to @paul28 "All the best to you, also, Mark! I get what you're saying about more sessions/ lower..." + (show)
@paul28

All the best to you, also, Mark!
I get what you're saying about more sessions/ lower dose rate. I dread the everyday drive. Originally, I was set for 6 weeks, then for whatever reason, it was changed to 5. I was excited to learn of 1 week less!

I'm just not looking forward to any of it. I'll be happy when it's over.

My hot flashes are the worst. Some days more than others. I too get some restless legs. It's aggravating!
I'm thinking that the "golden years" are overrated!!
Let us know how you make out!
PAUL

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I had terrible hot flashes as well. my doctor put me on depo-provera after a year and it stopped my hot flashes almost completely until I went on Zytiga. I also got a wave 2 device from Embrlabs.com. It stopped my nightly hot flashes completely., I used to wake up with the sheet wet under me. No more. The Wave 2 fits on your wrist and sends cold waves through your body to stop the hot flashes. It has two buttons, I set one for daytime hot flashes, and one for the night.

There are other hormones that can do the same thing, ask your doctor about them. Some people in the forum have said that eating tofu every day has stopped their hot flashes, heard it from two different people. Something you could try.

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