Brachytherapy vs. BT plus EBRT

That’s a great result. HDR BT is faster and cheaper than any other modality (that I know of).

Well folks, as some may know I don't drop in much anymore - but this is 11 years after my Dx so I did look around. Of course once I saw Tudpock's post on BT I thought I'd add my own stats and singular treatment approach with LDR BT, to perhaps help those that may be in that stage of researching treatment options.

PSA got up to 5.8, resulting in a biopsy that showed 9 of 12 cores positive: 4 were 3+3 and 5 came back as 3+4. All were negative for perineural invasion. Staging came back as NO (No cancer detected in the lymph nodes.) / MO (Cancer that is confined to the prostate, surrounding tissues and pelvic lymph nodes.) / T1C (PSA elevated, not palpable, found in needle biopsy.) / Gland size 40gm and Vol. 22gm. (Indicative of a "small" prostate)

My RO also recommended LDR BT as a single treatment based on my stats, and his experience and results as one of the foremost authorities/practitioners of LDR BT. The results in my 'signature' speak for themselves, and I continue to live a healthy life with no SE's ever. (Awesome and current study results Jim!)

Best to all,
Yoop

A Yooper said...
Well folks, as some may know I don't drop in much anymore - but this is 11 years after my Dx so I did look around. Of course once I saw Tudpock's post on BT I thought I'd add my own stats and singular treatment approach with LDR BT, to perhaps help those that may be in that stage of researching treatment options.

Yoop, great to see you, and so glad all is well with you. I won't ever forget that phone call, where you talked me off the ledge when I was first diagnosed.
That's 11 years well deserved, very happy for you

centralPAdude said...
It is LDR BT, so correction on my part. Had to go to the actual trial page to figure it out. Even then, they never mention LDR or HDR. They do mentions seeds.

I suspected as much. Studies have to use yesterday's information for obvious reasons.

My Dad had LDR BT in Chicago area around 20 years ago and had recurrence at 13+ years treated with ADT for 2 years due to age and has had a couple of urinary strictures over the years that required procedures.

Based on that one observation, HDR BT would seem to be preferable where nothing is left in the prostate. It would be equally interesting to compare the two BT's when sufficient data exists.

JNF said...
The results should be similar as HDR is generally viewed as better in radiation field conformity than seeds and can vary radiation exposure to small areas better than seeds, so it should be more efficacious in cancer control.

@Jack, this is theoretically true I suppose but can you point me to any studies that prove this, especially for men who are well suited for LDR, i.e. PSA less than 10, T1C and Gleason 6 or 7? Thanks.

@Yooper. Glad to hear from you again and I'm especially happy to hear that you continue to do so well. Same here...almost 15 years and counting.

Jim

Davie, your treatment choice and the institute (UCLA) is as good as it gets. Based on my experience and many other men that have used HDR-BT, you will do very well. My only side effect from the HDR-BT was some nether-region tenderness for a few days after the second procedure. Avoided hard chairs.

Thirteen years later, it is like nothing ever happened. Undetectable PSA and absolutely zero negative treatment side effects. Best wishes for great and long lasting results.

Michael! congratulations that you are graduating twice at UCLA.. my treatment at UCLA was top notch, I am in for triple play and so far so good, beside little side effects that i can literally handled feel great, just so everybody to know, Docs at UCLA from now on HDR brachy will come with IMRT are standard for low risk and intermediate risk. I guess the treatment has changed. In some cases like me with gleason 4+3 t2a will add in 6 months ADT.

Post Edited (davie1803) : 8/16/2023 10:44:49 AM (GMT-8)

I definitely had low libido when on ADT. (Probably more accurate to call it *no* libido.) However, I didn't have ED--just no desire to do anything with it. My doc (not the UCLA RO) had me on cialis to encourage blood flow while I was on ADT, so perhaps that was the reason.

If you're referring to the side effects from the ADT, yes they went away but I found it a rather slow process. I did 18 months of Lupron/Casodex/Zytiga and while I didn't expect an immediate change when it ended, I think it took 3-6 months before I started to feel normal again. (It's been a while, so I'm not sure of the exact timing anymore.) You might want to ask about taking cialis while you're on Lupron just to make sure things are primed for when your libido comes back.

FWIW, my testosterone has never gotten back up to what it was pre-treatment, but it's high enough that I feel more-or-less the way I did pre-treatment.

I was on Orgovyx for 18 Months which drove my T level down to zero. My first 3 month check showed my T level above 200. My energy and libido came back much quicker. The hair loss remains on my torso. I never lost any hair on my face or head.
Jack