HealingWell
Search Close Search
☰

I have made my treatment decision, and now the process is starting (Yikes am I ready)

Support Forums
>
Prostate Cancer
✚ New Topic ✚ Reply
12
❬ ❬ Previous Thread |Next Thread ❭ ❭
Posted 1/14/2015 1:12 PM (GMT -5)
I have called the team and am starting the HDR Brachy mono process.. I am of unsure and yea , scared, nervous. Dont have much of a personal home support group so that is a challenge. Dont know why exactly but feel HDR Brachy (mono) is right for me, taking into account my psychological state.

1. Last night attended a prostate cancer support group (here in Chicago) . They never had someone that went this treatment route? That kinda freaked me out, but Im ok now about that.

2. At any rate I feel comfortable with the RO and URO team here that does it (and there is only one really in CHI-town)) even though he has only done 100 HDRBT for prostate, I feel comfortable with that number. He is Dr. Santosh Yajnik at Illinois Masonic Med Center.

2. Unlike the UCLA guys my doc does two day straight with an overnight in the hospital and the catheters left in over night. He explained why and I bought it. He indicated one doesn't need to have the "one week healing time" still getting the same amount of radiation. And doing the catheter insertion protocol twice is less comfortable for the patient.

3. I have printed out and read soooooo many studies and stats. I like what I read about HDR mono, but there is always the caution that perhaps it hasn't been done long enough(mono specifically) to say absolutely its equal , but the direction is there for it being so---- equally successful that is for cure rates for low risk guy like me @ 95%

4. Nothing is perfect with making any choice so here I go.

5. why wont this f*&%king beast go away but it wont, so one has to take a leap of faith , and I guess this is mine.

Will keep everyone up to date as dates are selected and I move forward. This site , this group has been so very very helpful for me. Thank you all so much!!

MS
Posted 1/14/2015 1:17 PM (GMT -5)
Good work, you've made your choice.

Now, put the research papers down and step away from the keyboard. Focus on getting it done. It's so easy to second guess our choice (some times I still do), but try now to focus on the path you've chosen and not the ones you've left behind. Yeah, easier said than done but it had to be said.

and yes, the beast never really goes away but over time, it gets small and easier to control. Most of the time. ;)

You're doing great, keep us updated,
Andrew
Posted 1/14/2015 1:28 PM (GMT -5)
Aren't I supposed to feel totally relaxed and relieved.... I dont..... I feel queasy... I guess I just cant get this right.... always the oddball.
Posted 1/14/2015 1:41 PM (GMT -5)
I had posted this response on DeWayne's thread, but I'll cut and paste it here since you've started your own.

BenSam,

With your G6 diagnosis, you should do well with any treatment including HDR brachy. And I'd have to say certain treatments sync up with particular folks' temperaments. HDR brachy clearly speaks to you. It also has the benefit of being a great treatment. To answer your specific comments.

1) I don't know the numbers, but I'd guess that surgery is by far the dominant treatment option and I suspect your support group reflects that. The vast majority of patients are diagnosed by urologists, and uros are surgeons by training.

2) If you feel you've got the right guy on your team, that's great.

2) (Your other number 2) I did overnights with the catheters in place. Not the most comfortable night in my life, but you'll do fine. And I had a night nurse that knew how to do back rubs without upsetting the catheter placement. Truly a gem.

3) Any treatment you are going to do is going to have excellent numbers. If there was a 93% chance of rain or a 96% chance of rain, you pretty much figure it's going to rain and you bring your umbrella. You'll do great.

4) Yep. Don't look back.

5) Yes, it's a leap of faith, but an educated one. That's all you can do. Let us know how we can help!
Posted 1/14/2015 1:47 PM (GMT -5)
Ben, congrats on making a decision. You have done your due diligence by consulting various doctors and have made an excellent choice. HDR should cure you with a high degree of certainty and your chances of onerous SE's is slim.

Good luck and wishing you all the best.

