Low Dose Radiation Seed Implants - Brachytherapy... My Journey

I posted my beginning story last week as being diagnosed in October of 2015. Low Risk, early stage, PSA of 6.2, Gleason score of 3+3=6. No symptoms relating to prostate cancer or prostate problems. After the biopsy, I developed prostatitis which was not fun and very uncomfortable - I took anitbiotics for several weeks and finally got better. At that point, my PSA went down to 2.0. Still knowing that I had the cancer was a worry to me in itself. At that poing, my urologist told that I could do the watchful waiting, or the active Surveillance, but knowing the cancer is there and could get worse, even though the doc said it was a slow growing kind - if and when I would need some kind of treatment,  I would be older and that it might be harder to deal with at that time. My overall health is good, I am 65 years old and fairly physically active. I don't run marathons, but I keep busy.  I did lots of reseach online about the various treatment options for low to intermediate risk prostate cancer. There are lots of websites for researching this topic. My urologist pointed me to one in particular that gave statistics on success rates etc on various treatment options. I narrowed my options down to (1) seed implants (Brachytherapy) and (2) Cyberknife for prostate cancer. My urologist was and is an advocate for the seed implants. He said that treatment has a very good success rate and has been around for a good number of years. He also told me that what ever treatment option one would choose, make sure it is one that has been used successfully many times. And also the doctor you choose should have performed the procedure numerous times. I met with the radiation oncologist doc to discuss all options available for my situation. He explained the pros and cons of each type of treatment - and he performed all of them. A lot is based on your own situation and what stage you have. I could have choosen from 3 treatments. (1) Traditional radiation - which would have been daily treatments from 4 to 9 weeks, (2) Cyberknife - which sounded like a good option: a beginning session where 4 gold markers are implanted into the prostate. A week or so later, the first of 5 radiation treatments begin. The markers help focus the radiation beam to the area needed which helps reduce the surrounding areas from large doses of radation... which is important. The less radiation to the surrounding areas is the best. That way you minimize the chances of unpleasant side effects. And all treatment options have their side effects. (3) The seed implants or Branchytherapy which is basically a one time treatment. Although there is something called a volume study before any treatment. That is where the radiation doctor uses an instrument much like the one used by the urologist who did the biopsy. This time though, no core samples taken... just a sonogram of the prostate to get precise dimensions, shape and overall size of your prostate. Uncomfortable, but not painful at all. From what I was told, if the prostate is too large, it has to be reduced in size to allow for the seed implants if that is your treatment plan. They can shrink the prostate with a hormone injection if necessary for seed implants. So I opted for the seed implants - which was recommended for my situation by both my urologist and the radiation oncologist. So I had the volume study done two weeks ago. Fortunately, my prostate was in the right size frame without a hormone shot. So the instructions for me were as such: I had to go from the doc's office to the hospital down the street from him to get a pre-op exam. This is also where the procedure would take place. They did a chest x-ray, took several viles of blood, and did an EKG - and of course asked many questions pertaining to my overall health. My seed implant procedure was then scheduled for Wednesday, February 24 (yesterday). One week prior to the procedure, I was to begin taking Flomax to help with urination. Honestly, I had no problem with urinating, nor frequent trips to the bathroom at night which seems to be a common problem with many men and doesn't necessarily mean prostate cancer.  My urologist explained to me why he wanted me to start taking the Flomax. He said that after the procedure, the prostate would swell a bit and this was really a precaution and to help keep me peeing well. And if you think about it, that is a good idea. I hate taking additional drugs, but this sounded like a good plan. He said that after a few months - that I may be able to stop taking it all together. So I hope that is the case. As those past few days had slowly gone by, my anxiety level increased. I dreaded the day, but I was anxious to get it done. I read lots of stories online from people who experienced the Brachytherapy... many of those stories were several years old. Most were good success stories, a few where not great, but not awful. So I decided to just quit reading about it... and think about other things... things I wanted to do when this whole thing was behind me. So yesterday morning, I had to wake up at 4:00 a.m. to give myself a Fleet enema... I had to be at the hospital at 6:00, and the procedure was schedule for 8:30. I arrived at the hospital and checked in. I was weighed, and had my blood pressure taken... I'm surprised that it was not sky high - but by that time I guess I was just wanting it to be over. I went into pre-op where the nurses hooked me up with an I V. My radiation oncology doctor came in to great me... and this man is really really nice. Very personable. He reasured me that all would be fine. Then my urologist came in to see me. He also was in high spirits and joked with me a bit. He said that they had scheduled 4 seed implant procedures that morning and that I had been schedule as the 2nd. But the first guy went to the wrong place - so I got bumped up to the number one spot. I then met with the anethesiologist who also asked many questions and looked over my pre-op results. He said all looked good and he didn't see anything of concern. He basically explained what he would be doing. First injecting a solution of Versed, a drug that would make me feel like I had had a couple of Margaritas. Which it did. Then he would inject an antibiotic, and then when we got to the operating room, he would give me something that would just put me out. He said I would feel nothinig and know nothing. He said it would feel like only a couple of minutes later, and I would be waking up. And that was all true. I had a catheter that was removed shortly after I awoke. I did have a feeling of needing to urinate. And I was given a plastic bottle for that purpose. I was able to pee a little - and it really burned... which the nurse said was normal. They wanted me to pee a few more times while I recovered from the anesthesia... each time it felt like I was peeing battery acid...  then the nurse wanted me to walk to the bathroom to pee the next time to make sure I was getting over the anesthesia. After about an hour or so, I was released from the hospital by 11:30 and I was home by noon. It is hard to sit let me tell you and the ride home from the hospital was not pleasant - watch out for the bumps in the road. And you do feel some pain... not intense, but you sort of feel like you've been kicked right between your legs - at the perenium which is where they insert the needles to do the seed implants. And you have a feeling that perhaps you may have a tennis ball up your behind. My urologist told me just to take ibuprofin for discomfort... so when I got home, I took 2 ibuprofin tablets... and within a couple of hours, I was feeling very little discomfort. But laying down is good. I could not sit comfortably, but i did manage to sit sideways to have dinner. The burning urination got better with each time I had to go. I was surprised that I didn't have the urgent frequent urination that I read about from some people. Although I couldn't walk very fast, so by the time I got to the toilet, I really had to go. I took another dose of ibuprofin at dinner time. I held the sofa down during the evening and watched some television and read. Another dose of iburofin at bedtime. I slept well and woke up around 6:00 a.m. to furinate. All okay with that too. This morning, another dose of ibuprfin with breakfast. I was also given a 5 day regemin of antibiotic as precaution. I am taking it east today, lounging around... catching up on emails and writing this post - but nothing extrme as I do feel a bit out of sorts. Still sore, but not as bad as yesterday. Sitting on a very soft cushion helps. My exercise today was to take a shower... which feels great.

I will post more in the follow days to let you know how things progress. The urologist's office just now called to check on my well being. I have a follow up with the urologist and the radiation oncologist next month on the 21st. I am relieved the procedure is done and now behind me. Both docs felt all went very well. I would answer questions that anyone my have regarding this procedure. I felt like this was the best option for me and glad it is a one time treatment option.We all have our fears and anxieties, but we work through them. Good luck to us all.

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