Re: High-dose brachytherapy?

[Guest guest]

Van,

I’d say anyone who says that most BT

(Brachytherapy) is high dose now might be a radiologist who does High Dose

Radiation Bracytherapy himself. I can’t lay my hands on the data right

now but as I recall, not only is BT (Brachytherapy) a ‘minor’

treatment choice, but HDR is an even smaller sub-set. Certainly the men who

tell their stories on my website seem to indicate that. The last time I checked

(when there were about 750 entries – there are more than 850 now) only 37

(5%) were from BT men and of those about 3 or 4 were from men who considered High

Dose Radiation Bracytherapy

If you go to http://www.yananow.net/Links.html and

enter HDR Brachytherapy in the Site Search Engine you will be able to access

the relevant stories.

All the best

Prostate men need enlightening, not frightening

Terry Herbert - diagnosed in 1996 and

still going strong

Read A Strange Place for unbiased information at http://www.yananow.net/StrangePlace/index.html

From: ProstateCancerSupport

[mailto:ProstateCancerSupport ] On Behalf Of VH

Sent: Saturday, 10 April 2010 8:36

AM

To:

prostatecancersupport

Subject:

High-dose brachytherapy?

Hi guys,

Have any

of you had the high-dose brachytherapy? How did you elect that

treatment, and how has it been for you? I've had 2 docs recommend

the regular brachytherapy, but I just spoke with a doc's asst. who said

most seeds are high-dose now...

Thank

you in advance,

Van

[Guest guest]

Van,

I’d say anyone who says that most BT

(Brachytherapy) is high dose now might be a radiologist who does High Dose

Radiation Bracytherapy himself. I can’t lay my hands on the data right

now but as I recall, not only is BT (Brachytherapy) a ‘minor’

treatment choice, but HDR is an even smaller sub-set. Certainly the men who

tell their stories on my website seem to indicate that. The last time I checked

(when there were about 750 entries – there are more than 850 now) only 37

(5%) were from BT men and of those about 3 or 4 were from men who considered High

Dose Radiation Bracytherapy

If you go to http://www.yananow.net/Links.html and

enter HDR Brachytherapy in the Site Search Engine you will be able to access

the relevant stories.

All the best

Prostate men need enlightening, not frightening

Terry Herbert - diagnosed in 1996 and

still going strong

Read A Strange Place for unbiased information at http://www.yananow.net/StrangePlace/index.html

From: ProstateCancerSupport

[mailto:ProstateCancerSupport ] On Behalf Of VH

Sent: Saturday, 10 April 2010 8:36

AM

To:

prostatecancersupport

Subject:

High-dose brachytherapy?

Hi guys,

Have any

of you had the high-dose brachytherapy? How did you elect that

treatment, and how has it been for you? I've had 2 docs recommend

the regular brachytherapy, but I just spoke with a doc's asst. who said

most seeds are high-dose now...

Thank

you in advance,

Van

[Guest guest]

> Have any of you had the high-dose brachytherapy? How did you elect that

> treatment, and how has it been for you? I've had 2 docs recommend the

> regular brachytherapy, but I just spoke with a doc's asst. who said most

> seeds are high-dose now...

It sounds to me as if the asst did not comprehend what was being

asked.

There are two forms of brachytherapy:

(1) Insertion of so-called (seeds) into the gland. These apply

radiation directly to the gland and such PCa cells as there are.

They eventually decline in radioctivity.

(2) Insertion through the perineum of highly-radioactive rods or

needles for a limited time over the course of a few days.

Details are found on the encyclopedic site of the Prostate Cancer

Research Institute. Specifically, here:

http://www.prostate-cancer.org/pcricms/node/359

Just about any PCa topic can be found on the PCRI site.

Regards,

Steve J

> Thank you in advance,

> Van

>

>

>

>

[Guest guest]

> Have any of you had the high-dose brachytherapy? How did you elect that

> treatment, and how has it been for you? I've had 2 docs recommend the

> regular brachytherapy, but I just spoke with a doc's asst. who said most

> seeds are high-dose now...

It sounds to me as if the asst did not comprehend what was being

asked.

There are two forms of brachytherapy:

(1) Insertion of so-called (seeds) into the gland. These apply

radiation directly to the gland and such PCa cells as there are.

They eventually decline in radioctivity.

(2) Insertion through the perineum of highly-radioactive rods or

needles for a limited time over the course of a few days.

Details are found on the encyclopedic site of the Prostate Cancer

Research Institute. Specifically, here:

http://www.prostate-cancer.org/pcricms/node/359

Just about any PCa topic can be found on the PCRI site.

Regards,

Steve J

> Thank you in advance,

> Van

>

>

>

>

[Guest guest]

I did HDR Brachytherapy about three years ago. As I

understand it there are only a few institutions throughout the country that

have the necessary equipment and not everyone is a candidate for the treatment.

The shape and size of your prostate plays a part in the determination The advantage

over seeds is that you don’t have migration issues (the seeds moving).

My procedure was done four times over a two day period. Three years out

my PSA has steadily declined and I have no side effects.

From:

ProstateCancerSupport

[mailto:ProstateCancerSupport ] On Behalf Of Terry

Herbert

Sent: 04/09/2010 7:15 PM

To: ProstateCancerSupport

Subject: RE: High-dose brachytherapy?

