Re: Post Brachytherapy problems

[Guest guest]

Hi Sy -

I had Bracy done on January 7th, 91 Palladium seeds and had similar experience 10 days after the procedure. Extreme pain when urinating (if I was able to urinate at all), discomfort sitting, loss of appetite, energy and nagging heartburn. Hounded both urologist and oncologist for several days - I was given another prescription for Medrol which seemed to help. Fortunately I did not suffer urine retention to the degree you described and did not need to be catheterized.

What helped, hot baths, double the dose of Flomax (take twice a day instead of once), Tylenol for pain, Medrol, and lots of family love and support. (see details in my write-up). The best thing on our side is time. I endured about 2 weeks of discomfort 6 weeks after I am about 80% back with only some discomfort when urinating - weak stream also. Make sure you stay after your doctors until you feel better.

Hang in there buddy -

Dave

To: ProstateCancerSupport Sent: Sun, February 21, 2010 6:58:01 AMSubject: Post Brachytherapy problems

Had low dose Brachytherapy procedure (70 Palladium 103 seed implants) on January 12th..Procedure itself was quite easy and painless but I started developing increasingly difficult symptoms about 2 weeks ago> urgency, burning, difficulty urinating, feeling rectal and urinary pressure and spasms.My Urologist wanted me to see him in his office right from the outset to measure the amount of fluid I was apparently retaining. Was hesitant to drive to his office because of feelings of urgency especially when seated and I also figured that this was just part of the "process" and would diminish.Over the last 2 weeks I continued with Flomax (2-4 a day), low dose prednisone tabs etc..I am appalled at my ability to endure what were 2 weeks of absolute hell.Finally, called my Doc last Thursday and told him that I really thought something had gone very wrong as I was only getting worse. Couldn't eat had no energy and was

developing increasing pain and soreness in my left kidney area.Went to his office on Friday and he did Ultrasound showing that I was retaining a huge amount of fluid and recommended that he catheterize me so I didn't end up in an E/R over the weekend. Though I wasn't happy to hear about the catheter he is very skillfull and considerate and getting the cath. installed was really not that bad at all. Within about an hour I emptied 2 1/2 bags of urine and felt 1000% better.He ordered blood tests and will get results on Monday. The pain in my kidney area has subsided by about 95% too. Anyway I asked him if he thought that I had sustained radioactive seed implant burns and he thought there was a definite possibility that I had and that some people simply have rare idiosyncratic responses to radiation treatments.Coincidentally earlier in the week I had received a report from Radiation Oncologistsaying that based on result from

post-op CAT scan, the radioactive seeds were implanted accurately.I am supposed to go on a regimen of 25 low dose EBRT treatments in about 6 weeks but am considering "punting" on that right at the moment.Question: Would appreciate any feedback from anyone who had seed implants and similar after-effects.Thanks.Sy

[Guest guest]

Hi Dave,

Thanks for your feedback.

Are you still taking double doses of Flomax? Anything else?

Though your symptoms sound much more " normal " than mine, was the possibility of

radioactive burns ever mentioned?

As I said in my original post, inasmuch as my prostate gland was successfully

irradiated (based upon post op CAT scan analysis) I am really questioning the

need for the planned 25 low dose (40 Gy) EBRT treatments scheduled for about 6

weeks from now.

My disease was " organ confined " and I have no desire to look for more problems.

This is all a statistical probabilities issue anyway and I'd like to find some

empirical data on people like myself who had the seed implants but did not

continue with EBRT (though it might have been recommended) . Based on how I

hear it discussed by the Docs it sounds something like " he'll get 70 Palladium

103 radioactive seeds and then we'll give him 25 low dose EBRT treatments 6

weeks thereafter " . Not unlike " cooking your soup and adding

'some salt or spices' to give it a little 'zip'.

I realize there are no easy answers but if my Prostate is successfully " fried "

by the seed implants, I don't see why I couldn't continue without EBRT but with

an " Active Surveillance " approach with quarterly PSA tests, DREs and other

monitoring by my Urologist.

Any comments will be appreciated.

Thanks,

Sy

>

>  

> Hi Sy -

>  

> I had Bracy done on January 7th, 91 Palladium seeds and had similar experience

10 days after the procedure. Extreme pain when urinating (if I was able to

urinate at all), discomfort sitting, loss of appetite, energy and nagging

heartburn. Hounded both urologist and oncologist for several days - I was given

another prescription for Medrol which seemed to help. Fortunately I did not

suffer urine retention to the degree you described and did not need to be

catheterized. 

>  

> What helped, hot baths, double the dose of Flomax (take twice a day instead of

once), Tylenol for pain, Medrol, and lots of family love and support. (see

details in my write-up). The best thing on our side is time. I endured about 2

weeks of discomfort 6 weeks after I am about 80% back with only some discomfort

when urinating - weak stream also. Make sure you stay after your doctors until

you feel better.

