Brachytherapy vs Surgery

Hello and thank you, in advance, for any input you might have.

My dear partner, age 59, was recently diagnosed with PC. Three biopsies were positive—one 3+3, the two others were 3+4. We’ve seen his urologist who suggested surgery, but also mentioned brachytherapy as an option. We met with the surgeon last week, and while he seemed optimistic, he did present some aide effects that appear to be a very slight possibility. From what I’ve read, though, men seem to have less severe, long term symptoms with the brachytherapy. Plus, from what I’ve read, the seedsappear as though they are equally as effective at treating the cancer. For me, I want him alive first and foremost. That said, as you well know, this is a very difficult and sensitive condition on many levels, and I also wish for quality of life for him (he is still working full time). The professionals seem to push the surgery, but I don’t want him to discount brachytherapy. We meet with a radiation oncologist in a few weeks. Hopefully that will help guide the decision. Thank you, again.

Hello HisSupport and welcome. Sorry you have to be here but hopefully you will find this a supportive and helpful place.

It's not surprising that his urologist suggested surgery. Most urologists are surgeons and that's what they know best. You don't generally ask a carpenter to do plumbing, etc. That said, with your partner's diagnosis he is very likely to be cured by any number of treatment options and if you do your due diligence you should explore most of them thoroughly. The first thing you should do, however, is to get certainty on the diagnosis. That means sending his biopsy slides to an expert in PCa. For many of us that means Dr. Jon Epstein at JHU. Read the sticky thread at the top of our forum and you will find out how to do that.

Assuming Dr. Epstein agrees with the diagnosis then you guys need to see various specialists. With his cancer I would suggest specialists in surgery, SBRT, LDR Brachytherapy (permanent seeds) and HDR Brachy. The radiation options mentioned are just as likely to cure him as surgery but with a better chance of avoiding onerous side effects like incontinence or ED. However, each of these radiation options have their own specialists and one may or may not have expertise in the others. If you want to share your geographic location then it's likely that some of our members may be able to suggest excellent doctors to you.

Good luck and stick with us. We are here to help you both get through this.

Jim

How long ago did he get his diagnosis? You may be rushing things. It may surprise you to learn that men with a small amount of GS 3+4 sometimes qualify for active surveillance. I'm not saying it's his best option, but I want you to understand that a decision does not have to urgently be made. This kind of PC is usually very slow growing. You have plenty of time to meet with experts in brachytherapy (both kinds) and SBRT, if you have access to them.

For now, the best you can do is to decide not to decide, especially while awaiting confirmation from Epstein.

Where are you located? We may be able to recommend some specialists.

Similar numbers and age at diagnosis here. As others have said, based on the numbers, your partner's condition should be treatable by any one of several different therapies, or may even be a condition that may not require immediate treatment, and could be monitored rather than treated at this time.

Meet with providers of different treatments to determine what you are most comfortable doing.

Like Subdenis, I had HDR BT, as I decided it was the best combination for me of effectiveness and low risk of Side Effects.

Thank you all for taking the time to reply. We both feel supported by your help.

We are in Portland, Oregon.

Welcome and we're sorry you're here. That said, I think it's great that you're researching and advocating for your partner. My husband was diagnosed in 2015 and I have received some wonderful advice here, as well as lots of emotional support. My husband is doing well, but I've stuck around as I've come to feel like part of the "family" here. Stick around, you'll get lots of good advice and support! Sue

Check out a member on here Subdenis he had branchy and I am very impressed with his report

Stan1961 said...
..I did the combo EBR and brachytherapy ...too many side effects ..and you won’t know fir years if it’s gone ...personally now I would like to know in 6 weeks if it’s gine

So Stan you are saying that if you have RALP you know in 6 weeks that the cancer is gone? Look at how many members on here had surgery and are going back for SRT! No guarantees with either treatment!

Stan, how about if you didn't have prostate cancer, no need for radiation or surgery.

Stan, we are all sorry you are hurting. But I will repeat (again) that many of the comments you repeatedly make about both surgery and radiation are incorrect. You can accurately report on your individual situation but your generalizations about the various modes of treatment are neither accurate nor helpful - especially to new members.

Jim

Ok fine let them look it up fir themselves ..but look at allll the dude effects from radition both long snd short and secondary cancers as well

Why are we allowing Stan to hijack this and other threads with his incessant "trolling". He has incorrect data, has been told that by just about everyone. He only wants to stir the pot and is doing serious damage, IMHO.

We should be talking about the concerns of this new member not all of the same old c**p from Stan.

HisSupport: I apologize for where your thread has gone I just hope you can understand that all people are not interested in helping others, some just want to feel important and others make themselves feel better by making others feel worse.

Roger

Please do delete the non-responsive comments to the OP. I feel bad her post is hijacked. Nike has an ad slogan that applies here.