Return of PC after brachytherapy

Barney you are probably not in the uk. It isn't always easy to just find another urologist in the uk. Ww often just get what we are given. Unless we have private insurance, which not many people do. Sometimes we can ask for a second opinion but it's not always available. We could only have the standard MRI too. There's no choice of a better machine.

I hear what you are saying.

My point is that for those that don't have private insurance, they should weigh up their choices carefully:

either follow the treatment plan of a urologist you don't really trust OR

find a high volume urologist attached to a hospital who through different scans can identify the extent if any of the cancer AND whose experience will enable him to offer the best options available. And the best option may mean a shorter treatment period or a very different type of treatment to that being offered by the urologist Helen's husband has been seeing .

Sure this option may be costly in dollar terms, but a lower cost, in dollar terms treatment could be costly in affecting quality of life unnecessarily.

Just my 2c

Very sorry to hear about the denial of reasonable treatment you're experiencing in the UK.  That is where we're heading in the USA unless we can manage to stamp out former President Obamanator's "The Tyrant" Care statures, and rid ourselves of the tyranny of the socialist elitest liberals who so disingeniously seek to drag our nation on toward their sick vision of a One World Ameritopia.

Assuming they're able to watch, I'm sure that both Priminister Thatcher and President Reagan are greatly saddened and dismayed to see the terrible state that both of our respective nations have fallen to.

Rereading your email makes me think that given your husband has a Gleason 5+4 (a step ahead of my 4+5), Brachy is not the answer. Certainly not Brachy alone.

Surgery + Radiation or

Surgery + HT may be the solution.

The fact that the SV was positive for PCa means more than the prostate bed is problematic.

And the urologist suspects it has spread beyond the prostate, hence he offered HT.

The best PET CT scans are those focussed on PCa such as PSMA PET CT scan or similar. These are different to conventional PET scans. I would have such a scan performed to indicate if the PCa has spread to another organ or bone.

Such a scan will identify other areas that may show evidence of PCa. If say there is just one area, let's say a certain bone, then you should ask a highly regarded urologist or radiation oncololgist if radiation to that bone and radiation to the SV and prostate bed (+\-) HT (presumably HT at a lower dose than if radiation was not applied) is a reasonable treatment.

If I was in your or your husband's shoes I would explore every option that has a good chance of success before agreeing to any treatment.

 

Barney I think once someone has had brachytherapy they cannot have it again or radiotherapy as that area has already had the maximum dose. They often won't remove the prostate after brachy either as it is too damaged. Some surgeons will but there is a very high chance of being incontinent, though that would be better than no surgery, but if it has already spread would be pointless. I think I'd be looking into other treatments. 

You make sense. I forgot that Brachy was already administered.

Hi Helen, Your Gp can refer you to another urologist in a different area. If you are not happy with your treatment or options. ONE of the drugs mentioned earlier zytiger should now be more easily available in the UK. STAY POSITIVE? My nest wishes to you both.