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Very High PSA 2 Years after Iodine Seed Implants

mcdcc
Posts: 4
Joined: Oct 2009

I underwent radioactive iodine seed implants over two years ago. My PSA kept coming down from 7.0 with an original Gleason score of 7 to .5 until 8 months ago. Then it was 11, 17, 25 28, 28 and now 32. Each of these tests were after 30 days. The first two tests were after a round of Cipro and then Sulphur. Bone scans are negative. CT Scans are negative. Prosatate is enlarged but no nodes obvious in digital exam. CT Scans negative. Blood Testing for markers negative. Consistant burning during urination.
I feel good. My urine steam is weak but not difficult. ED and loss of libido present. Fullness in the pernium area. It feels like when I had chronic prostatitis.
I am 58 and in good health, except this.
My Bracheotherapy was done at The Seattle Prostate Institute.
I am thinking of going to Mayo in Arizona to get to the bottom of this.
Any suggestions would be helpful and appreciated.
I am working with an MD, a urologist and the Dr. who performed the seed implant. They are scratching their heads.

William Parkinson
Posts: 60
Joined: Oct 2009

Hi. Around one third of all brachytherapy patients experience a temporary rise in their PSA. It is often thought that this is due to radiation damage to the cells resulting in lysis (cellular breakdown), where the cellular contents are released out, which causes the PSA rise. It is more often than not accompanied with a return of the urinary symptoms that were there early on. Also, it usally happens between 18-24 months for most men. All of that points to something like that happening. However, I have never heard or seen anyone having the type of PSA rise that you are having now. Any number that high can't be ignored. I don't know if you see Landis or Eulau, but if it were me, I would have them do a biopsy. But be aware, at this pont, many times a biopsy well still show some so-called viable cancer areas or areas that can't be determined. Usually, given more time, the positive regions and the indeterminate regions turn negative. If you need to see someone in your area I would see either Dr. Peter Grimm (who was one of the original founders of the Seattle Prostate Institute at Swedish), who is in Northgate and Tacoma or Dr. Kent Wallner, who is at Group Health in Seattle and the Puget Sound VA hospital (he is also one of the most published doctors in brachytherapy and he co-wrote with Blasko, Dattoli and Merrick "Prostate Cancer made complicated"). I hope this helps and I hope that it is all just the dreaded "bounce" that sometimes happens. This is, by the by, the one reason why so many men keep away from brachytherapy. It is this uncertain time, which can happen that scares everyone involved!!! Good luck!

mcdcc
Posts: 4
Joined: Oct 2009

Thank you for your insight.
Dr Grimm did my original seed implant and is my current Dr.. He is also not familiar with such a large bounce and I am talking to him on Monday.
I think the next step will be a biopsy but it feels like starting all over again and salvage surgery has a terrible reputation.

William Parkinson
Posts: 60
Joined: Oct 2009

I just talked to Dr. Wallner and he said you could call him and he would talk to you; you don't even have to go and see him. He is a nice guy and he might give you some helpful insights. Let me know if you want his number. I hope that all will go well for you.
Cheers
Bill

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