Van,

I’d

say anyone who says that most BT (Brachytherapy) is high dose now might be a

radiologist who does High Dose Radiation Bracytherapy himself. I can’t

lay my hands on the data right now but as I recall, not only is BT

(Brachytherapy) a ‘minor’ treatment choice, but HDR is an even

smaller sub-set. Certainly the men who tell their stories on my website seem to

indicate that. The last time I checked (when there were about 750 entries

– there are more than 850 now) only 37 (5%) were from BT men and of those

about 3 or 4 were from men who considered High Dose Radiation Bracytherapy

If

you go to http://www.yananow.net/Links.html

and enter HDR Brachytherapy in the Site Search Engine you will be able to

access the relevant stories.

All the

best

Prostate

men need enlightening, not frightening

Terry

Herbert - diagnosed in 1996 and still going strong

Read A

Strange Place for unbiased information at http://www.yananow.net/StrangePlace/index.html

From: ProstateCancerSupport

[mailto:ProstateCancerSupport ] On Behalf Of VH

Sent: Saturday, 10 April 2010 8:36 AM

To: prostatecancersupport

Subject: High-dose brachytherapy?

Hi

guys,

Have

any of you had the high-dose brachytherapy? How did you elect that

treatment, and how has it been for you? I've had 2 docs recommend the

regular brachytherapy, but I just spoke with a doc's asst. who said most

seeds are high-dose now...

Thank

you in advance,

Van

[Guest guest]

VH wrote:

> Have any of you had the high-dose brachytherapy? How did you

> elect that treatment, and how has it been for you?

I had a combination of HDR plus 3DCRT external beam therapy plus

neoadjuvant (i.e., before radiation) androgen deprivation

therapy, in my case, that was a short course of Casodex plus 4

months of Lupron.

The treatment was done at the National Cancer Institute (NCI) in

Rockville, land, as part of a clinical trial of MRI guided

HDR brachytherapy. I chose the treatment largely because I was

working at NCI as a computer programmer, I believed in their

clinical trials program, and I was impressed by their doctors.

After working on their computer data (see http://www.cancer.gov),

I felt that ought to use my cancer to contribute to their

mission. If NCI had offered me a different treatment and told me

that thought it would work for me, I probably would have taken

it.

As I understand it, it is not possible to give a sufficient dose

of radiation via HDR brachytherapy in a single session without

harming the patient. So the treatment is delivered in two or

more separate sessions. In my case, I had one session, followed

by five weeks of external beam, followed by one more HDR session.

Six years later, my last PSA reading was 0.08, so I consider the

treatment to have been successful.

My side effects of treatment were:

1. Difficulty urinating.

Radiation can cause the prostate to swell, clamping down on

the urethra and making it hard for the patient to squeeze

urine through. The result is that you may not be able to

urinate at all - a serious situation requiring an immediate

visit to the emergency room and insertion of a catheter, or

just very frequent urination, each time only getting a small

amount out.

I had no problems with the first HDR procedure, but did have

the latter effect after the second HDR. I was up as many as

seven times each night to urinate. I had to take Flomax. The

problem was acute for about two months but I was back to

normal after about five months.

2. Aggravation of existing hemmorhoids and rectal scarring.

This may have been due more to the EBRT than the HDR. I'm

told it's very common. I was okay within a couple of weeks

after the end of treatment, but for a while I had a lot of

itch and a little pain. Preparation H helped.

3. Peyronies disease.

I've had some bending of the penis. I don't know what caused

this. It could have been the HDR, the EBRT, or the Lupron.

Or maybe it had nothing to do with any of them. I noticed it

about six months after the end of treatment. It has not been

severe.

4. Some impotence.

Again I don't know the cause. I was a whole lot less potent

before treatment than I was as a young man. After treatment,

my potency has gradually declined further. Was it the HDR?

The EBRT? The Lupron? Advancing age? I have no way of

knowing. However it is not uncommon for any radiation

treatment to damage blood vessels that supply the penis. The

damage can apparently have increasing effects over time -

usually taking a couple of years to reach an end point.

Would I do it all again? Yes, I think I would. I got the

outcome I wanted vis a vis the cancer. The side effects I

suffered were not as good as those of the people who did best

with either radiation or surgery, but not nearly as bad as those

of the people who did worst. All in all, I probably came out

in the top half on side effects, maybe even in the top quarter.

Would I recommend HDR to others?

Well, I hesitate to recommend any specific treatments, and I

hesitate to recommend no treatment. There are a number of

surgical and radiation treatments that work pretty well. I

believe that HDR is one of the good ones among a number of good

ones. Your success with it will depend to a great extent on the

particular characteristics of your particular cancer, the skill

of the radiation oncologist and surgeon (often a surgeon implants

the seeds under the rad onc's guidance), and plain old luck.

All in all, I think I would still prefer radiation to surgery,

and I think that brachytherapy, both HDR and LDR, are pretty

good.

> ... I've had 2 docs recommend the regular brachytherapy, but I

> just spoke with a doc's asst. who said most seeds are high-dose

> now...

I don't believe it. HDR has some advantages and some

disadvantages. Control of placement is potentially better. High

dose effects are claimed by some to be more effective. But the

equipment and preparation needed for HDR is much more expensive

(in my case, the actual placement of the seeds was done by a

robot because the seeds were too " hot " for other people to be in

the room with them.) I doubt if most radiation oncology clinics

are equipped for it.

An advantage of low-dose rate brachytherapy is that you only have

one procedure, not two or three. You're in the hospital, you get

it done, and that's the end of it.

Best of luck whatever you do.

Alan

[Guest guest]

I came across this article on HDR Brachytherapy some time ago. It is old, but

you might find it helpful:

http://www.cetmc.com/images/stat/ASTRO%20monoposter_Final.jpg

>

> Hi guys,

>

> Have any of you had the high-dose brachytherapy?  How did you elect that

treatment, and how has it been for you?  .....

>

> Van

>