>  

> Hang in there buddy -

>  

> Dave

>

>

>

> ________________________________

>

> To: ProstateCancerSupport

> Sent: Sun, February 21, 2010 6:58:01 AM

> Subject: Post Brachytherapy problems

>

>  

> Had low dose Brachytherapy procedure (70 Palladium 103 seed implants) on

January 12th..

>

> Procedure itself was quite easy and painless but I started developing

increasingly difficult symptoms about 2 weeks ago> urgency, burning, difficulty

urinating, feeling rectal and urinary pressure and spasms.

>

> My Urologist wanted me to see him in his office right from the outset to

measure the amount of fluid I was apparently retaining. Was hesitant to drive to

his office because of feelings of urgency especially when seated and I also

figured that this was just part of the " process " and would diminish.

>

> Over the last 2 weeks I continued with Flomax (2-4 a day), low dose prednisone

tabs etc..I am appalled at my ability to endure what were 2 weeks of absolute

hell.

>

> Finally, called my Doc last Thursday and told him that I really thought

something had gone very wrong as I was only getting worse. Couldn't eat had no

energy and was developing increasing pain and soreness in my left kidney area.

>

> Went to his office on Friday and he did Ultrasound showing that I was

retaining a huge amount of fluid and recommended that he catheterize me so I

didn't end up in an E/R over the weekend. Though I wasn't happy to hear about

the catheter he is very skillfull and considerate and getting the cath.

installed was really not that bad at all. Within about an hour I emptied 2 1/2

bags of urine and felt 1000% better.

>

> He ordered blood tests and will get results on Monday. The pain in my kidney

area has subsided by about 95% too. Anyway I asked him if he thought that I had

sustained radioactive seed implant burns and he thought there was a definite

possibility that I had and that some people simply have rare idiosyncratic

responses to radiation treatments.

>

> Coincidentally earlier in the week I had received a report from Radiation

Oncologist

> saying that based on result from post-op CAT scan, the radioactive seeds were

implanted accurately.

>

> I am supposed to go on a regimen of 25 low dose EBRT treatments in about 6

weeks but am considering " punting " on that right at the moment.

>

> Question: Would appreciate any feedback from anyone who had seed implants and

similar after-effects.

>

> Thanks.

>

> Sy

>

[Guest guest]

Hi Sy -

First of all, like you I am a patient and not a doctor, so my opinions are my own. However, I am totally with you regarding you concerns, so for what it's worth.....See my replies below.......

Hi Dave,Thanks for your feedback.Are you still taking double doses of Flomax? Anything else?

My double doses (0.4Mg capsules) were doubled up recently after I had very little improvement in my urine flow. I have been taking the double dose for a little over a week and am beginning to see some improvement. Outside of Flomax no, I eat healthy foods (stay away from greasy and junk foods, cut down on coffee and sodas).

Though your symptoms sound much more "normal" than mine, was the possibility of radioactive burns ever mentioned?

Yes - my radiation oncologist said that the first 17 days are when the radiation is strongest and therefore the worst discomfort occurs in the prostate and surrounding organs. After 17 days, the radiation is reduced by 50% and then another 50% the next 17 days and so on. Hang in there.

As I said in my original post, inasmuch as my prostate gland was successfully irradiated (based upon post op CAT scan analysis) I am really questioning the need for the planned 25 low dose (40 Gy) EBRT treatments scheduled for about 6 weeks from now.

I don't know your case and as I said I am not a Medical person, however, in my case only the Bracy was agreed upon. I will have my next PSA in May and only after those results, I will decide what is my next step if any. You might consider discussing this option with your doctor or get a second opinion.

My disease was "organ confined" and I have no desire to look for more problems. This is all a statistical probabilities issue anyway and I'd like to find some empirical data on people like myself who had the seed implants but did not continue with EBRT (though it might have been recommended) . Based on how I hear it discussed by the Docs it sounds something like "he'll get 70 Palladium 103 radioactive seeds and then we'll give him 25 low dose EBRT treatments 6 weeks thereafter". Not unlike "cooking your soup and adding 'some salt or spices' to give it a little 'zip'.

You absolutely need to check out www.yananow.net (YANA=You Are Not Alone) this website totally dedicated to prostate cancer. The mentors document their experiences about pre treatment choices and post treatment experiences. There is an ample section under "Treatment Experiences" were you will find my story about Bracy and dozens of others. You'll probably find someone's whose experiences matches closer to yours.

I realize there are no easy answers but if my Prostate is successfully "fried" by the seed implants, I don't see why I couldn't continue without EBRT but with an "Active Surveillance" approach with quarterly PSA tests, DREs and other monitoring by my Urologist.

Why not - it's your body.....but discuss with your doctor or get a second opinion. Feel free to write anytime.

