Newbie from Spain

I cannot aspire to tell my personal experience as well as Pratoman is doing (congratulations!) but I will give it a try by updating this thread. Maybe it will be useful for future Spaniard forum visitors.

I have now the results from the MRI and there are no surprises. Translated from Spanish: "Probable cancer in the right lobe, contained within the capsule. No other involvement detected". Now considering that the MRI operator asked me for the biopsy results before writing the report, I can not say that they have really seen nothing in the left lobe.

I have LDR Brachy scheduled now for February 2, and in the next week appointment with the RO where she will review the MRI results I will probably pull the trigger and commit to it. They will then proceed to order the seeds from Germany. During the visit I will ask a lot of questions about the real time dosimetry they are supposed to be using and how the quality of the implant is checked after the procedure, since I think that there is no CT scan performed later.

I visited again the urologist that will be part of the Brachy team and surprisingly he sort of tried to get me to consider again the surgery track. He tried the age argument (I am too young for radiation) that I have read in the forum that it is very common for surgeons to use. He is a very experienced doctor with a very strong reputation (especially in kidney transplants) so he managed to get me a little nervous. After a brief discussion he said that he could see that as an engineer I had properly investigated the alternatives and that he only wanted to be sure that I understood my choice and the consequences.

Vision... like me, just on the right lobe. I am scheduled for HDR Brachy on Jan 28/29. I am certain we both will do great. Can't wait to get back to Espana!!

Best MS

Vision10,

It sounds like you handle yourself extremely well with doctors. I know that at the beginning, I would get tongue tied, and second guess myself. Now I go on doctor visits with men in my support groups and chatter away with doctors. Most, I've found, are happy to not be asked to "play God" and encourage a shared decision-making process. Sometimes the doctor and I go into nerd freefall discussing this or that research study (I always walk in with a folder full of them, and send them in advance if I can), and forget to include the patient. This is the stuff they have devoted their lives to, and they care passionately about it.

My understanding of why they check the dosimetry a month later is for two main reasons: (1) seeds, even stranded ones, migrate, increasing the risk of cold spots, and (2) the prostate swells up (edema) during the implantation procedure, so that placements may be in a different place by several millimeters when the swelling goes down. I understand that with modern intra-operative planning techniques, the dosimetry is generally very good, but it seems prudent to me to check it after a month.

- Allen

I think they would implant more seeds to fill in any cold spots. A few seeds wouldn't take very long. A CT-scan is comparatively inexpensive. I think they also need it to compute an accurate dose-volume histogram to show the actual doses to the organs at risk. I would think they'd want that for quality control purposes, if nothing else.

BTW - I came across a study by some doctors in Barcelona who have been doing HDR brachy for quite a while, but I don't know if they do HDR monotherapy.

www.redjournal.org/article/S0360-3016(13)01682-9/fulltext#sec4

- Allen

Time for an update. After sorting all types of paperwork problems, I am finally scheduled for LDR-BT for next Monday February 23rd, two days from now.

I hope I will getting the same type of results as Casper! After all we are in the same continent (although I know some British people that would dispute that)

Vision, congratulations on your decision and pending treatment! All the best and keep us updated!

Cheers, Doug

Thanks for the update. Good luck and let us know how everything went.

Vision: catch you on the flip side. You'll do fine.

I am already out. The procedure itself took only 2 hours but there was a lot of waiting involved. I will spend the night in the hospital (with a catheter in) since we finished so late. Right now I do not feel any pain since my lower half is still mostly numb from the epidural.

Now the catheter part was not as described in the hospital info package. They mentioned that it was removed before leaving the OR. Not happy!!!

Vision, good to see you. I'm on day 6 with a catheter.

Good luck to you vision on a rapid recovery. And, of course, kick the cancer's butt!

Yes, you are absolutely right. I don't know how the "few months" idea got into my mind. By the way, I'm already at home an letting my wife take care of everything, although I feel perfectly fine!