Just finished HDR Brachytherapy Monotherapy with Dr Demanes, UCLA

I just finished my second implant of HDR Brachy at UCLA, and thought I would share my experience
I was diagnosed August 2016 with a 4+3 tumor. At that time my PSA was 15. I did a lot of research and quickly decided that radiation would be my main choice, and HDR Brachy the preferred mode for the radiation. Because I am 52, potency was important and it seemed like the HDR had pretty good results on that front.

I had heard mixed opinions on the addition of Lupron to HDR, or other chemical castration drugs, so really did not want to do that. I also heard mixed opinions on the usefulness of adding EBRT to my HDR. My doctor, Dr. Demanes, felt the internal radiation was strong enough that we probably did not need to add EBRT to the mix.

By the time I decided on UCLA, in January, 5 months after initial diagnosis, my PSA zoomed to 20.1. That was and is a huge concern, Dr. Demanes felt that was a huge increase from 15 to 20 in only 5 months, indicating the possibility the tumor had gotten into the lymph or bones. I will not know for sure if that has happened until my body settles down from the radiation, and i get PSA tests in 3 months.

So, I had two implants 1 week apart, each 13.5 Gray in strength. I had some painful urination and blood in urine, but after 1 week, those symptoms seem to be going down. I actually felt good enough physically to go skiing in between the implants. I have had a couple of erections since, and my doctor gave me a Cialis prescription, 0.5 mg daily, in order to get blood flowing back to the region, not so much for erections.

Overall, I am happy so far with the lack of symptoms. I have no pain, can urinate with no problems, and don't have to take long term prescriptions of Lupron or EBRT visits. I am hoping in 3 months to have a very low PSA and that the cancer has not spread

Glad to hear you're on the other side. I also had HDR brachy at UCLA, although with IMRT and HT (since I'm a glutton for punishment). I also had burning urination, but it calmed down after several days to a week. Good luck on those future PSA tests!

I just found out about the 20.1 PSA the week before the HDR. The PET scanner did not have the right isotope available, so we decided to do the HDR now. I understand it takes 3 months for your body chemicals to recover after HDR, so any tests before that will be suspect

You can get a NaF18 PET at UCLA, and a Technetium bone scan as well. They are not at all dependent on any "body chemicals" that recover (I assume you're referring to PSA). At any rate, it doesn't matter at this point. I'm just kind of surprised that Demanes didn't check that beforehand.

I'm glad to hear Dr. Demanes is still practicing, I had read somewhere last year that he had retired. He treated me with HDR mono-therapy in 2014. My PSA and the rest of my situation was similar to yours. I had a choice of mono HDR, or combination with external radiation. I chose mono-therapy in hopes of less severe side effects, at the time though,we were pushing the envelope a bit, since the accepted protocol for my PSA etc. was HDR combination treatment.

GDS,

I had an initial set back on sexual function, but recovered pretty quickly. Am now slightly below pre-treatment function. Still OK, except that I don't last as long as I did before treatment. I didn't realize that Dr. Kamrava had moved on, nice that Demanes came back. He was top notch in all of my dealings with him.

I'm also an HDR brachy grad from UCLA, in conjunction with IMRT and HT. I came out of with full sexual function, with the exception of no (or very limited) ejaculate, which is something they never seem to tell you about. I had no short term effects either, although I was on HT and that completely destroyed my libido. Everything worked...just had no desire to use the equipment.

The only long-term SE I have is that I don't pee quite as well, although that's remedied by taking Flomax.