HealingWell
Search Close Search
☰

For those interested in HDR Brachytherapy

Support Forums
>
Prostate Cancer
✚ New Topic ✚ Reply
❬ ❬ Previous Thread |Next Thread ❭ ❭
Posted 1/9/2013 9:59 PM (GMT 0)
My wife and I saw the radiation oncologist today at Moffitt Cancer Center in Tampa, FL.   I had in my mind pretty much what I wanted to do – High Dose Rate (HDR) Brachytherapy.   The advantages of HDR are 1) you are not radioactive when you come home; 2) it is a shorter regime than external radiation; the radiation does not have to travel thru healthy tissues to get to the prostate; and the success ratios are comparable to surgery, external radiation, and Low Dose Rate (LDR).   They will do pretty much everything I wanted except they do it in two fractions (treatment sessions) separated by a couple weeks.   I had hope for all the treatments to be done is one session with an overnight stay in the hospital but that is not how they do it at Moffitt.   I can live with the two fractions being separated by a couple weeks if they give me plenty of pain meds.   I wanted it as a monotherapy, i.e., no external beam radiation and since I only have one of the three criteria that put me in medium risk so they will do it as a monotherapy.   They called it low medium risk.   If I had two or more of the criteria they would want to do external radiation also and I would be shopping for another microwave oven.   The three criteria are Gleason Score of 7 (which I have); a PSA of 10 to 20 (don’t have – mine is 9.4); Stage T2b or T2c (don’t have – mine is T1c).   The doctor I met today isn’t the actual one that does the HDR (he does external radiation) so I have another appointment next week on Wednesday with the doctor that does the HDR.   They use general anesthesia when they are putting the catheters in and propofol – the Michael Jackson Ultimate Sleeping Aide (gotta love that stuff).   I think they mentioned they do it on a Friday so you at least have the weekend to rest.   Not sure if I will have to take more than just Friday off.   My wife is Ok with the regiment and that is important so I think I am set for the microwave oven treatment.   I see my surgeon tomorrow and have to tactfully tell him to quit sharpening his knives.   He is very good and was actually the one that encouraged me to talk to a radiation oncologist so I am pretty sure he will be OK with it.   Also since he works at the VA and doesn’t have a profit motive I am sure one less surgery won’t break his heart.   Aster is going with me to that appointment also.   I did have an appointment at the VA with a radiation oncologist but one of the interns I talked to day said all they do is external radiation so I think I am going to cancel that appointment.   No sense wasting their time or mine.   More than you ever wanted to know about cooking a prostate, huh?   Sorry.   If you have any questions, please don’t hesitate to ask.   David
Posted 1/9/2013 10:16 PM (GMT 0)
Great post David, it will go along way towards helping others that are considering HDR as an option. You did good - tons of research, educated yourself, and made your decision. You'll do well I'm sure, and please continue to provide updates - your turn to "Pay Forward" now!
Posted 1/9/2013 11:48 PM (GMT 0)
I wish I had access to this data when I was scheduled for mine....I wouldn't have suffered any of the anxiety I went through!
Posted 1/10/2013 12:13 AM (GMT 0)
Good research. Glad you've got a plan.
One of the reasons I didn't select this treatment was because of the general anesthesia - I'm not very tolerant of those drugs (heart/lung issues) and my RO and Uro though the risks weren't worth the benefit.

Not every treatment is for everyone. There are days I wish I could had this rather than 6 weeks of going to the clinic to get IGRT every weekday.
Posted 1/10/2013 12:16 AM (GMT 0)
This is just an update on what I already posted earlier.   The radiation oncologist I saw today had done some studies I had read about .  They use hyaluronan gel to add space between your rectum and your prostate - the benefit being a lower dose to your rectum and hopefully less side effects.  The principal investigator in the trials was the doctor I saw today.  They are using it at this facility as standard treatment.  You can read the abstract here:   http://www.ncbi.nlm.nih.gov/pubmed/20591748   David
Posted 1/10/2013 12:56 AM (GMT 0)
David you will do well.

I had HDR two years ago and my docs used the protocol that Moffitt uses. I had two procedures one week apart. I did not need pain meds at all. The only discomfort was urinary for two days after the first procedure. I told the docs and they used a different lubricant for the catheter the second time. Problem solved. I was also undergoing IMRT and ADT due to my high risk diagnosis. The HDR was a breeze and only left me with some discomfort sitting on hard chairs for a couple if weeks, but never missed a day of work aside for the two days of the procedures.

