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?

JDL_Coffee profile image
13 Replies

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?

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JDL_Coffee
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Tall_Allen profile image
Tall_Allen

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.

JDL_Coffee profile image
JDL_Coffee in reply to Tall_Allen

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 profile image
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.

rpvsf profile image
rpvsf in reply to Smallfall

Hi Smallfall, just curious as to what is the gap (number of days) between your HDR procedure and the start of your 5-week IMRT? Thank you in advance!

Smallfall profile image
Smallfall in reply to rpvsf

rpsvf, I was scheduled to start IMRT within a couple weeks after the HDR Brachy, but I fired my first RO and it ended up being a month or more between radiation.

rpvsf profile image
rpvsf in reply to Smallfall

Thank you so much, Smallfall! -Rpvsf

Smallfall profile image
Smallfall in reply to rpvsf

I hope it helps...

rpvsf profile image
rpvsf in reply to Smallfall

It sure did! Thank you so much again!

timotur profile image
timotur

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 profile image
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 profile image
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 profile image
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 profile image
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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