Seed radiation treatment Information needed

I have set up for surgery but the more I read about the seed radiation treatment the more interested I become.  I am in the early stages according to my doctors.  Has anyone gone through that seed program?

Hello Esperanza:

My husband has undergone Brachytherapy and I have posted under JustJulie's Brachytherapy Journey - there's lots of information in there but if you still need to know more, post and I'll answer anything I can.

JustJulie

JustJulie, thanks for your informaation. I have done a great deal of reading but my doctor felels surgery is best. I ahve a telephone appointment withthe settleprostate center tomorrow to ask tehm questions. I am in my late 50's and my pSA and Gleason scores are law so I am in my early stages. Did ou go to Seattle which seems to be the predominant player in Brachytherapy?

Dear Esperanza

Let me give you my indirect knowledge of brachytherapy or radiative seed implants into the prostate. I suggest that you read the section of Dr. Peter Scardino's book on prostate cancer that relates to seed implants. he is one of the top open or radical prostate surgeons in the U.S. at Sloan-Kettering in New York City. while one might consider him biased because he is an expert surgeon, I took to heart his somewhat negative thoughts on seed implants (notwithstanding that they do many seed implants at Sloan-Kettering)

from what i have read, among the dangers of seed implants is that they can migrate to other areas of the body. moreover, it seems that a lot of seed implant patients have urinary complications, in particular, because the seed implants are close to the urinary tract which passes through the prostate. i talked to one patient recently who had seed implants in the summer of 2006 followed by some x-ray radiation treatments. he told me that he was unable to urinate (complete blockage of the urinary tract) and he had to be treated to relieve the condition which appeared to be related to the seed implants and not the x-ray radiation.

this is not to say that some seed implant patients have not had good experiences. the key is often getting the best expert doctor you can find for a particular PC treatment. were you referring to the Seattle Prostate Institute in Seattle? i believe that they are considered among the top experts in brachytherapy. the former mayor of new york, rudy guiliani, had seed implants a few years ago and he seems to be doing fine based on his current aspirations to run for president! i believe that he was treated by Dr. Richard Stock at Mount Sinai Medical Center in New York City, who has a good reputation for the seed implants. refer to this website which lists some of the top doctors who treat PC by type of treatment (http://www.prostate-cancer.org/resource/special.html). a few doctors at the Seattle Prostate Institute are included in the list.

my suggestion would be to talk to many patients who have had seed implants fairly recently to a few years ago, to see how they have fared. take a look at the www.yana.com (you are not alone) website, where many prostate cancer patients have posted their journey with PC whether it be surgery, seed implants or some form of beam radiation treatment. their stories are very interesting and informative--in most cases they give their e-mail address so that you can contact them. all the best.

Dave

Esperanza-

Two points:
1. "but my doctor felels surgery is best. " If (s)he is a urologist (and, therefore most likely a surgeon), (s)he has a biased view re: surgery vs. other options.

2. You talk about "seed implants" - are you aware of the other type of brachytherapy called HDR (high dose rate) brachytherapy?

-Gordy

Hey Esperanza

Sorry for my late response.  My husband was only 44 when diagnosed.  His PSA was 3.74 and he opted for Brachytherapy because the location of the tumour posed problems - namely if they cut too wide, he'd be left incontinent, if they cut moderately, they could split the tumour and leave some in.  He did not like the options so he went with Brachytherapy which is yielding the same results as surgery at this point.

We used Toronto's Princess Margaret Hospital - WONDERFUL experience there.  I have to mention that my husband has had NONE of the serious side effects mentioned - no urinary blockage, no erectile disfunction, no bowel issues (other than some inflamed hemmoroids) and no loss of appetite or irritable food issues so maybe we were lucky, maybe we were blessed with a great surgeon, I don't know, I'm just thankful.

If you need to know anything else, just holler, I'm happy to help.  Every doctor we saw thought their procedure was best.  What it boils down to is do what YOU feel most comfortable with and don't look back - best wishes to you.

JustJulie

Hello, it's just me stopping in again ...

Yes, my husband had a number of test to determine the location of the tumour including x-rays and an MRI.  It is apparently easier to remove a tumour in the middle of the prostate as you can don't have to worry so much about splitting a tumour in the removal - we didn't have a clear path for removal so we opted for Brachytherapy and have been pleased with the results.

My husband had a 91-seed implant, the man beside him a 102-seed implant.  Rated out of 100, his score was 97 for placement of the seeds.

Hi Esperanza, I noticed your question in regard to Seed Implant. I just wanted to add a few thoughts. I am also considering Seed Implant as I have been told that I qualify.
T1c, G of 3+3(6), Localized to left, psa of 10, age 74 and currently watching. Dre is normal. Size is approx 40.

I have found three types of Seeds, Iodine -125, Palladium -103, and Cesium -131. The last, Cesium was developed in Washington state and approved in US by FDA in 2004 but only a few clinics are licensed so far. All three are approved by Medicare and consequently most insurance plans.

What I have found interesting is the facts presented in regard to the Half Life of the Radiation. I want to believe that the shorter the Half Life, the quicker the total effect of the radiation will be over and out of the body. The half life of Cesium is less than 10 days, Palladium is 17 days, and Iodine is about 60 days.

From what I have found they are almost identical in treatment. One area to ask about is Hot Spots, ie some spots get over 100 % of treatment and some spots get less. What i read is that Cesium and Iodine is the stronger of the three. Iodine has been the most used.

Another point to consider is the method of treatment planning. Some clinics have developed improved techniques to place the seeds more accurately. One site that I am aware of calls it "Interoperative Seed Tracking". In addition, the mapping of the prostate is done just before the procedure and not a day or week before to maintain the most accurate placement.

I am still doing research on seed implants, the one thing that i like about the procedure is that it takes about 4 hours and it is a one time affair.
Hope this helps. If not let me know. I need all the thoughts that i can get to improve my thought process, I am running out of questions to ask or look into .

My Oncologist was a Seed specialist and initially wanted to do seeds. He sure told me how good he was for 30 minutes. After 1 1/2 hours of getting my history of Prosatitus and the size and shape of my prostate he said I really was not a good candidate. I was glad as I'd heard of the seed migration and being radioactive for some time. I also considered hi-dose radiation where they use radioactive rods and they are placed next to the prostate, 2 different times and your done. sometimes followed up by IMRT. A good friend had those two and is cancer free after 4 years.

I ended up choosing Proton Beam Treatment At Loma Linda.

Ken