has anyone here had salvage brachytherapy? High dose radiation Brachytherapy is being recommended for me at MSK pending results of a very recent MRI to determine if I can have it.
Sounds promising….administered with carefully placed needles over two sessions two weeks apart.
Current PSA is 0.02 on eligard,abi and pred….last psma showed only one area of active cancer(psa 18 at that time prior to ADT). Thanks for any personal experiences…..could be low dose seed implantation or sbrt as well as those are on the table as well if I’m not anatomically a candidate for the high dose procedure…… original treatment was EBRT alone in 2012.
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Tommyj2
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it’s been about 8 years. My initial IGIMRT had biochemical recurrence after six years. Went with salvage HD BT. Completely ‘burned’ away my prostate gland and I’ve struggled with stress incontinence. Wasn’t allowed to hold my grand daughters for a month or so after seeds were inserted. Made our ‘together’ time in the swimming pool a bit awkward.
2nd biochemical recurrence 3 years after BT. Unfortunately residual disease hiding in seminal vesicles (by PSMA PET) but with Lupron then a nearly 3 year ‘vacation’ with only bicalutamide PSA <0.1 until recently.
Not sure about the future but it’s been 16 relatively active years since original diagnosis.
Read my bio, it's all there. No problems with HDR brachy. I had 17 rods inserted into the prostate, not much fun as you have to lie on your side and the nurses will turn you over every 2 hrs.
I wish, it is a full blown inpatient surgical procedure lasting all day, at least for me it was. Side effects for next two weeks but at a minimal disruption to daily activities, especially considering it offered my best chance for a cure.
I’ve had others say that it only takes a few minutes…..something wrong in translation here….so I’m dropping it……I think the confusion is people mistaking seed implantation with rod insertion.
If it is High Dose Radiation you don't have 45 minute sessions! My brachy consisted of having the 17 rods connected to the radiation machine (looked like a bollard). Once all 17 electrodes were connected, the procedure only took a few seconds. I had 3 sessions, one in the morning, one in the afternoon and one the next day, all in hospital. My biggest problem was trying to pee afterwards. Spent 4 days in hospital. I suggest that you are not getting the rods inserted but having seeds inserted (for location) and then getting brachy, but with a lower dose of radiation.
Bollard a thick, low post, usually of iron or steel, mounted on a wharf or the like, to which mooring lines from vessels are attached. b. a small post to which lines are attached.
No….the MD was quite specific that the procedure involved metal rods attached to an X-ray emitting device……I was sure to clarify with him that I would not be getting seed implantation…….apparently there are different protocols with this procedure.
So you had EBRT radiation with no ADT in 2012, now have recurrence, and salvage brachytherapy radiation is recommended.
Like you, I had EBRT with no ADT in 2021, and did not start ADT + Abi until 3 years later (after recurrence plus mets).
I am told I cannot have any salvage radiation. I think you being offered salvage brachytherapy because the prostate has had 12 years to recover and you apparently have no mets.
Apparently brachytherapy for salvage is done quite frequently at MSK……I’d be surprised if you can’t have it ultimately after enough time has passed……and pending results of your ADT.
Yes, I have heard at least 5 years must pass. And if my PSA remains at present 0.03, there will be no justification to have a PSMA-PET scan to determine if the tumor is still in the gland.
I had HDR BT at MSKC in 2023 for recurrence in both Seminal Vessels. I originally had LDR in 2012 but Vessels were missed. My procedure went smoothly and my PSA has remained at .005. I have full confidence in MSKCC.
I had Salvage HDR Brachy last August. Original treatment was 2015 with one dose of HDR Brachy.
PSA slowly dropped from 7 at time of 2015 treatment to 0.545 then began to rise again last year.
My PSMA showed no spread so options were remove it or my Brachy. After consulting with surgeons at MD Anderson and my prior RO now at UCLA, I decided in the Brachy.
This time around it dropped from 7.0 to 0.4 in 3 months. Then to 0.2 six months after. Has remained there the last 3 months.
My decision was balancing quality of life vs treatment outcome. Surgeon couldn’t guarantee that it may not have already spread.
That combined with permanent incontinence, possible bowel damage, permanent ED, made me opt for HDR.
I’ve been very happy with limited side effects and apparent ability to address situation.
Obviously the 10 to 20 year outcomes are an unknown but at this point no regrets
Good luck and feel free to reach out with questions
For focal treatment, I think it can be good. I only had HDR Brachytherapy for initial treatment, not as salvage, at UCLA. I had two sessions, with 12 tubes in which wires with a radioactive isotope on the end were lowered sequentially into the prostate and were timed by seconds (each less than a minute) for determining the amount of radiation to a specific site. They control the spatial area treated by the amount of time the isotope is in place. My actual procedure was less than an hour, under general anesthesia. The area of treatment was a 2 cm lesion. So far successful.
They had to insert platinum markers, and then 12 tubes about the size of a small diameter straw through the perineum into the prostate and suture them in place. Movement had to be restricted also.
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