Local relapse after HDR Brachytherapy and EBRT

[tmfo]

I'm hoping to get some suggestions of what to ask my husband's Dr. when we see him next week.

Dx fall 2018 G9 PSA was 46. His prostate was too big and close to his colon for surgery. He started ADT (Firmagon) Jan 2019 then had HDR Brachytherapy and 22 EBRT. He stayed on ADT for a total of 20 months, his T was not going below 0.7 so he switched to Eligard for the last 6 months.

After stopping ADT his T never really came back but his PSA started to rise and got up to 1.9 from a nadir of 0.6. He restarted Eligard and they did a bone scan, CT scan. The CT scan shows spots in his prostate.

What treatments are possible for local relapse? Could they do more HDR Brachy?

We are in Canada and while it is great that we do not have to worry about whether insurance will cover treatment, it seems like we have less options outside of clinical trials and standard of care. We are willing to travel and pay for treatment if it gives him a better shot of being around for our kids. The youngest is only 8.

Any suggestions of what we should be asking would be much appreciated.

[GP24]

I would get a PSMA PET/CT scan which will probably show further lesions. So treating the prostate will only treat part of the tumor. For salvage treatment after radiation I would try cryotherapy:

ncbi.nlm.nih.gov/pmc/articl...

[imdelightful in reply to GP24]

You will benefit from reading the brilliant fact finding book 'World Without Cancer - The Story of Vitamin B 17' You won't regret it . You may also try apricot kernels, laetril . For your own sake and your health I sincerely hope you do read the book carefully. Also look up on You Tube Dr Robert O Young - ' Alkalising Nutritional Therapy in the Prevention and Reversal of any Cancerous Condition ' I hope this helps. I don't like to see people conned into beleiveing these Big Pharma companies when the cure is easily managed and drug free , at a far lesser cost that we/you can easily afford. I wish you all the best. Take it easy on yourself. x

[Tall_Allen]

Yes, they can do focal HDR brachy for the resistant spots. If there are several spots, salvage SBRT can be used:

prostatecancer.news/2016/08...

NIH has a free trial of salvage SBRT, and I've heard they accept Canadians. They will also do a PSMA PET scan to confirm that it is only local.

clinicaltrials.gov/ct2/show...

[tmfo in reply to Tall_Allen]

Thank you for the links. I will look into SBRT.

[teacherdude70]

Going through similar path - 12/15 Gleason 9, 4+5, Casodex 30 days, Lupron 24 months, 25 sessions IGRT, two sessions HDR Brachy Boost.NADR - 0.16. ADT vacation 18 months then psa rose to 3 19 so took Casodex alone for 12 months until psa strted rising to 2.16 then Eligard for 8 months 'till psa started climbing. Last Eligard was a6 month shot & two months after that had a 1 month Lupron, psa dropped but not below 1.0 so now on monthly Lupron and Nubeqa twice a day.

Testosterone was less than 5 except when When Eligard failed it jumped up to 325 before lupron restarted.

Options? Remove prostate, HIFU, Cryotherapy, different meds, chemo, Immunotherapy. Then trials.

Rad doc gave me max overall dose so no more on the prostate bed.

I had MRI and PET Scan but PSMA not available yet, soon. No mets but spots in lower lymph were found to not me cancer but were zapped anyway.

What are your LDH numbers?

[bluesnjazz]

There is a type of brachy they call high dose brachy or reclaim(?) brachy in which they do not insert seeds, but radioactive needles that are left in there for several hours, I believe, then withdrawn and done again sometime later. I'm not sure of all the details, but a friend who lives in Singapore did this a couple years back.

[tmfo in reply to bluesnjazz]

That is HDR Brachytherapy. He had that before EBRT. Not sure if they will do that again. I know others have had more than one HDR Brachy but it may not be the same dose as he had.

[imdelightful]

There is help beyond the companies that have people believing chemo etc will help. Codswhallop! Please be kind to both yourself and your hubby go to You Tube (if possible) and find Dr Robert O Young's video 'Alkalising Nutritional Therapy in the Prevention and Reversal of any Cancerous Condition...' You will be astounded with the information and recommendations he informs people to apply/use. He will help you both. Just give him a try you have nothing to lose and a lot to gain. Also read ' World Without Cancer - The Story of Vitamin B17' by G. Edward Griffin. I'm not here to make a money it's simply my nature to help people who are being made fools of. I sincerely hope you take my advice as many have and are now on the road to a healthy and better life. I wish you all the best. Take care.x