Considering HDR Brachy, any recommend... - Prostate Cancer N...

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Considering HDR Brachy, any recommendations for doctors in the San Francisco Bay Area?


Met with one Dr. who recommended one day HDR Brachy and 5 weeks IMRT. Hearing CarverD's positive experience and noting slightly higher cure rates than EBRT, I want to take a closer look at this option. Any recommendations for doctors who specialize in this located in the San Francisco Bay Area?

8 Replies

Jim Hsu at UCSF. There are no better oncological outcomes with a GS 7 vs brachy or SBRT without a boost, and fewer side effects.

Thank you Tall_Allen, I currently have an appointment with Felix Feng at UCSF, but think I will change it to Joe Hsu. I spoke with Dr. John Lee, who specializes in brachy, last week and he recommended brachy + 5 weeks of IMRT so will be good to see what Dr. Hsu thinks.

Smallfall in reply to JDL_Coffee

I agree with Tall_Allen, Dr. Hsu did my HDR Brachy last summer; I can't say enough good about him and his team. I, also, had 5 weks of IMRT after, but not through UCSF.

JDL: you may consider Dr Chang at UCLA. He did an excellent HDR+SpaceOar treatment for my stage-3b PCa. He was at USF prior.

JDL_Coffee in reply to timotur

Thanks timotur, congrats on your HDR! He may be a little to far but if it is only one or two treatments it may be workable. In our case, was the 5 weeks of IMRT and ADT planned ahead of time? The doctor I saw is recommending 5 weeks of IMRT also, but we are trying to avoid the ADT. Also, how was the procedure itself? It sounds painful!

timotur in reply to JDL_Coffee

JDL: I started ADT (Lupron/Zytiga) two months before HDR, and continued it for a total of 18 months. I had to do ADT because I was high-risk with seminal vesicle and LN involvement. You may be able to do "mono-HDR" therapy without ADT if you don't have SV or LN involvement, especially with PSA < 10 and GS (3+4). The HDR procedure went very smoothly-- in at 7am, out by 3pm, one session, stayed at a local hotel, and drove back to San Diego the next day. The procedure is not painful at all-- afterwards, had a little urination burning the first evening, and a little soreness in the perineum, but no other SE's, and still have none 20 months later. After HDR, I did 25 sessions of IMRT here in SD with a local RO. (see profile) The thing I liked about Dr Chang is that he's done hundreds of these, and all of the feedback I've heard about him is positive. It may be worth a consult.

Smallfall in reply to JDL_Coffee

JDL, my urologist recommended 18-24 months of Lupron; Dr. Hsu thought that 5-6 months would be enough, it was doable. My procedure schedule was similar to Timotur, except no SpaceOar. I had NO pain at all, I passed blood clots in my urine for a day or 2, then nothing.

JDL_Coffee in reply to Smallfall

Thank you Smallfall & timotur, good to hear both your procedures went so well and that pain was minimal. Had a friend go thru HDR, a few years back who had a very painful experience (3 days) so hearing your experiences makes me feel better! Best to you both!

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