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Posted 3/12/2014 11:39 PM (GMT -5)
I am considering using a high dose of radiation for my prostate cancer. The success rates seem very good with very few complications or reoccurrence. I have Gleason 6 cancer with only one core of twelve positive. PSA is 4.19. My father died of prostate cancer with a similar biopsy as mine in a nine year period. There was some mention of perineural invasion in the nerves of his prostate. He used ebrt at a low dose for 40 treatments. What do you think? Thanks for your help.
Posted 3/13/2014 12:32 AM (GMT -5)
I had brachy therapy, IGRT and hormone therapy -- the full monty -- beginning about four years ago and I am in remission. what do I think? I'd be inclined to do radiation in some form before surgery but either surgery, radiation and probably AS would work for you. how old are you?

and welcome to HW cool

ed
Posted 3/13/2014 12:53 AM (GMT -5)
Talked to a friend today. He had brachytherapy 4 yrs. ago and hasn't been able to stand up to pee since. Has to self cathiterize every 4 hrs. His prostate is mush.... Was going to his doctor today for some kind of "rotor rooter" treatment. His words not mine. I guess anything can happen. He said he never would advise brachytherapy for anyone!
Posted 3/13/2014 1:56 AM (GMT -5)
Farmerboy, I would strongly suggest you obtain a book called "The Decision" by Dr. John C. McHugh. It guides you through the treatment decision process in a unbiased way. The read is light and easy to comprehend. The author is an urologist who has personally gone through what we are experiencing. The information you get from this forum is INVALUABLE so keep taking advantage of it. The book puts it all into perspective and helps you make a decision based on your needs. I bought the book at Amazon for my Ipad.
Best of luck, Doug
Posted 3/13/2014 7:19 AM (GMT -5)
Hello FarmerBoy and welcome to HW. Sorry you have to be here but you will generally find this is a place filled with folks who are willing to provide both info and support. To help us help you more you might consider completing a "signature" with your age, PSA history, % of cancer in the positive core, etc.

I would recommend that a good place to start is for you to reference the sticky thread at the top of our forum that is designed for new members, www.healingwell.com/community/default.aspx?f=35&m=2652250. You will want to get as educated as possible about our disease before making your decision. A couple of excellent books I can recommend are Dr. Walsh's, "Guide to Surviving Prostate Cancer" and Dr. Scholz', "Invasion of the Prostate Snatchers".

Your initial post would indicate that you have very early stage PCa and that is good...it means that you likely have many options that will cure your cancer. You asked specifically about HDR and SBRT. Both of those options show excellent success in curing cancer with minimal SE's. We have a number of members who have made those choices and I expect some of them will chime in on this thread.

Jim
Posted 3/13/2014 10:10 AM (GMT -5)
Thank you to everybody for your quick replies and helpful information. I'm not sure how you add a "signature" to your profile, but here is my history. I have checked my PSA regularly for years because of my fathers history with Pca. PSA was in the 2's for last 4 or 5 years. In December 2013 it came back at 6.77. Had it redone in February and it was 4.19. Same lab. Did some major changes with diet and supplements in that period of time. Checked in with a urologist and did a biopsy with one of 12 cores positive with 20% involvement. Came in at Gleason 6. Age 59.

After checking I think I figured out how to do a signature page! Ha
Posted 3/13/2014 11:38 AM (GMT -5)
Farmerboy,

I had HDR brachytherapy, IMRT, and HT for my cancer. This is similar to F8's trteatments. My urologist suggested HDR due to the effectiveness and low side effects. My oncologist also suggested HDR. I have experienced no lasting side effects from the radiation and I am three years and three months since the HDR and IMRT.

Based on you situation, you may be a candidate for HDR monotherapy. The best HDR information I can send you to is www.cetmc.com. This is the website of Dr Jeffrey Demanes, the HDR pioneer and now head of radiation therapy at UCLA Medical Center.

Let me know how I can help.

