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Bladder wall recurrence of prostate cancer after HDR brachytherapy

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Posted 12/25/2014 5:20 PM (GMT 0)
I guess all newbies here sooner or later develop a fever to read as much as possible on the possible treatments for PC. I was just doing that for HDR Brachy when I found this article summary in PubMed:

www.ncbi.nlm.nih.gov/pubmed/25533416

According to the authors, it's the first report of prostate cancer recurrence in the bladder wall after brachytherapy. "Review of the CT scan obtained for dosimetry at the time of brachytherapy demonstrated a lone catheter protruding through the bladder wall at the site of eventual recurrence". The patient was "high risk".
Posted 12/25/2014 6:08 PM (GMT 0)
Vision10: LDR and HDR seem to have the same outcomes. Some on this forum believe that HDR is superior for technical reasons and less SEs. However, HDR has not quite stood the test of time.
Posted 12/25/2014 8:33 PM (GMT 0)
You'd think the patient would know pretty much immediately if one of the catheters punctured the bladder, right?

Certainly there would be symptoms of that having happened.

I'm nine days out from my final HDR Brachytherapy session and don't have any indication if such mistakes in my procedure.
Posted 12/25/2014 9:00 PM (GMT 0)
Hi Vision:

Yes, if you look hard enough you can find a study about almost anything re our cancer! Of course this particular "study" was one guy with one problem that evidently occurred several years ago. In terms of decision making I put this in the category of non-material information. Sorta like the fact that a small percentage of men die on the operating table during PCa surgery. True facts but not particularly pertinent to an individual trying to make a decision.

My personal recommendation on decision making is to focus on the big facts about cure, continence and sex. You can find a whole host of problems but most of us will do just fine if we choose a treatment that optimizes the big three.

Happy Holidays.

Jim
Posted 12/25/2014 11:10 PM (GMT 0)
Jim you are correct. One guy. And, the big three is also correct. You win the X-Mas cookie for today. ;-)
Posted 12/26/2014 7:58 AM (GMT 0)
Thanks all of you. Yes, I understand this is just anecdotal and it does not put me off Brachy at all. In fact SBRT is already out since my insurance thinks it's still "experimental" and they will not cover it. That leaves both types of Brachytherapy as my candidates for now.
Posted 12/26/2014 3:19 PM (GMT 0)
The bladder wall puncture by a catheter should be a very rare event with an experienced doctor, I would hope.

After I woke from the implant surgery, they put me under an X-ray and moved them some so hopefully they were mindful of not puncturing the bladder.
Posted 12/26/2014 4:46 PM (GMT 0)
Dewayne, thanks for that. You, along with Jack and a few othesr have actually had the HDR experience so your insight on these things is essential. Consider this my recruitment effort for you to STICK AROUND and help new members as they are exploring options. Your decision was well researched and well thought out...it's important that we have members from all procedure types to help the dialogue.

Happy Holidays!

Jim
Posted 12/28/2014 1:49 AM (GMT 0)
You're welcome Jim. I just saw your reply actually. I can already feel some positive effects, 10 days out, from my HDR brachytherapy. Seriously, it feels like my bladder empties better now. Before, I'd walk off from a urinal and feel some drips (I like to wear very loose Under Armor boxer underwear so any drop is magnified by that material). And I don't get up in the middle of the night to pee like I did pre-procedure. I'm even feeling less fatigued than I did as well.

My biggest SE's still go back the the barbaric biopsy performed by the too-enthusiastic urologist. The hemorrhoid problems I've had the past two months have been the worst ever. They hadn't bothered me in 10 years prior. I'm seriously going to have a surgery or something next year to fix that problem.
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