My HDR brachy experience

Just finished my second (and final) HDR brachytherapy session and I wanted to report in how it went...

I had my treatment at UCLA in conjunction with external beam radiation (still to come and also at UCLA) and HT (started this past Nov). At UCLA, the protocol is for two treatments a week apart and each was two days with an overnight in the hospital. I had a "fraction" each day...if I had had this as a mono therapy, there would have been two fractions each day.

In general, everything went well. At the end of session #1 (a Friday), I couldn't pee on my own, so I had to go home with the catheter. It was removed the following Monday. I also got sick when I got home on Friday, which I attributed to the fact that I was going a bit heavy on the pain pump. I had neither of those issues the second time around. (I was really laying off the pain pump for session #2.) I had some frequent urination and burning for the first day and half. That's gone now, but my peeing is still a bit weird--stream is about 75% of what it was and although I can go hours before I need to go--when I need to go, I really need to go.

Being on my back for two days was a challenge. You could shift to your side, but only with the help of nurses so I never really got to stretch out. I was always a bit uncomfortable for this reason--particularly the second time when I wasn't really using the pain pump (which would make me sleepy).

My penis and scrotum were black and blue after the first session. I had assumed this was normal (I thought I had read that here), but when the docs saw me for the second session they were quite surprised. During a follow up consultation with Dr Kamrava today he told me he had "never" seen a bruised scrotum before and said they go nowhere near that area. Interestingly, it didn't happen during session #2 and everything is mostly back to normal.

Overall, I feel a bit more "beat up" than I expected to. Five days after the last session, I'm still sore down below and sitting is a challenge. If I stand for a while, the discomfort is greater. I was sent home with Vicodin, which I haven't taken, but I'm definitely tender. Others have said they were back at work right away--either they are super human or I'm a total wuss. While I'm sure I could work if I really wanted to, I don't really feel like working right now. (I'm self employed, so I have some control over my schedule.)

I thought the whole team at UCLA was great. For the record, I never met Dr Demanes during this, but I was fine with the doctors that treated me--Dr Kamrava and Dr Banjerlee. And the support staff was top notch--we sent them all Thank You cards. Now it's onto the external radiation, which will begin on Feb 4.

Michael

Thanks for posting your update Michael, these are always helpful for others and your detail is great. Continue to keep us in the loop and best to you.

I had two similar procedures, but I wasn't overnight with either. After the first I had urinary pain and for the second procedure they used a different lubrication on the catheter....problem solved I didn't have any need for pain meds and didn't use any. My scrotum and penis was black for a few days after each procedure. Other patients told me to expect this as did my rad onc. He said there is some internal bleeding when positioning the catheters and that gravity will pool the blood in these areas and is absolutely normal so no surprise here.

hi michael,
i just read this to harold and he shuddered - especially about the discolored private parts! harold is still waiting to be scheduled - we hope we will hear soon so we can make plane reservations.
aloha, viv

Jeez, you guys would scare me, but my HDR wasn't that kind of bad. I had 21 needles, and I will forever remember them coming out in the hand of the Rad Onc, but the cath came out at the end of the proceedure and I had no issues peeing right after. (I did have a slight problem a couple weeks later, but it cleared up once I passed some small blood clots.) I had no bruising, and my wife couldn't even see where most of the needles had been inserted. But I did settle into a sitting position gently for a couple days. For the higher Gleasons, I think the HDR should always be considered as a possibility. It's a major punch at the prostate with limited side effects. Combine it with IMRT to cover the outlying tissue with a wider killing swath. Probably the hardest part was the 8 hours between each treatment while lying flat (or a limited amount of side to side) and by the end I was ready to get the stuff out of me. But I would do it again as I think it is a great targeted treatment. My Rad Onc and Uro team up for this proceedure several times a week. Go for experience, just like anything else.