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Posted 8/21/2013 1:48 PM (GMT 0)
Has anyone heard of seed implants for gleason 8, PSA 5, 1 core out of 12, 45%; contained. Does it make sense or am I not realistic?
Posted 8/21/2013 2:28 PM (GMT 0)
Hi Samg and welcome.  Before I (and others very soon) chime in too much it would be helpful if you could share more of your statistics with us - for example creating a "signature" in the "My Profile" section would be very helpful.  You can refer to mine and other posters here, at the very bottom of our posts.

In general with a G8 however my input would be that a combination treatment/approach of ADT+brachytherapy boost+IMRT is what is generally recommended.

Again, welcome to our little corner of the world and best to you.

Posted 8/21/2013 6:56 PM (GMT 0)
Hi Samg...sorry you're here and part of our club. Yoop's point about using brachy in conjunction with other treatments makes a lot of sense. In fact, for high-risk patients like yourself (Gleason 8 and above) the combo is generally regarded as one of the best treatments.

I'm also high risk (Gleason 9) and I had brachytherapy as my primary treatment, which I've combined with IMRT and hormone therapy. I had high-dose radiation (HDR) brachy, while you're asking about low-dose radiation (LDR) brachy since you referenced seeds. Both are viable as a primary treatment and this community could give you all sorts of info on the difference if you're interested. But bottom line, both would likely work for you.

Good luck and do let us know how else we can help.

Michael
Posted 8/21/2013 7:05 PM (GMT 0)
Hi samg and welcome. Theoretically, either LDR or HDR brachytherapy should take care of the problem. However, with a G8 physicians generally are more cautious and recommend brachy + IMRT.

Before you make a decision, however, I would suggest getting your slides read by an expert PCa pathologist such as Dr. Epstein at JHU or Dr. Bostwick at Bostwick Labs. Let's make sure you are really a G8 before making any decisions...

Good luck and stay in touch.\

Jim
Posted 8/22/2013 2:50 AM (GMT 0)
*******BUMP*******

We've got a new guy here looking for some help - while I obviously agree that the OD/OT topic is important, please, let's not forget the newbies out here looking for our help/input................

Posted 8/22/2013 3:00 AM (GMT 0)
My boss was a gleason 8. He did BT and Hormone treatment. Minus some minor SE during the treatments he did exceptionally well and has scored a 0 for 4 years now.
Posted 8/22/2013 12:47 PM (GMT 0)

Michael_T said...
Hi Samg...sorry you're here and part of our club. Yoop's point about using brachy in conjunction with other treatments makes a lot of sense. In fact, for high-risk patients like yourself (Gleason 8 and above) the combo is generally regarded as one of the best treatments.

I'm also high risk (Gleason 9) and I had brachytherapy as my primary treatment, which I've combined with IMRT and hormone therapy. I had high-dose radiation (HDR) brachy, while you're asking about low-dose radiation (LDR) brachy since you referenced seeds. Both are viable as a primary treatment and this community could give you all sorts of info on the difference if you're interested. But bottom line, both would likely work for you.

Good luck and do let us know how else we can help.

Michael

Michael and I are about 2 years apart and we can offer some great advice......good luck!
Posted 8/22/2013 2:56 PM (GMT 0)
At G8, I'd hit it with everything. Brachy + IMRT is a good combo but adding a short term HT plan might make sense too.

The real question is - what's the chance that the PC has escaped the prostate? If it's still local, brachy will do the trick. If it's escaped, you've got a different problem to deal with.

Andrew
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