Has anyone had 33 EBRT and one HDR brachy?

Radiation is radiation whether it comes from seeds or beams. What matters is the dose the prostate receives. Doing the external beam exposes other tissue to the radiation while HDR keeps the radiation in the prostate. EBRT alone would be effective and curative.

Therapeutically, your RO's plan will be as effective as the original plan. There is a chance of increased side effects with just the one HDR.

Do you have a reason not to believe the medical opinion of your RO?

Andrew

I trust our RO. I did not mean to imply otherwise.

Realize, that we are trying to process this. I think our RO is on the fence about this.
He was on the fence about adt. When he sent us to the uro who does the catheter insertions,
the uro said Dan should have been on hormones. So, Dan’s Eligard was given weeks after radiation started.

We are from
Little Rock. We are having treatment in Atlanta. At home we would have our PCP to talk to.

The “plan” was 28/2. I have not read about one HDR?

We were told that EBRT alone would not be enough with the “gross overlying epe”?

I don't understand when the RO said he could stop the radiation to give atropine. The only time your husband is under propofol is when they do the procedure to insert the catheter. (At least that's how it was with me.) He's awake during the actual radiation, correct? Which also isn't very long.

Can you post your husband's stats? I'm curious at to what risk group he's in. As to is one HDR session enough, I would think that as long as they can adjust on the EBRT side of the equation that he would probably get a sufficient dose of radiation. At least that's what the RO seems to be telling you.

EDIT: After posting this I saw your additional posts with Dan's stats. As a Gleason 7, I think there's less worry than if he was in the high risk group. I think it all depends on what the chances are of a major heart issue. Remember, most intermediate risk PCa is curable, but a heart issue can be...well, worse. Maybe have your cardiologist and the RO discuss together?

I am sorry I have a messed up “signature”. I think some of it is there. Pca3 65% chance gleason 7or>
Had mri before biopsy. Epe and pirads 5. Biopsy with mri- sent to NYU Langone:
Pi-rads assessment category5
T2 weighted images 5 1.5 cm of definite invasion/EPE
Diffusion weighted images 5> 1.5 cm of definite invasion/epe
Extra- prostatic extension Overlying gross EPE
Zone: Peripheral
Sorry I do not know how to cut and paste.
Our uro in Little Rock said unfavorable intermediate?

With the Propofol: they gave it to him during insertion. They let me be with him when they were plotting dosage. His hr was 38 but came up when I told him to breathe. I believe they gave him more Propofol before the radiation. Plus, the RN gave him two doses of Dilaudid while we were waiting.
Dan said he slept during the radiation and Carolyn the RN kept telling him to breathe.

We will just see what cardiologist says. Did not know maybe he does not need to sleep during radiation?

Thanks so much. I keep trying to be grateful for one HDR

I will get the anesthesia records tomorrow and take them to cardiologist.
Dan has resting heart rate of 52-60. Normal sinus rythm
I think they gave him Propofol for catheter placement, radiation and Catheter removal.
It will be alright either way.
Thanks so much

Thanks, Andrew.
I really do appreciate your responses.
I think if we were at home I would not be so crazy.
Kit

15/1 here. Just finished external beam today. Good luck!

Hi Kit,

Changing the radiation so Dan doesn’t get the second HDR but gets more external beam should be fine. Dr McCord has a lot of experience with this and I would trust him. From a cancer control aspect both methods are fine.

I only had propofol for the 30 minutes it took for the HDR catheter placement. I also had a spinal block and was numb during the radiation and catheter removal. I did not get a second dose of propofol.

Isn’t Nurse Carolyn the best? She took great care of me.

Best wishes to you and Dan,

Jack

I have to speak up here sorry ..if there is anything u can do to do the second HDRb....do it .

Please look up side effects of prostate radiation both short and long and radiation proctitus ....I did EBR and regret it let’s leave ut at that

FWIW, my SEs--which were all short-lived--were more pronounced from my HDR brachy then my EBRT.

kit...I remember you saying that they didn't do spinals there. I wonder why since it was the same anesthesiologist that gave me my spinal and propofol. BTW, my spinal was one of the stranger sensations I've ever had. That's what it must feel like to be paralyzed from the waist down.

Kit...no, I'm in California. The only point I was trying to make is that the anesthesiologist *should* be able to do both the spinal and propofol, so not sure why they could do one and not the other. But if as you say the spinal would also lower his heart rate, then that's probably a non-starter anyway.