Lorraine is a nurse specialist and sex therapist and here to answer your questions...
Has anyone had any experience or any views on this treatment? A friend has said she has heard of some great success stories, wondered what you all thought?
I can tell you it's not suitable for everyone, which I found out right at the start when Brachytherapy looked to me like the treatment that I'd mind the least. I was told I just wasn't suitable for it for a few reasons.
If your husband is suitable for it, I think there are two types of Brachytherapy - click on these two links: permanent and temporary, although there might be more, you'd need to ask.
To help you choose a treatment, this link might be useful. It's possibly one of the most useful links for the stage you and your husband are at now.
Please keep on asking as many questions as you need to and I hope you get some replies from guys who've actually had Brachytherapy and not just those of us who've been told we couldn't have it.
Can I ask why it wasn't suitable for you?
Hi Kelly, I was told Brachytherapy wasn't suitable for me as there was a chance (later confirmed in post surgery pathology) that the tumour in my prostate had broken through the capsule. The MRI showed my prostate bulging on one side due to the cancer. I was left to decide between external beam radiotherapy and surgery. I chose surgery but because my cancer progressed after surgery I have also had salvage external beam radiotherapy. Because of the way brachytherapy works it has a limited range inside the body. Hope this is helpful,Ian.
The two main reasons I was given were that my prostate was too big and the other was that as I'd already had waterworks problems there was a chance the Brachytherapy would make those worse. When I asked how, I was told any type of radiotherapy, which is what Brachytherapy is, can make things inside swell up which could result in me needing a catheter and that there was a small chance that things would stay swollen permanently and I might need a permanent catheter.
I should emphasise that was in my case, it's not necessarily the same for everyone.
As things turned out after I'd had surgery (my first treatment) it was discovered my cancer had already spread so Brachytherapy wouldn't have been any good because it would not have treated the spread, only the cancer contained in the prostate. (My post-surgery Staging was T3b N1 M0).
I also thought at the start of this journey that Brachytherapy would be a good option for me but because I had already had a TURP operation where some of the prostate is removed from around the uretha to help with urine flow problems caused by a swollen prostate about 12 years before I was diagnosed with PC this was nt suitable for me as the radiotherapy delivered by the brachytherapy would not travel across the spaces left from the TURP I believe. Again MRI also showed that there was a bulge on the back of my prostate so although brachytherapy had already been discounted because of my previous TURP operation it would probably also have been discounted because of that bulge too. I went on to have radiotherapy with the help of fiducial markers (gold seeds about the size of a grain of rice placed in my prostate to help target the radiotherapy and avoid collateral damage to bowel and bladder as I already had problems with an oversensitive bladder and had lost part of my anal sphincter muscle from a fistula about 10 years ago. All in all I am pleased to say that I think I chose the very best treatment for my situation - it was not easy and I had 2nd, 3rd 4th and 5th opinions from various oncologists and radiologists - all the while I was on hormone therapy nd my PSA and testosterone reading was going down. I am now just over 6 months post radiotherapy and am doing really well. I don't know whether it was because of the gold seeds but I only had one night during my radiotherapy when I had to get up to urinate about 10 times and never had any problems with my bowel - where other people having radiotherapy at the same time as me without the gold seeds complained about this from about the 10th radiotherapy session.
I do hope someone who actually hads experience of brachytherapy comes along soon to give you a better understanding and their own experience of brachytherapy.
All the best
Thank you for your replies, you have all been really helpful. From what I have read I wonder if husbands cancer is too advanced for this treatment with a Gleason score of 9 and it being locally advanced?
I am feeling a little overwhelmed with the thought of the journey we have a head. My Husband is such a fit & healthy man at the moment and the thought of all those horrible side effects from which ever treatment you you choose is upsetting me greatly.
Correct me if I'm wrong, but it does seem as if it's six of one and half a dozen of the other as far as the side effects of the different treatments go?
Sorry if I sound like a whimp! You have all talked so bravely and eloquently trying to help me and I know you have all been through and are still going through difficult treatments and living with this horrible disease.
