HDR Brachytherapy after initial RT

[Simonapo]

Anyone has a success story to share on using HDR Brachytherapy 2-3 years after initial Radiation of the prostate gland in case of recurrence of cancer? Thank you for sharing your story.

[timotur]

It's a good option for your Dad (read his profile). I had it five years ago for Stg3N1M0 +SV at UCLA (Chang) and had a successful outcome with virtually no SE's other than from 18 months of ADT. (See my profile). GL!

[Simonapo in reply to timotur]

Thank you so much, that’s good to hear. We are going at UCLA as well. Thank you again and best of luck

[timotur in reply to Simonapo]

Thanks, good to hear about UCLA, talk to Dr Chang if you can, he did an excellent BT-HDR for my advanced PCa. PM me if you have any questions. Best wishes.

[billy1950 in reply to timotur]

timour, from your bio i don’t see that you first had some form of radiation and then had HD brachytherapy afterwards. It looks like you had brachytherapy only…

Am i reading this correctly? Thanks, billy

[timotur in reply to billy1950]

Hi Billy, I first had HDR-BT, then IMRT pelvic radiation a few weeks later to cover the lymph nodes.

[billy1950 in reply to timotur]

Ok…i thought that Simonapo was asking about HD brachytherapy after first having some other kind of radiation.

The reason for responding is that i first had EBRT (external radiation) 20 years ago. Docs were suggesting that (with having a BCR- biochemical recurrence) that i should now have HD brachytherapy…I chose not to have HD brachytherapy… Personally, i find it difficult to now have the HD with having radiation first….too much radiation….

[timotur in reply to billy1950]

Billy, ok, thanks for pointing that out. I’ve seen it done both ways, HDR-BT first, or IMRT first.

[spencoid2]

I am not sure if the responses were specifically about follow up Brachytherapy. Personally I have never heard of this use. I would guess that in most cases of failure of initial radiation therapy that after 2 to 3 years the cancer is not likely to be still contained in the prostate. Of course it depends on the aggressiveness of the cancer but why was it not killed by the initial radiation? Maybe you are lucky and have low Gleason cancer and it might not have spread. I would discuss this with your oncologists to determine if they think your cancer is contained. Brachy does nothing to metastatic cancer.

I had IMRT and Brachy for Gleason 9 and got maybe 7 years before recurrence

[Simonapo in reply to spencoid2]

Thank you for your response, PSMA Pet scan shows recurrence in the prostate gland and one rib. The oncologist recommended SBRT to rib and prostate or SBRT to rib and HDR BT to prostate. We were thinking to go with the second option. Gleason was 9 at the time of diagnosis.

[spencoid2 in reply to Simonapo]

If the cancer is in your rib and you have Gleason 9 it is almost certainly elsewhere as micro mets. I hate to be negative but it is just a matter of time before you have lesions elsewhere. I do not understand what focused radiation will do in the long run. I would get another opinion and also check out any trials that might be appropriate. I have Gleason 9 and had brachy and IMRT 10 years ago. It was hoped that the cancer had not spread but it obviously had. My radiation oncologist at the time was Dr. Grimm who was a major researcher. His specialty was statistical metastudies. He told me that there was a significant chance that the disease was already metastatic. I sort of did not think about that until my PSA shot up. At that time there were no trials that would have been appropriate but now there likely are. I have heard of the early use of radiopharmaceuticals similar to Pluvicto. Has no one proposed ADT?

I would get DNA tests both from biopsy and somatic. Maybe you are lucky enough that some current treatment or trial will be a good match for you.

Where are you and your doctors? I don't think you are getting good advise. Gleason 9 is not something to play with.

[Simonapo in reply to spencoid2]

We had somatic testing/tumor sequencing and didn’t show any available treatments or trials. We are seeing Dr Dorff at City of Hope and Dr Kishan at UCLA, California. Thank you.

[spencoid2 in reply to Simonapo]

I got a second opinion from Dr. Dorff (video visit) and was favorably impressed. So it sounds like you are in good hands.

[Simonapo in reply to spencoid2]

Thank you so much for all the info and help, I really appreciate it🙏

[maley2711]

If a PSMA PET is negative for spread beyond the prostate, and show local recurrence, yes!!!

[Simonapo in reply to maley2711]

Thank you

[John54321]

I had ADT, HDR Brachy then External Beam about two years ago. PSA is still 0 and testerone is in the normal range. I don't feel as though I have any lingering issues.

[Simonapo in reply to John54321]

Thank you so much, great response.

[j-o-h-n]

Simonapo, I just had to tell you that your avatar bears an uncanny resemblance to my blow up doll named Dolly- of course my Dolly is prettier (Sisters/Twins?)

Good Luck, Good Health and Good Humor.

j-o-h-n

[Simonapo in reply to j-o-h-n]

Thank you John for your humor, we all need it ❤️

[j-o-h-n]

Thanks, You can say that again. You can say that again.

Good Luck, Good Health and Good Humor.

j-o-h-n

[MoonRocket in reply to j-o-h-n]

What was that, again?

[j-o-h-n in reply to MoonRocket]

It was a thank you for my humor and I consider that a gain and not a loss.

Good Luck, Good Health and Good Humor.

j-o-h-n