Brachytherapy v Radiotherapy

Thanks for that leeniepee. Yes that makes sense. I think in the past two months I've favoured RP RT and Brachy at various times! At Least there are options but trying to decide is so difficult.

Thanks Personal20. Good luck to you too. Would like to hear what your decision was when the time comes.

1st biopsy with 6 cores, 2nd saturation biopsy with 20 cores. 2nd biopsy caused severe infection, which took some time to clear. Took Ofloxacin, Cefaloxin, and Trimethoprim before suitable antibiotic prescribed.

Hi Supercargo, I guess given those particular circumstances, I would do the same as I believe you can still have RT if needed following RP but not viceverse. 

Best wishes

Same with my hubby,he had 1st biopsy took 12cores,next day severe infection,Septacemia ,took quite a while to get over,he was then told 3 out of the 12cores were cancerous (localised) gleeson7, he also opted for RT/hormone treatment.  He sailed through the RT,finished about 2weeks ago,but he's had another hormone injection last week,and this time he's going through hell,with hot sweats,particularly at night.

But all in all he's not doing to bad at all now.  But by god I thought I'd lost him with the Septacemia in the beginning .

actualy you can do both ways, but it depends on if the cancer has spread outside of the prostate gland. the most commonly seen way (if both are done) is RP with EBRT after to make sure theres nothing left behind, but technically theres no reason not to do EBRT then surgery if it didnt work - this is quite often done for other cancers. the problem is that with prostate cancer if it come back it is most often spread outside of the prostate gland when it is discovered, so there isnt much point in doing a prostatectomy.

Hi Kombi,

thanks for your reply. Believe me I am seriously involved in what's about to happen. This for me is the fact-finding stage where I want to hear about other peope's experiences, the choices they made, and what informed them.

As for the easy path? Well I don't know if there is one. In this fact-finding stage it appears that everyone has their own unique set of circumstances which will ulimately lead them to come to their own personal decision.But that once again is based on your knowledge of PC, tratments, and side-effects.

Talk to those qualified to give answers? well yes of course I have and will continue to do so. I'm a nurse, my wifes an ICU nurse and I can get professional opinions all day long but I know from eperience they are not always right. You only have to look at the number of people who have been over-treated because of an elevated PSA to see that

 I was talking to a Consultant Urologist at work the other day and he said he wouldn't know what to do given my own particular circumstances.

So thank you for your concern, but as i said, at this stage it's about becoming more informed from all possible sources, in order to arrive at the most appropriate decision.

best wishes.

Hi, 

I am a radiotherapy student, so i will say now I am not qualified but have seen alot of these cases and observed patient choice.

The benefit of brachy means the seeds are delivering radiation directly to the area without impacting your bowel. The implants are one treatment and disruption to life is small. Also RT can be given post the seeds if required.

If brachy seems to invasive ( which it is for some) RT is a great option with good success rates. I am sure you have been given all the information regarding side effects, everyone responds differently as im sure you are aware of.

Personally if i was you, i would get in touch with the RT dept and ask a qualified therapist to talk you through this at a slower pace than a consultant. It is a big decision and it has to fit in with your lifestyle needs.

I do not know if this will mean anything, but a male lecturer said he would have brachy as a first choice if given the option, (however we do not know all your diagnosis).

All the best with your choice

Hi Sharon, thank you very much for that. It's really interesting and informative - I hadn't even considered that you could have RT if needed after brachy. Also about what your lecturer said.

I'm 52, 3 + 3 with last PSA 3.3 although it was 7 two years ago  when I had my first PSA test. A couple of weeks later it was down to between 1 and 2 up until 2 months ago. Biopsy showed 1 core out of 12. It's a small cluster contained with no spread according to an MRI 2 months ago.

anyway, thanks once again for your input.

best wishes

Hello Sharon. We were told after brachy that the prostate had had the maximum dose of radiotherapy and no more could be done should it return, also prostate removal after brachy is difficult due to damage. We live in the hope that if it returns there will be a new treatment, I know Hifu and cryotherapy are being used more, so hoping they'll be more common practice eventually. 

Thanks for sharing that alfred5. Can I ask if things returned to "normal" or were the side effects longer lasting?

best wishes

Hello. We know of 3 people that have had brachytherapy with no side effects whatsoever. But not the same for my other half. He got an infection or prostatitis from the biopsy, not bad but had a dull ache in his prostate all the time. Had the biopsy in June. As psa was 3.7 Gleason of 6 they suggested leaving the cancer, but by Dec psa was 4.9 so decided on treatment. He had several lots of antibiotics between July after biopsy and Jan when he had brachy. First week after brachy was good, then he got the prostatitis back again but worse. Also suffered from radiation induced cystitis. Meaning severe burning when peeing, he said it was like peeing burning glass. Also had a lot of problems getting the flow to start. He had more antibiotics, tamsulosin twice a day and another tablet called mirabegron. Before treatment he rarely got up in the night to pee, by 6 weeks after treatment he was up anything from 3 times to 10 times. As he works from 7am until 10pm in the height of summer it was a struggle. The consultant said this was rare to suffer this badly.

Now 10 months on all side effects have near enough gone. The morning pee if he's gone all night, which he usually does, is hard to get started. Rest of the day is fine. He still can't drink caffeine, alcohol or eat spicy food as the burning returns.

As for ED there were certainly no problems before treatment, he is 57, but now everything still works but "it" has deflated slightly and it is more hard work to maintain. I think this is the most life changing difference, all the other side effects will eventually be forgotten, but that one is here to stay. Brachy is meant to be the least effect on ED too.

Thank you so much for that very informative reply. It must have been really difficult for him (and you) but it sounds as though the worst is behind him now. It was also encouraging to hear that other people who had Brachy didn't experience side-effects at all.

all the best for the future