Where are my brachytherapy bros?

[KMY28]

Scheduled for HDR brachytherapy in three weeks, followed by 5 sessions of EBRT over 10 days. What was your experience? Dos, don'ts, tears, fears, words of wisdom?

[dude69]

September 2023 had my HR Brachytherapy. Was under for 4 hours. Before that had 25 days of EBRT. Woke up with a catheter on while staying at hospital an additional night. Woke up the next morning and catheter removed after the urine flow was determined to be fine. Walked home from the hospital that day. No real side effects for me but we all take it differently. PSA since not detectable while I continue on pamorelin (castration) shots this month than final in May next year. One day at a time and be greatful for every moment.

[Teacherdude72]

In the spring of 2016 I had 2 sessions so EBRT and three wks later two sessions of HDR Brachy.For the HDR I stayed awake. Went home shortly after recovering full mobility in my legs. Had a catheter for both sessions and both later in the evening got plugged and stopped working. Bladder began to fill and called the ph# was given for issues That Dr said "you can remove the catheter". Did as directed and after immediate voiding no issues.

[ulfhbg]

Hi !

Sorry for stupid questions but, 5 sessions over 10 days; is it SBRT you’re doing and are they zapping bone mets and lymph nodes?

Best wishes - Ulf

[KMY28 in reply to ulfhbg]

Yes, zapping two very small bone mets and two lymph nodes after the brachy therapy. Apparently both are very high dose, so that's why only 5 rather than, say, several weeks worth.

[ulfhbg in reply to KMY28]

Hi !

Ok, sounds like SBRT. Do you know why they choose not to do WPRT (Whole Pelvic Radiation Therapy) to all pelvic lymph nodes and do higher radiation doses to affected lymph nodes instead?

I understand the bone mets. But if you can see 2 regional lymph nodes, there might be micro mets that you don’t see and then why not ’play safe’ and radiate the pelvic lymph nodes?

Well, anyway I was just curious about your treatment pathway and you have experts doing the best treatment for you so, best of luck 😀

Best wishes - Ulf

[KMY28 in reply to ulfhbg]

I really appreciate your question as it will help me ask all the right questions as well! I actually have a call scheduled today so will ask. From what I understand, my PSMA scan was so specific in pinpointing the areas of concern, that SBRT in those lymph node areas should so the job. But again, I will inquire because, like you I assume, I want to be as aggressive as possible with treatment. I'll let you know what I find out.

[ulfhbg in reply to KMY28]

Hi !!

Yes, I mean you’re high risk with mets so, why not ’be the most aggressive’ when they are treating you.

But again, they are the experts and know whats best for you.

Best wishes - Ulf

[ulfhbg]

Hi!

I could think of:

20 fractions of Hypofractionated VMAT RapidArc IMRT and with WPRT

Do 20 x 3 GY to affected lymph nodes otherwise 20 x 2.2 GY to the whole pelvic

HDR Brachytherapy

SBRT sessions to SBRT to the bone mets.

And of course the system therapy that they’ve put.

I mean, you’re high risk, with GG 9, aT3BN1 and two identified bone mets so perhaps it could be good to have a dialouge with your MO at options.

Best wishes - Ulf