Best of luck

Dave

>>  > Hi Sy - >  > I had Bracy done on January 7th, 91 Palladium seeds and had similar experience 10 days after the procedure. Extreme pain when urinating (if I was able to urinate at all), discomfort sitting, loss of appetite, energy and nagging heartburn. Hounded both urologist and oncologist for several days - I was given another prescription for Medrol which seemed to help. Fortunately I did not suffer urine retention to the degree you described and did not need to be catheterized. >  > What helped, hot baths, double the dose of Flomax (take twice a day instead of once), Tylenol for pain, Medrol, and lots of family love and

support. (see details in my write-up). The best thing on our side is time. I endured about 2 weeks of discomfort 6 weeks after I am about 80% back with only some discomfort when urinating - weak stream also. Make sure you stay after your doctors until you feel better. > Â > Hang in there buddy - > Â > Dave> > > > ____________ _________ _________ __> From: copanahoy <copanahoy@. ..>> To: ProstateCancerSuppo rtyahoogroups (DOT) com> Sent: Sun, February 21, 2010 6:58:01 AM> Subject: [ProstateCancerSupp ort] Post Brachytherapy problems> > Â > Had low dose Brachytherapy procedure (70 Palladium 103 seed implants) on January 12th..> > Procedure itself was quite easy and painless

but I started developing increasingly difficult symptoms about 2 weeks ago> urgency, burning, difficulty urinating, feeling rectal and urinary pressure and spasms.> > My Urologist wanted me to see him in his office right from the outset to measure the amount of fluid I was apparently retaining. Was hesitant to drive to his office because of feelings of urgency especially when seated and I also figured that this was just part of the "process" and would diminish.> > Over the last 2 weeks I continued with Flomax (2-4 a day), low dose prednisone tabs etc..I am appalled at my ability to endure what were 2 weeks of absolute hell.> > Finally, called my Doc last Thursday and told him that I really thought something had gone very wrong as I was only getting worse. Couldn't eat had no energy and was developing increasing pain and soreness in my left kidney area.> > Went to his office on Friday and he did

Ultrasound showing that I was retaining a huge amount of fluid and recommended that he catheterize me so I didn't end up in an E/R over the weekend. Though I wasn't happy to hear about the catheter he is very skillfull and considerate and getting the cath. installed was really not that bad at all. Within about an hour I emptied 2 1/2 bags of urine and felt 1000% better.> > He ordered blood tests and will get results on Monday. The pain in my kidney area has subsided by about 95% too. Anyway I asked him if he thought that I had sustained radioactive seed implant burns and he thought there was a definite possibility that I had and that some people simply have rare idiosyncratic responses to radiation treatments.> > Coincidentally earlier in the week I had received a report from Radiation Oncologist> saying that based on result from post-op CAT scan, the radioactive seeds were implanted accurately.> > I am

supposed to go on a regimen of 25 low dose EBRT treatments in about 6 weeks but am considering "punting" on that right at the moment.> > Question: Would appreciate any feedback from anyone who had seed implants and similar after-effects.> > Thanks.> > Sy>

[Guest guest]

copanahoy wrote:

> As I said in my original post, inasmuch as my prostate gland

> was successfully irradiated (based upon post op CAT scan

> analysis) I am really questioning the need for the planned 25

> low dose (40 Gy) EBRT treatments scheduled for about 6 weeks

> from now.

I'm not certain that the seeding is done exactly the same way

when performed as a monotherapy as when performed in combination

with EBRT. You have to ask your radiation oncologist about this.

If you have lost confidence in him, then you may want a second

opinion from another rad onc, but you'll need to get a complete

copy of your treatment plan to take to him.

> My disease was " organ confined " and I have no desire to look

> for more problems.

How did you find that out? When EBRT is prescribed in addition

to brachytherapy, I thought it was because the doc thinks it's

useful to treat the area just outside the prostate?

> This is all a statistical probabilities issue anyway

Very true I think. If there was no _evidence_ that the cancer

was outside the prostate, the only thing anybody can base a

decision on is statistics. There is some percentage of patients

with no evidence of capsular penetration who nevertheless have

it. There are nomograms that can give you some rough

probabilities based on PSA, Gleason score and stage. See the

Memorial Sloan Kettering website.

> and I'd like to find some empirical data on people like myself

> who had the seed implants but did not continue with EBRT

> (though it might have been recommended).

I think you'll get more information from the nomograms than from

anecdotes.

> I don't see why I couldn't continue without EBRT but with an

> " Active Surveillance " approach with quarterly PSA tests, DREs

> and other monitoring by my Urologist.

This is a question for the rad onc. Ask him how long you can

wait for the EBRT. Ask him if there is a specific time period,

or a specific indicator (like PSA rise) that limits the time.

Ask him to explain why.

I always hate it when a doctor can't explain why he recommends

something, or just says, " It's my experience that ... " It makes

you wonder if he's making it all up.

Let us know what you find out.

Good luck.

Alan