Jack
Posted 3/13/2014 1:03 PM (GMT -5)
Farmerboy,

I think HDR brachy monotherapy and SBRT are the two best treatments available... IF:
  • You have low to intermediate risk disease (which you do)
  • You are temperamentally indisposed to do Active Surveillance
  • You are temperamentally indisposed to do Focal therapy
  • You can live without getting your prostate removed or seeing a final pathology report
  • You are comfortable watching PSA decline over a number of years, and not fall immediately to undetectable as with surgery
  • You are comfortable with 6 years of data (for SBRT) and 8 years of data (for HDR brachy monotherapy).

I also think LDR brachy can be an excellent choice, but only if it is done by one of a few acknowledged artists. Seed placement is a skill learned after a lot of experience. Just as with surgery, there seems to be a steep learning curve. For HDR and SBRT, the RO's experience comes into play in putting together a highly accurate treatment plan; the actual treatment in both cases is under computer guidance and isn't subject to human skill or error.

SBRT is based on HDR brachy, so it isn't surprising that the results are nearly identical. What it came down to for me was that 5 trips to UCLA, which is only 10 minutes from where I live, for the 5-10 minute SBRT treatments seemed a lot less bother than the two overnight stays a week apart with anesthesia. BTW, Demanes has recently changed his protocol, so the patient also has the options of doing it in a single overnight stay, or two in-office visits a week apart (He increases the dose per fraction to 10 Gy).
Posted 3/13/2014 5:15 PM (GMT -5)

Lotsahope said...
Talked to a friend today. He had brachytherapy 4 yrs. ago and hasn't been able to stand up to pee since. Has to self cathiterize every 4 hrs. His prostate is mush.... Was going to his doctor today for some kind of "rotor rooter" treatment. His words not mine. I guess anything can happen. He said he never would advise brachytherapy for anyone!

This type of "knock" on brachytherapy warrants more information.....can you or your friend elaborate a little on what what went wrong?
Posted 3/13/2014 5:25 PM (GMT -5)
I'm not a big fan of the friend of a friend stuff. and it's obvious that there are horror stories with every form of treatment.

ed
Posted 3/14/2014 6:06 AM (GMT -5)
Farmer,
I don't know what the guy with the 'mush prostate' is talking about, but I had LDR brachy as a stand-alone treatment 4 1/2 years ago and I could not be happier. My PSA is <0.1, and my SE's are practically nil. I would recommend brachy to anyone who is a candidate, and it sounds like you are. I've heard that HDR brachy may be even better. I have not researched that, and have no need to, but if I were in your spot, I probably would. There is quality life after a pc diagnosis. My oncologist uses the 'c' word (cure, not cancer), and I don't argue with him.
Best wishes.
Posted 3/14/2014 7:51 AM (GMT -5)

GOP said...
Farmer,
I don't know what the guy with the 'mush prostate' is talking about, but I had LDR brachy as a stand-alone treatment 4 1/2 years ago and I could not be happier. My PSA is <0.1, and my SE's are practically nil. I would recommend brachy to anyone who is a candidate, and it sounds like you are. I've heard that HDR brachy may be even better. I have not researched that, and have no need to, but if I were in your spot, I probably would. There is quality life after a pc diagnosis. My oncologist uses the 'c' word (cure, not cancer), and I don't argue with him.
Best wishes.

The only SEs(knock on wood) I can admit to is "no pressure" when urinating and erections are not as rigid(and that maybe from the HT) as before.....
Posted 3/14/2014 8:50 AM (GMT -5)
Just to add a bit more info about my HDR.   I did two sessions one week apart on consecutive Mondays.  Neither required an overnight stay.   I was at the hospital at 10:30 in the morning and home by 4:00 in the afternoon.   I had a Foley catheter during the procedure and it was removed before I left the treatment facility.

There are two basic HDR protocols.   Demanes uses two or three sessions/frctions over a 24-30 hour hospital stay (one overnight).   The catheters are inserted and stay for that duration.   While the catheters are in you can not move around or get out of the special bed..   Martinez, in Detroit, introduced the non-overnight method.   Each procedure has one or two fractions during a day with no overnight stay.   This is the method my uro-rad onc team uses.  

Posted 3/23/2014 8:50 AM (GMT -5)
Well I've got an appointment for SBRT in Colorado in 2 weeks. Does anybody know why BCBS is such a pain for paying for SBRT? Do they pay any easier for HDR brachytherapy? They seem to be very similar is dosage and results.
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