Newly diagnosed Teal stage prostate cancer, trying to prepare for possible HDR brachytherapy treatment.

[Isaiah43-1-2]

Hi, I'm new to this forum. I was diagnosed Teal stage prostate cancer last February. I have no symptoms. I did a lot of research & decided to choose radiation treatment, was referred to our local cancer center for IG-IMRT, but my treatment got delayed trying to authorize SpaceOar hydrogel procedure first, my insurance denied covering the hydrogel. Since then another Radiolgist oncologist phoned me and offered to treat me with HDR brachytherapy out of town, in June or July with 2 treatments 2 weeks apart. My biopsies in January diagnosed Gleason score 3+3, but my PSA was 10.6 thus teal stage cancer. The new RO sent me 3 hours away to get a special MRI and it confirmed 3 small areas of cancer inside my prostate, my cancer has not spread outside my prostate and is slow growing.

I'm glad for the option of HDR brachytherapy; it's at a medical center that's a 3 hour drive over a mountain pass from me and I will need to drive myself back home when recovered enough. I can stay at a Ronald McDonald home close to the hospital before and after treatment, and my wife can drive me to the Ronald McDonald home after treatment to stay the night or nights. My question is: has anyone had the HDR brachytherapy and how long do you think I need before I can safely drive back home after the treatment? My wife will be with me each treatment, but she has vertigo and is unable to drive on the highways without getting dizzy. We're just trying to be as prepared as we can, before deciding on this treatment. Thank you so much for any suggestions.

[Tall_Allen]

I don't know what you mean by "teal stage." SpaceOAR is only a minor aid and not worth forgoing treatment for. Bring a plastic urine bottle in the car - you'll probably have to pull over and pee a few times.

[Isaiah43-1-2 in reply to Tall_Allen]

Thank you TA so much for that advice, I got the teal stage from speaking to the Cancer Research Institute, I'm low stage, slow growing cancer and it's contained within my prostate, with a bit high PSA kicked me into needing treatment as opposed to observation.

[Farlo in reply to Tall_Allen]

Hi TA, it’s from the D’Amico staging system. Low-Basic-High Teal. From the Dr.Scholz book, The Key to Prostate Cancer. Three categories of Blue, Sky-Teal-Azure (bad to worse). Appreciate your posts.

[Tall_Allen in reply to Farlo]

Thanks. Rolling my eyes at doctors making up their own risk categories.

[Farlo in reply to Tall_Allen]

I understand, he’s out of Dana-Farber.

[timotur]

Get the SpaceOar-- it gives you about 10-15 mm separation between the prostate and rectum. I had HDR-Brachy/SpaceOar for Stage 3b+SV+LN, higher risk than yours, with Dr Chang at UCLA with no absolutely no radiation SE's three years after treatment. You may want to get a room after your procedure. Mine was over at 3pm and I went back to the hotel and crashed, slept three hours, then walked to dinner. I drove home two hours the next day with no problem. (see bio for details).

[Isaiah43-1-2 in reply to timotur]

Thank you for sharing! I will not be able to get the SpaceOar hydrogel, since my insurance declined coverage, it would cost quite a bit out of pocket Thanks for letting me know what your experience was after HDR brachytherapy, since I don't know anyone that has gone through this. Appreciate your help.

[timotur in reply to Isaiah43-1-2]

Sure. First 24 hours you may have a burning sensation when peeing as a result of the catheter irritating the urethra during the procedure. The burning went away after the first time for me. They give you some medicine for that, and for pain, which I didn't have to take. There may be a little oozing from the perineum-- I wore Depend diapers for a couple of days, and just noticed it a little bit. Overall recovery was very easy-- I was doing some light running/tennis in a few days.

[TylexGP in reply to Isaiah43-1-2]

I had HDR Brachytherapy without Spaceoar. RO felt it was not needed due to proximity of lesions and bowel/rectum. I did well with the HDR.

[CarverD]

Good morning! I had HDRBrachytherapy beginning of October 2020 and my QOL today is as good or better then it was pretreatment. You should be fine to drive the day after the procedure but i'd recommend bringing a foam "donut" to sit on in the car. I'd be happy to share my experiences with you.

[Isaiah43-1-2 in reply to CarverD]

Thank you so much! I'm new to all this, besides tons of research in the past few months, but what is QOL stand for ? Good suggestion on bringing a foam donut to sit on, I was thinking also bringing soft ice packs for the drive home... in case it starts to hurt. My wife and I will stay in a home that first night at least. Good to know 2 others were able to drive the next day, mine will be a 3 hour drive over a mountain pass. I would greatly appreciate you sharing your experience after the HDR Brachytherapy. I'm concerned about possible side effect of urinary issues on the drive home from swelling. Thank you again for any insight.

[Burk in reply to Isaiah43-1-2]

QOL - Quality of Life

[conbio]

I had Brachy recently. You should be good for the drive - but as suggested take the donut thing. Also, I would suggest taking Flomax right away to keep your urine flow going instead of waiting for trouble. Talk to your urologist. On an odd note - my Brachy surgeon had a guy he treated here in Seattle who rode in from Idaho on his motorcycle. After treatment he got back on his bike and rode home. THAT sounds extreme.

[Isaiah43-1-2]

Thank you all so much for sharing and for the suggestions, I truly appreciate it! I will speak to my urologist about the Flomax and good to know I will be able to drive back home not too long after the procedure, planning on staying the first night there and hope to drive back the next day. Thanks again

[Isaiah43-1-2]

I'm a Kaiser patient, so the closest RO offering HDR brachytherapy is at Kaiser Santa Clara, Ca. Dr. Xu graduated from UCSF, did her 4 year internship at UCSF then on to Kaiser for the last 2 years. She does 4-5 HDR procedures a week with a total so far of 280 of them. Has anyone heard of her or had brachytherapy done at Santa Clara Kaiser?

[Isaiah43-1-2]

Just an update: I just finished my first HDR Brachytherapy treatment on July 1st. I had a hard time urinating the first night (painful)... but by the next day the pain began to subside. I did have some changes in my bowel movements, difficult and a bit thin. Today is 2 days after treatment and had a more normal bowel movement. I am tired, which is to be expected with radiation. I was able to make the 3 hour drive home, but the donut pillow helped a lot (thank you). I took 2 tylenol and stopped a few times to urinate and eat a sandwich. I'm doing fairly well, just frequent urination and fatigue. I read the second treatment will have more side effects, trusting God to see me through.

I'm eating a rather bland diet to avoid colon irritation after the radiation. I was able to eat a turkey/avacado sandwich today without problem. Thank you again members for your prior advice.

[MackworthGuy]

Just checking to see how you are doing? I had HDR the day before you. One thing I notice is my doc gave me a protocol with ibuprofen to keep swelling down, paired with Pepcid for stomach protection, and Flowmax for easier urination. If you’re fine now, no need for those, but if you have issues those could help, might ask your doc about them. I’m feeling pretty normal aside from BM’s still not the usual.. Sounds like you’re doing the 2nd HDR whereas I’m doing EBRT instead. I wish you well and hoping the best for us both.