Brachytherapy HDR

[JWPMP]

So, after 3 months of scans the EBRT here locally was canceled. Today Jim's RO from UCSF called and said the radiation board talked a long time and decided Brachytherapy HDR was appropriate. Jim will have two treatments at an overnight stay. After all the frustration and anxiety over the delays since May, it feels strange that something is actually going to happen. Not sure why I'm posting, but maybe someone has thoughts or experience with this? Jim's only concern was if this treatment would alter his qol and if he'd still be able to ride his horses. That of course wasn't a problem. Anyway, thank you all for listening.

[Tall_Allen]

I wouldn't get on a horse for a few days after - it'll be sore.

[JWPMP in reply to Tall_Allen]

LolYes Dr Mohamad told him he'll need to take some days off...

Jim was worried he was going to have to quit riding. He would draw the line there.

He said everything ADT has taken from him, he's not giving up the horses too.

[spencoid2 in reply to JWPMP]

I was sore for a few days but back in the saddle (bicycle) in a week. I imagine it is the same with horses but take it a little easy for as long as you can stand.

[JWPMP in reply to spencoid2]

That's so encouraging! He's not convinced he'll be OK, but hearing these experiences makes me look forward to seeing him be so relieved when this part is over.Thank you

[timotur]

He'll be fine. I had HDR-BT with SpaceOar, walked to dinner that night, drove home two hours the next day, and was doing some light running and tennis a few days afterward. The area weeps a little for a couple of days which Depends are good for. It wasn't that sore-- hard to believe they had stuck my prostate with 20 needles. I had the one-and-done session at UCLA with Dr Chang, in by 7am, out by 3pm. Best wishes! (see profile)

[JWPMP in reply to timotur]

Wow! I can't even imagine 20 needle sticks! And being able to function so quickly, that's incredible. They told us Jim will come in on a Thursday morning (and explained the procedure which freaked Jim out. ) The Dr said Jim will stay overnight and have a 2nd dose Friday and go home in the afternoon. Thank you for sharing, really appreciate it. When Jim isn't so stressed, I can share this with him (minus the 20 needles part lol)

[timotur in reply to JWPMP]

The anticipation of the procedure was much worse than it actually was-- it's really pretty easy for the patient, being asleep for about an hour while the insertions take place. Then, while awake over the next three or so hours-- a CT scan for radiation mapping, and then radiation pellet insertion into the tubes for about 15 mins each. I was a little anxious laying still that long, but I took the edge off with one 10mg Lorazapan. After the tubes are removed, the patient goes to recovery, and after being able to pass urine, the catheter is removed, and the patient can go home. I'm not sure why your husband is doing two sessions, but the hardest part will be the waiting period between radiation sessions from evening to the next morning. In the past, the patient was given an anesthesia pump if there was any pain, not sure if they still do that. Post op meds were given for urine flow, pain, and inflammation-- I only took one of tablet of the pain med for the first urination that evening, which burned, probably because I had a cytoscopy done to check for intraductal invasion in addition to the catheter, all of which probably caused inflammation of the urethra. After that, no problem. It's a very good, well developed procedure with the best outcomes, so it's a good choice. UCLA has a writeup of the procedure, and explains in some more detail. uclahealth.org/radonc/prost...

[JWPMP in reply to timotur]

What a process...wow.! Jim's definitely going to need some good drugs. I would think UCLA and UCSF are quite similar with their procedure. Jim says he doesn't want to know anything about it, he said the Dr already told him more than he wanted to hear. But I wanted to know what he'll be dealing with and what the aftermath will be so I have some idea what to expect. It's about an 1 1/2 hour drive, so sounds like I'll have plenty of time to drive home and do chores and get back.Thank you for the link, I will read that this evening. Thank you again.

[Radar1 in reply to timotur]

Excuse my ignorance but I was under the impression that there was now a non-invasive Brachytherapy treatment. If so, what is the difference - pros and cons etc. ?

[doc1947g in reply to Radar1]

What are the disadvantages of brachytherapy?

Side effects of brachytherapy

Erection problems. Brachytherapy for prostate cancer can cause problems getting and keeping an erection. ...

Infertility. Having brachytherapy on its own can still cause infertility, but the risk may be lower than with external beam radiotherapy. ...

Bowel problems. ...

Effects on the bladder.

Prostate brachytherapy is a minimally invasive procedure

[Radar1 in reply to doc1947g]

"What are the disadvantages of brachytherapy?"