Keep us posted and let me know how my experience may be of benefit to you.

Jack
Posted 1/10/2013 1:11 PM (GMT 0)
Jack,

They said this procedure would be done on a Friday and I would be discharged the same day.  Do you think I could reasonably expect to be back to work on Monday.  I have a desk job and have to walk less than 1000 feet from my car in the parking lot to work.  There is one flight of stairs.  My job doesn't involve any lifting at all.  I am 62 years old.

Thanks for your post and the info.

David

Posted 1/10/2013 3:00 PM (GMT 0)
David

I did mine on Monday.  Showed up at the hospital at 10:30 to be prepped, knocked out at 12:00, 25 catheters inserted, awake at 1:00, transferred by ambulance to the radiation center, under the CT for fine tuning of the catheters, put in a room with a light lunch while the physicist did the final work up, 15 hoses hooked up to the catheters by the dosemetrist at about 2:30, wheeled into the treatment room at 2:45, zapped for 20 minutes and returned po the patients room.   At about 3:30 the rad-onc and nurse checked me and removed the urinary catheter and radiation catheters( no feeling), and let me rest until I started to regain feeling in my legs.   Got me dressed at 4:00 and into a wheel chair and out the door by 4:15-4:30.   30 minute ride home, was able to walk with a litle assistance as the feeling returned.   At about 7:00 was fully functional and prepared dinner for my wife.   Early to bed and to rise on Tuesday for the 45 minute commute and worked a full day with no problems.   I park at the far side of the lot and probably have at least 200 yards to the door.   I sit and stand in the office and take stairs (3 floors) rather than the elevator, but basically a desk job.   Was tender and sat down carefully, don't just plop down and stay away for hard chairs.   Three days after the second procedure I drove 9 hours without any problems and then three days later returned the 9 hour drive to Atlanta.   I was also doing IMRT and had the Monday and Tuesday off each week I had the HDR procedures.

With you doing yours on Friday, then back to work on Monday, from my experience will be a piece of cake.   The only issue I had the first time was some urinary burning from the catheter which was solved the second time with better lubtrication.

Best wishes and lats erradicate the bad cells.

Jack

Posted 1/10/2013 3:33 PM (GMT 0)
Hi David,

I am probably going to have the same procedure done. Great to read your story and plans.

Best of luck to you!

Buddy
Posted 1/11/2013 2:25 AM (GMT 0)
hi david,
my husband probably will do the same procedure at ucla the beginning of february. we will follow your story with interest.
Posted 1/11/2013 12:04 PM (GMT 0)
Very informative, David. Posts like yours are very important for the newly diagnosed. I understand that results with HDR and LDR are nearly identical, so I know you will be pleased with your choice.
Good fortune, Brother.
Posted 1/11/2013 12:13 PM (GMT 0)
Hi David:

Great detail on your story and great job of due diligence on making a choice.  Good luck and we will follow your sure to be excellent progress!

Jim

Posted 6/22/2013 4:16 AM (GMT 0)
David,

thanks for putting this out there for people like me to see.  My insurance company uses moffit center and I ahm looking toward HDR brachytherapy as well. 

How are you feeling?  Did you get the HDR brachytherapy as a monotherapy?  How long did it take?  were you able to work and maintain normal activities?

Hope you are ok with these questions.  thanks, chris

Posted 6/22/2013 6:40 PM (GMT 0)
I am 3months post HDR Monotheraphy at UCLA. I am 64. I got myself in top physical shape (primarily cardio) prior to my treatment. They used a spinal anesthetic and that phase was flawless. The treatment was relatively painless. My worse pain was back pain that was caused by laying on my back for 30 hours. UCLA does 2 treatments as well, at one week apart.
I was walking the mall the first day after treatment. No problems. No pads, no leakage. I attended a wedding the day after the second treatment and was able dance all night and not worry about where the nearest toilet was.
I am waiting for my first PSA test (3 month post therapy) and am very optimistic. I honestly believe that HDR has the least side effects with the most precise (millimeter precision) radiation coverage of any prostate treatment option. Remember, the radiation is controlled from within the prostate (3 dimensionally) with controlled doses around the urethra, bladder and rectum for minimal side effects and 5mm outside the prostate for any possible microscopic cancer cells
Posted 6/22/2013 7:52 PM (GMT 0)
Congrats SactownTom on how well your brachy went. I also had HDR brachy at UCLA (in conjunction with IMRT) and MauiViv's husband Harold also had the procedure. I'm sure there are other UCLA grads as well.

