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waiting time for HDR Brachytherapy in top USA clinic/hospital

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Posted 10/20/2015 8:24 AM (GMT -5)
Hello,

I have been recently diagnosed with PC. Because of the relatively low grade I qualify for Brachytherapy.
My problem is : I can get LDR Brachy at short notice, but I have to wait for HDR Brachytherapy for about 3 months in Holland, where I live. (Only one hospital in Holland does the HDR version)

Because I prefer the HDR version, I am looking for better options maybe even in the US or Germany.

Who can advise a top clinic/hospital in the US and/or Germany and any idea how long I would have to wait for treatment?

I am hoping to get some better understanding about HDR brachytherapy treatment options abroad.



JBdV

PSA 6, Gleason 6, several positive cores
Posted 10/20/2015 8:54 AM (GMT -5)
Hi John - Welcome, sorry you have to be here, but you couldn't have found a better resource.

I have nothing to add about Brachy, but others will be around soon to give you some great information.

My question is, what's the issue with the waiting for 3 months? You are very low grade, I don't think the 3 month wait would have any adverse effects.

Best of luck to you on your treatment path!!!

Jordan
Posted 10/20/2015 1:03 PM (GMT -5)
I'm with jpenn44. I'd wait the three months.

1) HDR is great and all, but you will be different afterwards.

2) LDR is great too, but if I wanted HDR I wouldn't 'settle' for sure, and

3) There are some options of flying to the US, but I'm not so sure they'd just schedule without a preliminary visit or two. So, it might take three months to get in over here as well.

I was diagnosed around Oct. 20th or so and my first HDR was Dec. 4 and the second on Dec. 16. In hindsight, I wouldn't mind waiting but I felt a lot better, psychologically, by going ahead but I doubt a few months will make much difference for you.
Posted 10/20/2015 3:32 PM (GMT -5)
3 months is very little to wait. You have low risk PC -- it doesn't grow very fast.

- Allen
Posted 10/21/2015 10:07 AM (GMT -5)
MD Anderson Cancer Center in Houston is a world-class facility that has patients literally from all over the world. They have one of the best brachytherapy guys in the U.S. but I don't know exactly what type they do. Getting an appointment is very simple and fast.
Posted 10/21/2015 10:11 AM (GMT -5)
I would stay at home and do the HDR in three months. Coming to the US may not save significant time. Avoid the travel and additional cost of doing it in the USA. By staying local you will have a much better time with follow-up. While HDR usually has very limited and minor side effects, if there are any problems, it would be better to remain with the providers that initially did the procedure.
Posted 10/21/2015 3:24 PM (GMT -5)
3 months doesn't seem long to wait, especially as you are classified as a Gleason 6.

Even if you started phone consults now with the few US facilities known for HDR it would take some time to decide on a provider and to schedule the procedure. And you would probably bear the cost of the procedure. Maybe your treatment in Germany could be covered by your Dutch Health Care?

If your facility in Holland has a good reputation you are probably better to wait. Post procedure follow up is also simplified if you are using a fairly close, local provider.
Posted 10/21/2015 7:27 PM (GMT -5)
If I recall correctly there was another thread where a poster from Holland mentioned that standard protocol there was treatment for gleason 6 by surgery or radiation. He really seemed to think that the US was not following proper protocol when we do a lot of Active Surveillance on Gleason 6.

Assuming that Gleason 6 in Euroland is the same as Gleason 6 in the US, (probably supposed to be, but that doesn't mean it is) the difference in protocols between the two countries may be partly causing the original poster confusion.

People in the US are saying no big deal wait the three months. Original poster may be feeling more like something needs to be done.

May be some of what is going on.
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