Thanks - but that isn't what I asked and doesn't address my question.

I was asking about the differences between the invasive and non-invasive Brachytherapy methods and their respective pros and cons.

[doc1947g in reply to Radar1]

Sure, there are 3 types of brachytherapy:

Low-dose rate implants,

high-dose rate implants, and

Permanent implants.

Low-dose rate implants, often called LDR for short, are implants that stay in for 1 day or less before they are taken out

high-dose rate implants, often called HDR for short, are implants that stay in for1 day or less before they are taken out

Permanent implants: Invasive with implement of 50 seeds more or lest depending of the your prostate's size, the bigger the more seeds you need..

[Radar1 in reply to doc1947g]

Thanks again but those are all invasive methods. I wasn't asking for the differences between the invasive methods.

[doc1947g in reply to Radar1]

ALL Brachytherapy treatments are INVASIVE.

[doc1947g in reply to doc1947g]

SBRT or VMAT-RT are non-invasive but are less cancer zone specific.They will irradiate the prostate with the VS and some pelvic lymph nodes.

[doc1947g in reply to doc1947g]

Personnaly with all my other chronic diseases, I could not hsve the anaesthesia neither the head down( Treldenbourg) needed for that surgery.My Urologist and RO decided to treat my Gleason(4+3=7)Grade 3 with VMAT-RT 3Gy X 20 fx for 60 Gy and Lutron Depot (ADT) 45mg/24weeks.

My nadir was <0.01 μg/L (2021/02/11), last PSA was 0.04 μg/L (2021/05/28)

[marka129 in reply to timotur]

Considering the same. Had difficulty getting info when called into. Maybe didn't get the best phone #. Would be flying in from out of state. Can you explain the "one and done" vs other HDR Brachytherapy treatment?

[timotur in reply to marka129]

Up to about five years ago, HDR-BT was often done in two sessions, 12 hours apart, thus needing an overnight stay. Most cases now are done in one session, in at 7am, out by 3pm, much more convenient and tolerable. Your RO will decide which one is needed based on the topology of the affected areas. I think the less spread, the more likely only one session would be needed.

Try to get a pre-consultation with one of Dr Chang's assistants...

uclahealth.org/providers/al...

You may try the UCLA Guest House for accommodations:

guesthouse.ucla.edu/

[timotur]

Ok, alles klar, yes the closer it got to the procedure the more I tried to talk myself out of it. I remember walking up to the medical facility that morning, my thoughts were “life would never be the same”. But alas, all that worry for nothing— so tell him to relax and trust the process— it’s well proven.

[JWPMP in reply to timotur]

omg! thanks for sharing that !!!He's already mentioned a couple times "what if I just pass up the whole thing".

He says it's not worth it to lose more of himself...good to know others feel the same way. I know there are no guarantees in life, but I truly appreciate your reassurances from actual experience. Thank you. When he is in the right frame of mind I will share this with him. It's impossible for me to really understand how it feels to be in his shoes, so I don't want to randomly be throwing out the ol' "you'll be fine, don't worry" that's gotta sound pretty hollow coming from someone who's not going through it.

[TylexGP]

I had my HDR Brachytherapy 5 weeks ago only 17 needles and 15 gy (amount of radiation). Really felt pretty good after the procedure and had dinner at home with my Kids and Grandkids. I was back to work in two days. I Felt like I was sitting on a spongy ball for a bout a week and was a little sore. Overall really not a bad experience. I would suggest a padded seat or a hemorhoid cushion it helps keep the pressure of the prostate and makes it more comfortable to sit. Overall I was really back to normal in about 10 days. I had only one HDR Brachy treatment because I was doing EBRT after the Brachy which I just started last week.

[JWPMP in reply to TylexGP]

Thank you! Pretty amazing that they can do something that invasive and you can bounce back so quickly. Jim isn't having EBRT due to a metal plate and screws in his pelvic bone. I'll discreetly pick up a cushion, thanks for the tip.. Thanks for taking the time to share your experience, it really is so helpful. Hope your EBRT goes smoothly.

[Aodh]

Never worry about why you’re posting, the people on this site are amazingly supportive.

Hugh

[JWPMP in reply to Aodh]

Very kind, thank you

[TylexGP]

I had HDR Brachytherapy. Felt like I was sitting on a spongy tennis ball for a couple of days. Not bad and found a hemorrhoid seat pad helped. After about a week I felt “normal “ but wasn’t riding a horse.