Prostate condition after Proton/Photon/Brachytherapy?

It's been about 15 months since my treatments and I'm still having some burning sensations when I urinate. Any other EBR + Brachy Seed Implants + HT candidates out there with these or other SEs?

Akai,

You have a valid point: I initially had a color Doppler ultrasound done followed with a biopsy - all by by Dr. Duke Bahn - once we saw there was some minor blood-flow. Only one of seven samples had tumor cells - and there was no blood flow at that specific area.

Since then, I had a multi-parametric MRI done to confirm I only had one tumor - and it was VERY obvious to see where the tumor was. The gotcha is that once you see the tumor, you still don't know what the Gleason score is. It could be a Gleason 2+2=4 and be left alone. Since I had a Gleason 4+3=7, I needed to decide on next steps and decided on Proton therapy. Right now I have 11 treatments behind me. The only side effects is some minor burning during urination.

It is unfortunate that multi-parametric MRI are not well-known and available around the country. My one day initial consult with blood test and multi-parametric MRI cost about $7,000. So a typical biopsy is a lot less expensive - unless something goes wrong, and then $7,000 looks cheap.

A good urologist/radiation oncologist should know where the areas are on the prostate where cancer can typically be found. Having the results from the MP-MRI should allow the biopsy to focus on those specific areas. Color Doppler ultrasound will/may not find early stage tumors, but Dr. Duke Bahn did anyway.

The reality is different in that many biopsies are more like a shot in the dark.

I am glad that with the feedback and knowledge shared in this forum I found the best treatment options for my situation.

Thanks for you all for your postings,

BB1100
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Age 62
Oct 2008 2.8 PSA
Jan 2011 6.1 PSA
May 2011 5.3 PSA
Sep 2011 5.6 PSA
Sep 2011 36.0 PCA3+
Jan 2012 6.9 PSA
Jan 2012 14.8 PCA3+
May 2012 6.9 PSA
May 2012 19.4 PCA3+
Jun 2012 Biopsy: 1 core out of 7 had 25% adenocarcinoma Gleason 4
- Gleason = 4 + 3 = 7 - Clinical Stage T2a
- Prostate size 35cc; tumor size 1.5 cc approx. 5mm next to NVB
- Tumor on left lobe only; tumor within prostate capsule
- No visible blood flow to tumor - very early stage, but intermediate grade
Jun 2012 Second Opinion on Biopsy: 1 core out of 7 had 20% adenocarcinoma Gleason 4
Jul 2012 7.27 PSA (5 weeks after biopsy - prostate must still be healing)
Oct 2012 7.7 PSA at MD Anderson Cancer Center
- Multi-parametric MRI showed a single tumor in the left lobe
- All serum and urine levels normal, except PSA
Oct 2012 - Started Proton Therapy at MD Anderson Cancer Center

Thanks for pointing this site out. Considering all the research I have done, I am surprised I hadn't come across it earlier. I also found protonbob, but it is geared more for those deciding on proton therapy.

BB1100
==================================
Age 62
Oct 2008 2.8 PSA
Jan 2011 6.1 PSA
May 2011 5.3 PSA
Sep 2011 5.6 PSA
Sep 2011 36.0 PCA3+
Jan 2012 6.9 PSA
Jan 2012 14.8 PCA3+
May 2012 6.9 PSA
May 2012 19.4 PCA3+
Jun 2012 Biopsy: 1 core out of 7 had 25% adenocarcinoma Gleason 4
- Gleason = 4 + 3 = 7 - Clinical Stage T2a
- Prostate size 35cc; tumor size 1.5 cc approx. 5mm next to NVB
- Tumor on left lobe only; tumor within prostate capsule
- No visible blood flow to tumor - very early stage, but intermediate grade
Jun 2012 Second Opinion on Biopsy: 1 core out of 7 had 20% adenocarcinoma Gleason 4
Jul 2012 7.27 PSA (5 weeks after biopsy - prostate must still be healing)
Oct 2012 7.7 PSA at MD Anderson Cancer Center
- Multi-parametric MRI showed a single tumor in the left lobe
- All serum and urine levels normal, except PSA
Oct 2012 - Started Proton Therapy at MD Anderson Cancer Center