Jim
Posted 1/14/2015 1:48 PM (GMT -5)
Ben, get it in your head, that you have made a decision that will give you a cure, and with all Gleason 6, there is no wrong decision. You've done it based on personal preference, you've done your due dilligence and chosen someone you presumably have faith in. Put it in his hands and go on cruise control. Time to let things happen it will be over in a flash, as Dewayne will tell you.
Posted 1/14/2015 2:12 PM (GMT -5)

BenSam said...
Aren't I supposed to feel totally relaxed and relieved.... I dont..... I feel queasy... I guess I just cant get this right.... always the oddball.

Of course you are.
But most of us don't - it's a scary thing you're about to do - queasy was the least I felt after making my choice.

Relaxed/relieved comes in about 10 years when you know you've beaten this thing - maybe.

Sounds like your like most of us here.

Hang in there, this will just be a bad memory before you know it.
Andrew
Posted 1/14/2015 2:18 PM (GMT -5)
Great work. Now go all in with the procedure and doing everything you can to promote your overall well being. I am confident everything well be fine. Please let me know if there is anything I can help with.

Jack
Posted 1/14/2015 2:24 PM (GMT -5)
1. any special exercises to help get through this procedure

(Like sitting on 20 knitting needles..ha)

2. Any prep items I need for when I get home? laundry list of items seems so long for post surgery but I haven't seen any list for post HDR brachy? Please update me if I have missed something?

Thanks. MS
Posted 1/14/2015 3:43 PM (GMT -5)
BenSam,

I too am considering HDR Brachy (and SBRT). I have a comprehensive, multi-page handout from UCLA on HDR. It includes "Home Care Instructions After High Dose Rate Brachytherapy". I'd be happy to scan this handout and email you a .pdf copy. Dr Demanes at UCLA is one of the best at HDR. PM me your email address if you'd like a copy.
Posted 1/14/2015 3:53 PM (GMT -5)
Super Max

That would be greatly appreciated absolutely.

My email is.

Thanks so much.

MS

MS...sorry, I deleted your email address from the body of the post. There are too many hackers harvesting this personal info these days...don't want you to start speaking North Korean! If you can activate your email address in your profile that will work. Or, alternatively, you and Super Max can each email me and I will forward the email info. Jim

Post Edited By Moderator (Tudpock18) : 1/14/2015 2:39:49 PM (GMT-7)

Posted 1/14/2015 11:50 PM (GMT -5)
Great that that part is over... Now for the fun stuff! (I have a really weird sense of "fun.") But the HDR technology is orgasmic for a techno-geek like me. I hope you provide lots of details - how many Gy in how many sessions, details of the dose-volume histogram, etc.

UCLA now offers a single 2-day session now as well - it always seemed cruel to me to make one wait a week in between. Martinez is even doing it in a single session now, I hear - now that's extreme hypofractionation.

You do realize that they've been doing HDR brachy monotherapy since 1996, right? How much longer would anyone ever need to be sure it's safe and effective?

- Allen
Posted 1/15/2015 6:30 AM (GMT -5)
BenSam,
You have made a decision that will most likely cure you and preserve your quality of life.
Congratulations.
Posted 1/15/2015 11:20 AM (GMT -5)
Date set for HDR Brachy: Jan. 28 and 29.

Im wondering why I wasn't told to take any meds that would totally clean out my system the day before? Ill check with my RO about that?

Had an interesting visit with a new URO this morn (part of the HDR Brachy tag team). One of the things he indicated was that there was not a lot of back up treatment plans if HDR Brachy fails. This made me very nervous. He said this was a URO perspective not the RO perspective. HMMMMM??

Overall he said I am a GREAT candidate for HDR Brachy and feels it will do well with me.

MS
Posted 1/15/2015 11:32 AM (GMT -5)
Which Chicago support group did you attend?

There is one at Weiss hospital run by Dr,. Bhalani. I attended it once with a friend from Inspire.com when I was there visiting my daughter. It was great to have a urologist rather than a willing volunteer (some laymen like Tall Allen and Rick Davis or Tony Crispino very good, others not so much).

Thee is another at Chicago Prostate center.

Sure there are others.

Anyway, congrats on making your decision and do keep us posted.

