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HDR Brachytherapy

I'm going in for my 2nd HDR Brachytherapy treatment tomorrow at UCLA. If anyone wants to share their experience about their HDR Brachytherapy treatments with me or ask me any questions about my experience, feel free. I did a lot of research on the various options and talked fairly extensively with medical professionals before I chose this treatment. However, I haven't communicated directly with anyone else that has actually experienced HDR Brachytherapy for prostate cancer. Probably something I should have done ahead of time.

12 Replies

Hi Cruiser,

Had HDR 11 Jan 2018. Other than the prep, things went fairly well. My body doesn't like having holes punched in it so there was some soreness and expected blood in urine.

A little touchy the next day, but workable.

Had more issues from the Lupron and 25 external treatments than from the HDR.

Right now, just waiting for the ADT sentence to be finished (Dec 2018) then see what comes back next year for 'T'. I had 5 '9's' and 1 '8' Gleason. Was not interested in surgery. I know I made the right choice for me. Now time will tell for the cancer.

Good luck and God Bless,



Thanks for your reply. More needles for me tomorrow. Then hopefully the worst is behind me. You've got some major stuff ahead of you but I can tell you've also got the right attitude.

Best of luck to you



I had treatment with Lupron, then 2 sessions of HDR brachytherapy separated by 25 sessions of external beam radiotherapy for a Gleason 4+3 cancer that had penetrated the prostate capsule wall. The treatment was at age 57 in 2003 and early 2004. I have not had any treatment at all since then and my current PSA is 0.07, so it appears that the treatment was a big success.

I did have a lot of "PSA bounce". The PSA went up (as high as 1.8 in one test) and down in alternating cycles and it took five years to settle down below 0.2. I was told that it was because the radiation does not kill the tumor cells all at once and, while they are surviving in a damaged condition, they can put out more PSA than usual.

My principal short term side effect of the HDR (there were others from the Lupron and the EBRT) was difficulty urinating. I was able to survive without a catheter, but I needed tamulosin (Flomax) to be able to urinate at all. Because I couldn't squeeze out much urine at one time, I had to urinate frequently, about once per hour - which was a sleep disruptor. That was very bad for two months and then gradually got better until, after five months, I was able to get off the Flomax.

My principal long term side effect was impotence. It took about five years to reach the point where my erections, such as they were, were no longer usable. I didn't like that but I didn't like cancer even more and my wife and I have adapted and have, if not a typical sex life, at least a still very enjoyable and satisfying one.

Good luck with your treatment.



HiYa CaCruiser - I am on the East Coast (Massachusetts) and am intrigued that you are one of a series of West Coast folks that I have seen treated with HDR brachytherapy, yet as far as I can tell, this is not a procedure utilized here. Neither Johns Hopkins nor Dana Farber include this as one of their recommended therapies. Here brachytherapy involves implanting radioactive iodine seeds in the prostate, basically in the same manner as prostate biopsies. Pretty much an outpatient procedure with minimal side effects (other than dealing with the radiation). I had this procedure, and was pretty much ready to go back to running the next day.

If UCLA Med is using this therapy, then I am sure it must be good, but it is interesting that the two coasts seem to have diverged on brachytherapy.

Did your oncologist ever discuss seed implants?


As far as I know UCLA only does HDR brachytherapy and surgery. My urologist is at UCLA and after the biopsy he recommended that I consult with a surgeon and the radiation oncologist who does HDR brachytherapy then make my decision. I had my last brachytherapy treatment on May 31. I think its all going well but I wish I had found this site before making my decision on treatment. I pretty much got the UCLA perspective and nothing else. I didn't know there were so many other options. Now that I've read about other treatments I think I may have gone with Proton Therapy. However, no buyers remorse yet. Its interesting that HDR brachytherapy isn't as widely used on the east coast. I know that in addition to UCLA HDR Brachytherapy is done at Cedar Siani, USC, UCSC, Stanford, and University of Washington. There may be others. I knew that LDR Brachytherapy (seeds) existed before I made my decision but read that occasionally a seed will go rogue which isn't good.


Interesting - but the occasional seed being passed doesn't seem to be regarded as an issue. Half life is 3 months, and the dosage of each individual seed is low


That makes sense. Funny how all of these fallacies about the side effects of treatments are spread around. If you know anybody thats thinking about doing HDR Brachy and wants information from someone who has recently experienced it send them my way.



Will do. This is a good place to follow so you can act as a resource for others. A good team of Drs is essential but it seems sites like this are helpful in providing another source of info that you would not necessarily have in your local culture.

Got to be careful though to take some of the advice with a grain of salt, but by and large I have been impressed with the quality of advice from the folks on this site (I am a PhD level biologist, so in many cases I actually understand the quality of what folks are talking about).



Jim, I am about to do HDR Brachytherapy for prostate cancer in Detroit, MI. I would love to know what to expect and any information you can give me, would be greatly appreciated. I am finishing up 25 Proton Therapy Radiation Treatment today, in Knoxville, TN. My gleason score was 9. PSA 26. Would love to talk to someone, first hand that has done HDR. Thank You, in advance, for any information you can share with me.



I had HDR Bachytherapy in 2012 at St. Lukes Hospital in the Philippines. It was basically not really bad as treatment goes. I had very low Gleason of 4 and stage 1. Treatment was scessful as my current PSA is .53 lowest it has ever been. I refused Lupron as it has a 40% chance of causing colon cancer. My father had prostrate cancer. He was treated with Lupron and controlled the prostrate cancer but died of terminal colon cancer.


My radiation oncologist never mentioned Lupron. My Gleason was 4+3=7, psa 5.2, and I'm Stage 1. What are the benefits of Lupron?


No benefit from Lupron except a 40% chance it will give you colon cancer if you tak eit.


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