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Stop halfway thru radiation and do brachytherapy - anyone done this?

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Posted 6/18/2015 1:38 PM (GMT 0)
Was scheduled for 45 radiation treatments. Now the doctor says he wants to try something new. He wants to stop radiation at 25 and do brachytherapy. Anyone had this done?

Thanks
Tom
Posted 6/18/2015 2:36 PM (GMT 0)
For intermediate and high risk guys (like you and I) it is very common to combine EBRT and brachytherapy. But, it is usually planned that way before starting.

As Tud says, you need better reasoning on the re-think and perhaps another opinion. How many Gy of radiation did the original plan call for? He is probably stopping now because if he did the full 45 sessions, additional radiation from brachytherapy would likely be too much total radiation. What type of brachytherapy is he suggesting? Seeds of High Dose? What is his expertise? Is your urologist in the loop? What does he say?

It is obvious you need a lot of info in a limited period of time. Good luck.
Posted 6/18/2015 4:04 PM (GMT 0)

goatts said...
Was scheduled for 45 radiation treatments. Now the doctor says he wants to try something new. He wants to stop radiation at 25 and do brachytherapy. Anyone had this done?

Thanks
Tom

I had mine at the beginning and again at the end of my radiation sessions.
Posted 6/18/2015 5:00 PM (GMT 0)
Just to clarify. I'm scheduled to start 45 days of radiation next week. The doctor says instead he would like to do 25 days and then nuke it with brachy. I'm going to talk to a brachy specialist Monday.

Thanks
Tom
Posted 6/18/2015 5:29 PM (GMT 0)
Makes sense. That is what I did. 25 factions of IMRT and two HDR brachytherapy procedures. The HDR procedures were done with about 10 fractions of the IMRT left.

In my opinion, the treatments and practitioners y should all be coordinated into a complete plan. I would think the IMRT would only start once the rad-onc doing the IMRT and the rad-onc/urologist doing the brachytherapy have collaborated on the plan. That you are only seeing the first brachytherapy rad-onc as you are starting the IMRT concerns me. What if you don't like him? What if you want to consult on both seeds and HDR before you decide on the method? I would want this all confirmed before I started any treatment. That you have started Lupron tells me that you have time to sort all this out.
Posted 6/18/2015 6:06 PM (GMT 0)
I also had 25 fractions and two HDR brachy procedures. But I share the same concern as JNF--the combo treatment should be part of a well-thought out plan...not dumped on you the week before. I agree that you should take a breath and get this sorted out.
Posted 6/18/2015 6:20 PM (GMT 0)
I gather from JNF and Michael that this is probably HDR Brachy with your IMRT. But it certainly seems kinda spur of the moment as opposed to well planned. I agree to taking a breath until you get some answers and get comfortable with a well thought out plan.

Jim
Posted 6/18/2015 9:03 PM (GMT 0)
does he plan to do the rest of the treatments after BT?

ed
Posted 6/20/2015 12:16 PM (GMT 0)

F8 said...
does he plan to do the rest of the treatments after BT?

ed

No, it would stop at 25.
Posted 6/20/2015 7:06 PM (GMT 0)
oh. I think I get it. in other words you were going to get straight IGRT and now he wants to do a combo treatment? if you are intermediate to high risk I think combo treatment makes sense. that's what I had and I am in remission going on five years.

ed
Posted 6/20/2015 10:09 PM (GMT 0)

F8 said...
oh. I think I get it. in other words you were going to get straight IGRT and now he wants to do a combo treatment? if you are intermediate to high risk I think combo treatment makes sense. that's what I had and I am in remission going on five years.

ed

I'm going to talk to the brachy doctor Monday. I found a European study that says the combo can double survival rate for high risk patients which is pretty impressive. I'm high risk since my PSA is over 20. Thanks for the input.

Tom
Posted 6/20/2015 10:16 PM (GMT 0)
Combo treatment can make sense. I think that what stands out in your case is that it wasn't planned from the start and seemed to be more of an audible. Also, the common wisdom here is that you want a great brachy doctor...not sure where you're being treated.
Posted 6/20/2015 11:37 PM (GMT 0)
Tom, I don't think it's the combo treatment that has some of us concerned - it's the sudden and unexplained switch in plans. I recommend that you be your own best advocate and get a COMPLETE understanding of what's going on before lying on the table. Will be very interested in what the brachy doc says -- just make sure he/she is well experienced...ask for their stats.

Jim
Posted 6/21/2015 1:54 AM (GMT 0)

Tudpock18 said...
Tom, I don't think it's the combo treatment that has some of us concerned - it's the sudden and unexplained switch in plans.

Jim

The sudden change was the result of my switching doctors. Switched to another doctor in same group. Sorry, should have made that clear. Thanks so much for all the replies, very helpful.

Post Edited (goatts) : 6/20/2015 8:05:14 PM (GMT-6)

Posted 6/21/2015 4:15 AM (GMT 0)
Goatts,
With you high psa and high volume the combo treatment makes sense. You get a higher dose of radiation with the same side effects as external radiation.
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