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Posted 8/4/2010 12:10 PM (GMT 0)
I had a biopsy with 1 of 12 samples showing 17% cancer. Gleason is 3+3.  My Uro sugested seed inplants. When I met with the Oncologest he said there was little difference between the beam and seed radiation. He said both have the same results rates and side effects.  I got the impression that it is a matter of convience in delivery, Beam  akes lots of visits where seeds is one procedure.  I am retired at 62.  Are there ant significent differences in side effects between the two?  Judd
Posted 8/4/2010 2:45 PM (GMT 0)
With your provided numbers, you would be a good candidate for Seeding. We have several men here, including Tudpock and JohnT, that had very good experiences with seeding. With regular radiation, you are right, it will be spread out anywhere from 6-9 weeks, and you have to go every day during the week. With the seeding, the whole process is usually over with in a single day.

Sure some of the "seeded" brothers will give you all the good advice you need on the subject.

Good luck

David in SC
Posted 8/4/2010 4:21 PM (GMT 0)
Seeds alone have overall less side affects than external radiation because the dose is more controlled and limited to only the prostate. External radiation can also affect the bladder and bowels where as the side affects to these areas are rare in seeding. The seeding dose is also higher about 100gy compared to 81 gy. The immediate side affects are higher with seeding with urinary frequency and urgency for about 4-6 weeks. There are some urinary issues during radiation but come on slower and are not as severe; but both are easily tolorable. The biggest difference is that radiation takes about 9 weeks and Brachytherapy takes about 1 hour.
I would also look into active surviellance as no treatment is better than any treatment if you have very low risk PC which it apperas you have.
JT
Posted 8/4/2010 4:25 PM (GMT 0)
Waitman, I had seeds implanted 7 weeks ago. The procedure was easy and I spent about 5 hours in the hospital from check in to check out. My side effects were a little more than I expected. Needed a foley catheter for a week. Weak stream and burning for about 10 days after the catheter came out. Still having frequent urination but manageable with Flomax. Both my urologist and radiologist said my side effects were "normal". Even though I had more side effects than I expected I'm certain they were less than I'd have had from surgery. I'd choose the same treatment again if I had to choose.
Posted 8/4/2010 6:42 PM (GMT 0)
Waitman, I actually had a combo treatment of seeds with IGRT. Side effects from both were minimal. Came home from the seed procedure same day with no catheter. Side effects were same as reported by John T above. Radiation side effects were some fatigue after the third week (only 5 weeks of treatments in my case) but that went away fairly soon after the last treatment. Mild urinary issues treated with Flomax. It was the right choice for me. And hats off to your Uro. You don't hear much on this site about Uro's who recommend seeding rather than surgery. That said, you owe it to yourself to explore all the options that are available to a Gleason 6. Best wishes down the road, Joe  
Posted 8/4/2010 7:02 PM (GMT 0)
Waitman, without seeing more of your stats it's a little hard to know if you might be a candidate for for active surveillance.  However, FYI, shown below is a link to Johns Hopkins where you can review their program and see if you think it might work for you.

http://urology.jhu.edu/prostate/advice1.php

The other guys have given you proper advice on the external radiation vs. brachytherapy options.  The big advantage of seeds is that you are pretty much back to normal activities (at least most of us were) within a day or two of your procedure.  Feel free to select the link in my signature if you want some details of my "journey" with seeds.

Good luck and let us know how you progress,

Tudpock (Jim)

Posted 8/4/2010 11:44 PM (GMT 0)
The seeds PLUS a run of IGRT treatment, which provides a very high (and effective) total dose is starting to show superiority over other forms of treatment for many men, including high-risk men, than other forms of treatment...
Posted 8/5/2010 12:05 AM (GMT 0)
Exactly ten weeks ago TODAY, I received the Brachytherapy procedure and the side effects (FOR ME) have been extremely minimal. Walked out of the facility about an hour after the procedure and did not leave with a catheter. Started Flomax that same day and have never had any issue in taking a good ole pee. Was a tiny bit of blood the second and third day but that too was minimal. I have had no problems due to the seeds and would certainly recommend Brachytherapy if the required conditions are met. Of course being almost 74 years old, I sure did not want to take the risk of having to endure some of the common side effects of surgical removal of the prostate. Hope I'm good for at least another ten or fifteen years of GOOD health. We shall see!
Posted 8/6/2010 3:27 AM (GMT 0)
I have some questions about sex and Brachytherapy. I am 62 and have some sort of sexual activity each week. I have some ED but we have gotten around that with some oral sex and other types of stimulation. How long after Brachy can I have sex? Is oral sex safe for my wife? Will my climax be significantly changed without semen? I apologize for the bluntness and nature of these questions, But I need some direct answers to these questions from folks who know. Waitman.
Posted 8/9/2010 2:53 PM (GMT 0)
Waitman, did you ever get all of your questions/concerns answered?
Posted 8/25/2010 6:04 PM (GMT 0)
Hello Waitman:

How about some answers from the wife of a "seeded brother".  My husband had Brachytherapy and, trust me, there is no problem in the "plumbing" department.  As for return to sexual encounters, we waited until he was feeling up to it - no pun intended.  As for the difference without semen - that is not always the case - some men experience dry orgasm, some reduced semen and some (lucky me) still have to deal with the "wet spot" LOL.

