EBRT SE after Brachytherapy

[electronics-guy]

Well, I can say the last 3 weeks after brachytherapy have been, medically, the worst of my entire life. QOL was poor at best. Maybe I have lived a sheltered life all these years and didn’t know what it is like to really be ill or have medical issues. I do now. Brachytherapy dose was 85 Gy, 60 seeds.

I had severe urinary retention at night (almost to the point of going to the ER), still bad, but better now; I was getting up every 45 minutes at night, now I’m down to 5-6 times a night; I had severe urinary urgency and frequency, again better now, but still a problem; I had lots of blood and clots (none now) and some pain when relieving myself (periodic now). RO did urinalysis which, other than blood, was normal and he said I was experiencing normal SE. To his credit, everything is better (my QOL of life (to me) was a D- and now it’s a C-). Before all of this started it was an A. He did place Barrigel spacer, like SpaceOar, right after the seed implants, along with fiducial markers, along with placing me on lots of meds for SE.

My question: I go in for simulation appointment next week and EBRT (28x) follows in about 2-3 weeks later, probably when I feel decent again. There will be no LN treatment in that he really thinks its confined to the prostate. Since I already went through the swelling, inflammation, irritation, soreness, trauma, and hopefully considering the prostate cells are kinda dead or at least sick now due to the seeds, am I going to go through the same SE with the EBRT??? I’m praying the prostate is “damaged” enough from the first radiation (and surgical) assault that this second assault will be easier to tolerate. Or is this just wishful thinking?

I do realize that radiation is cumulative and that down the road I may have to pay the price of radiation toxicity for both seeds/EBRT, but right now I’m worried about the near future. I’m trying to prepare myself mentally (plus or minus) for what may come. Anyone have thoughts on this?

Thanks

[Tall_Allen]

Seeds give a lot of SEs in the first month. The EBRT will make it worse, unfortunately. If it helps, the SEs typically are transient.

[conbio]

I had 24 sessions of EBRT and then brachy, plus ADT for 18 months. I hear you. I had issues with urgency as well, getting up what seemed like every hour. My sleep sucked. I was on Flomax and what helped a bit was taking both doses at night instead of one in morning and one at night. Because I did mine in the other order - it felt to me like after the brachy the issue really escalated.

It took a good 3 months before things settled down. It would have helped if someone said "Look - this is going to suck for a few months, Flowmax will help a bit but not eliminate the issues, but yes, it will settle down and go back to normal."

Now it's all good. Get up at most twice at night, most times just once. All I can say from my experience is hang in there - it WILL get better.

[cancerfox]

I experienced more side effects after brachytherapy than I did from IMRT, but my treatments were done in the reverse order of yours, so maybe it was the cumulative effect of the two treatments I noticed, rather than the individual effects of each treatment. Like others have said, the LD Brachy effects lessen with time, but I still have lingering residual SE's two years out from the two types of radiation treatments. 🦊

[cscmetsfacil]

Hang in there, EG! None of this treatment is a walk in the park, but as a guy with advanced PCa I can tell you that we want to do what you can to have a successful primary treatment. You will recover and hopefully have no recurrence. That's the hope and the plan.

If you want to chat, I think we can do that through this platform.

Wishing you all the best.