You actually bounced back quicker than I did...after round 1 I couldn't pee so I came home with the catheter. Round 2 was better in that regard. But I did have some problems sitting for a month or so afterwards...sounds like you didn't have that issue at all. Mine was in January and my IMRT ended in March. So far, so good.
Posted 6/22/2013 8:50 PM (GMT 0)
That's puzzling. I wonder if your treatment was more aggressive because of your Gleason scores? I had one core of 3+4 and the rest were sixes and a 3.0 PSA going into treatment....although mono theraphy has 2 additional radiation sessions.
I'm curious...I'll be taking my 3 month post theraphy PSA test in a few weeks...... where did the doctors expect your PSA to be at the 3 month test? And how did you do?
Posted 6/22/2013 9:47 PM (GMT 0)
Yes, since I was high risk I had the combo therapy, with HT thrown in just to make me grouchy for a year. Because of the HT, I also won't have an accurate PSA reading until I finish. (Although it's close to zero now.)

But MauiViv's husband Harold recently had his and his PSA had dropped significantly. You should check out her post at https://www.healingwell.com/community/default.aspx?f=35&m=2766802. Harold also had mono therapy.

Who was your doctor? Rather than the famed Dr Demanes, I had his understudy Dr Kamrava, but I was quite happy with him.

PS I forgot to comment in my previous post, but yes the back pain from lying down so long was by far the most painful thing about it.
Posted 6/22/2013 10:25 PM (GMT 0)
Thanks for the link. It is very encouraging. I don't understand why anyone would risk the effects of Robotic Surgery when HDR is available. It seems that the lot of people on this site read Dr Walshs book and are intimidated into the "gold" standard.
I had Dr Kamrava as well and was very happy (under the circumstances) with the entire treatment process. Every phase and every person involved with the treatment was over the top "Professional".
By the way, with my second procedure, I spent most of my idle time on my side and the back problems were much better...the only thing worse than my back problem was having to drink that magnesium citrate...yuk!
Posted 6/23/2013 4:36 PM (GMT 0)
SactownTom,

If you'd like, you can click on the envelope under my name and send me a personal e-mail. That way we can stay in touch and compare notes as we progress from our HDR brachy. MauiViv and I stay in contact every couple of months, so that would give us a group of three UCLA brachy graduates going forward.

Michael
Posted 9/21/2014 8:57 AM (GMT 0)
I just found this forum today, and have read many of the brachy related posts with great interest. I was diagnosed with Gleason 3+4 prostate cancer in July, and after researching the options under the guidance of my prostate oncologist, I have decided on getting the HDR brachytherapy at UCLA, which I am scheduled for next month with Dr. Demanes. Thank you to all who have posted about their experiences here.

One thing I have noticed on this forum, is that some posters are mixing up the terms HDR and LDR. If the seeds are permanently implanted, it is not HDR brachy. With HDR, the seeds are only temporarily placed inside the prostate for a short time period.

Hawaii-Guy, I have started a new thread for you so that folks will be more likely to welcome and answer you rather than having your comments buried on this old thread. Jim

Post Edited By Moderator (Tudpock18) : 9/21/2014 7:33:45 AM (GMT-6)

Posted 9/21/2014 12:13 PM (GMT 0)

Hawaii-Guy said...
I just found this forum today, and have read many of the brachy related posts with great interest. I was diagnosed with Gleason 3+4 prostate cancer in July, and after researching the options under the guidance of my prostate oncologist, I have decided on getting the HDR brachytherapy at UCLA, which I am scheduled for next month with Dr. Demanes. Thank you to all who have posted about their experiences here.

One thing I have noticed on this forum, is that some posters are mixing up the terms HDR and LDR. If the seeds are permanently implanted, it is not HDR brachy. With HDR, the seeds are only temporarily placed inside the prostate for a short time period.

www3.islandtelecom.com/gkavanagh/MyBrachyProcedure.pdf
✚ New Topic ✚ Reply