Once again thank you for your support
The oncologist will make it clear which options are available or not. You are right about the side effects. My wife and I looked at all of this when surgery was the choice made and concluded it was tails you lose, heads you lose as far as side effects are concerned. I have lots of side effects due to having had surgery, radiotherapy and still on hormone therapy. You are not being a wimp. I still feel overwhelmed at regular intervals. For example I have a review appointment with my oncologist on Monday which I dread as you never know what is going to be said. This is no reflection on my oncologist, he is great. I also dread waiting for my PSA test results. That all said, I often feel really well and can do most of the things I want to. It is definitely an emotional roller coaster ride and I am sorry you both are in this situation. Enjoy the good things each day brings. Best wishes, Ian.
Hi i had high dose rate brachaytherapy in march HDR and this involved fifteen sessions of RT followed by the brachay my brachy did not implant seeds but placed the radiation source dirctly into the prostate/ tumour leaving it in place for a set amount of time before removing it
Six months on my psa is undetectable read my posts under bobby12
Hi Kelly, My situation is similar to that described by Jim. Hence Brachytherapy is not an option for me . As others have said there is no easy solution and it is best to see as many different urologists as you can. I have seen five in two different countries. Still no concensus and what is the best treatment for me and you will probably find the same. The waiting is awful but unfortunately there is no alternative
I wish you and your husband all the best
I had low dose Brachytherapy in March 2015 after being on active surveillance for 2 years.My PSA was 5.5 Gleason 4+3 with 2 cores + out of 32 in template biopsy at the time I was advised to have treatment ( I was 61 then), either surgery or Brachytherapy was offered. MRI indicated the cancer was well away from the prostate wall and I had good urine flow hence I was a prime candidate for Brachytherapy. I chose the Brachytherapy after much research as it offered the lowest risk factors in my case and equal success rate to surgery. I was in hospital on day care for the procedure, admitted in the morning back home by late afternoon. Two days off then back to work. All has gone well with no incontinence or ED, The radiation peaks after about 6 to 8 weeks and you need to be not more than 5 minutes from the toilet due to increased urgency to urinate, can be managed quite well by controlling fluid intake. After 2 months the urgency slowly diminishes and now i'm pretty much back to normal. PSA drops much more slowly than with surgery taking about 2 years to fall to minimum, mine is now 0.7. PSA apparently can remain between 0.5 and 1 due to some residual prostate cells giving a reading. The procedure was no worse to deal with than a template biopsy. I have some minor regret that I didn't have it straight away when I was first diagnosed but that's the wisdom of hindsight. I am now on 6th monthly PSA checks and telephone check ups from the hospital.
Wikipedia has an excellent write up on Brachytherapy which you might like to check out. As Jim has said there are two types, in low dose the radioactive seeds are left in permanently, after about 2 years the radiation will have decayed to virtually nothing. High dose is much stronger radiation but the radioactive seeds are removed after a certain time period.
If you want any further information I am happy to help if I can.
Hi Rob, thank you for your reply. It sounds like a really good treatment option and certainly sounds like it has worked for you with relatively minor side effects. I have read some really positive research on this treatment. Unfortunately for us my some of my husbands cancer is bulging is how they described it out of the prostate wall. So I don't think he will be able to have it, but will ask the consultant when we see him when we get back from our holiday.
Really pleased it has worked so well for you.
Kelly I had high dose brachytherapy back in November 16 for locally advanced PC gleeson 12, Tb4 which although I had nodules hadn't broken through.
I was only 56 fit and healthy so the prospect of having prostate removed didn't appeal.
The operation was followed by 15 session of external beam radiology.
All I can say is it seems to have worked for me so far minimal side effects related to water works and bowel, but all gradually getting better.
Best advice I can give us talk to your oncologist get the full facts, also husband needs to stay positive and with your support all will be good.
It's devastating when you get told and is hard for others to appreciate what is going on in your mind.
Good luck and regards to your husband if you have any further questions don't hesitate to ask
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