LupronJim
Posted 1/15/2015 12:03 PM (GMT -5)
Exactly. I attend the Weiss Hosp. Support group led by Dr. Bhalani Very good group.

Thanks
Posted 1/15/2015 4:24 PM (GMT -5)
BenSam,

My RO in Atlanta was surprised I even had heard of HDR Brachytherapy. One PCP I went to hadn't heard of it.
Posted 1/15/2015 6:23 PM (GMT -5)
Hi BenSam, - Congratulations on making a choice of treatment, it should provide great relief compared to previous indecision.

Understand that there is no guaranteed right or wrong answer in making such a decision and now that it is made, you should feel confident that you have made the best choice possible for YOU, based upon the knowledge you have acquired to date. Rest assured that successful treatment is far more subject to the stage of disease than to treatment choice, assuming competency in the provider.

Assume successful treatment will be the outcome and never look back or second guess your decision. I say this regardless of eventual results, good or bad, because NO ONE can ever know what the results of any other decision would have been.

I assume you will do fine and will be able to enjoy a long life filled with happiness and future good health. So proceed with full confidence in the likely success of your treatment choice and your provider's abilities and your confident enthusiasm is likely to be rewarded.

Incidentally, the two consecutive day treatment is, by far, the most popular method of HDR placement and time frame that exists in most places, in my experience over the last 16 years. Best wishes for a quick and complete recovery from your PCa experience, - John@newPCa.org (aka) az4peaks
Posted 1/16/2015 9:06 AM (GMT -5)
Thank you az4peaks.
Posted 1/16/2015 12:41 PM (GMT -5)
I find myself already second guessing my treatment decision..... according to the national comprehensive cancer network I am a very good candidate for active surveillance .yet I have chosen to have HDR Brachy..... Why?

is this over treatment syndrome? Is it because 5 of 12 cores came back showing cancer , 2 at 60 percent..... 1 pni...all in the same lobe?....?anxiety dcision making. But otherwise look at my numbers......is this how over treatment begins?

docs who recommend treatment all have something to benefit from it... am I being too cynical??

MS
Posted 1/16/2015 2:21 PM (GMT -5)
I don't consider myself to be any sort of expert when it comes to AS, but personally if I had been a G6 I would have seriously considered it. Choosing a treatment option means choosing which SEs you can live with. Arguably, AS has the least SEs of any.

I realize not everyone can live with AS, but I think I could have. (That dang G9 messed everything up!)

I'm not sure how serious you are about AS or if you're just musing about it for now. But if you are somewhat serious, you should start a thread about it and I'd bet you get lots of feedback.
Posted 1/16/2015 2:53 PM (GMT -5)
BenSam,

Have you considered focal treatment at all? HDR, cryo, laser can be used to just treat the known tumor and not ablate the entire prostate. Demanes at UCLA will do focal HDR, Eric Walser at UTMB does focal laser on an outpatient basis. There's a forum devoted to focal laser over at inspire.com. There are other options to be aware of.
Posted 1/16/2015 4:00 PM (GMT -5)
Super max,

Interesting article (2014) regarding FOCAL Therapy. Check it out:


http://jco.ascopubs.org/content/32/13/1299
[url]
Posted 1/16/2015 4:35 PM (GMT -5)
I don't think any competent doctor would consider BenSam for focal.
Posted 1/16/2015 4:42 PM (GMT -5)
Ben - I think it would be worth asking yourself what exactly it was that made you start second guessing yourself.
My personal opinion, and like Michael, I'm no expert, is that AS is not a good idea with 5 positive cores, and as I recall, some of them high volume cores. Among other reasons, what if one of those cores turns out to be something other than a G6.

But I think the first thing you should do is ask yourself why you chose HDR in the first place and why you are reconsidering (if you really are) or hesitating.
This is not an easy choice. Its one of the bane's of this disease. When I was going through the decision process I remember thinking, I wish there was only one choice, one protocol, and the Dr told you what to do instead of asked you whether you want egg drop or won ton soup. So I feel for you
✚ New Topic ✚ Reply
12