Don't be embarassed by your blunt questions, I learned long ago, there is no room for modesty here and honesty is the best policy so there you go - carry on :)

 

Posted 8/26/2010 3:48 AM (GMT 0)
You may also wish to investigate CyberKnife radiation treatment which has many of the advantages of convenience and dosage concentration in the prostate.


Posted 2/18/2011 12:51 AM (GMT 0)
Joe - Your treatment protocol sounds identical to what is currently proposed for me. I have a Gleason 7, Intermediate Risk, Contained. My doc wants to give me 5/5 IGRT followed by seeds. It seems more logical to me to do the seeds first then IGRT. Which order was yours performed?

Thanks, Tim



Joe67 said...
Waitman,


I actually had a combo treatment of seeds with IGRT. Side effects from both were minimal. Came home from the seed procedure same day with no catheter. Side effects were same as reported by John T above. Radiation side effects were some fatigue after the third week (only 5 weeks of treatments in my case) but that went away fairly soon after the last treatment. Mild urinary issues treated with Flomax. It was the right choice for me.



And hats off to your Uro. You don't hear much on this site about Uro's who recommend seeding rather than surgery. That said, you owe it to yourself to explore all the options that are available to a Gleason 6.



Best wishes down the road,



Joe

Post Edited (timzter) : 2/17/2011 5:54:46 PM (GMT-7)

Posted 2/18/2011 1:06 AM (GMT 0)
>>Is oral sex safe for my wife?<<

sure, as long as they don't seed your tongue cool .

ed

Posted 2/18/2011 1:29 AM (GMT 0)
Waitman,

I am one of the few 'brachy's' here. Had mine on 10/4/10. I could not be more satisfied. PSA went from 6.1 to 0.24 after only 6 weeks. Sex was one of my major concerns. No complaints there either. You are correct in that there is no ejaculate...or very little. That is really no big deal. Your partner is safe from radiation after 30 days (and likely before that. Danger from seed radiation is greatly exaggerated from all that I have read). If you have had ED issues prior, be aware that you are more likely to respond to 'drugs' after brachy than you are after surgery. Take this one to the bank. Good luck in whatever course you take.

Post Edited (GOP) : 2/17/2011 6:34:43 PM (GMT-7)

Posted 2/18/2011 1:49 AM (GMT 0)
I would like to send you a PM, Waitman, but I don't know how to do that on this site. Perhaps that is not a feature.

Posted 2/18/2011 3:30 PM (GMT 0)
Timzter,

I had seeds first followed by IGRT. I asked my rad why he chose that order. His answer was that he had done it both ways but he and his colleagues (8 other oncol/rads in this group) had come to believe (from the data in their practice) that seeds first resulted in slightly reduced side effects.

Either way you do it, I think you will be pleased with your treatment choice. If you want any other info about my experience to date please feel free to contact me at the email address in my profile. Regards,

Joe
Posted 2/18/2011 4:13 PM (GMT 0)
Also look at High Dose Radiation Brachytherapy. It is a more accurate version than permanent seeds and nothing is left in the body. That solves the issues of seed migration, being radiative while the seeds work, and limits the side effects. HDR allows the radiation to be more conformal to the area in both shape and dose. It also solves the problems associated with normal changes in the body during the 90 day period of radiation from the seeds that can result in unintended hot and cold spots.

I did the HDR with IMRT and had minimal side effects which are all gone now. Sex has been fine and the only side effects have been a lower volume of semen and for the first few times it was dark from blood. These are the same side effects that the seed procedure presents.

You can learn more about the HDR procedures and advantages over permanent seeding at www.cetmc.com. This is a site for Dr. Jeffrey Demanes at UCLA. He is a pioneer with the HDR having performed them since 1981. He also has treatment results for up to 15 years based on his experience. There is also a Dr Martinez in Michigan that publishes his long term results with HDR. Both use HDR as mono-therapy for low risk patients and HDR coupled with IMRT for intermediate and advanced patients. HDR is also used for many other cancers such as breast, head and neck, gynocological, and others.
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