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Reoccurance of Prostate Cancer after Brachytherapy

MFR
Posts: 5
Joined: Jul 2012

I am 53 years old and had brachytherapy in 2/2010. My PSA rose to 4.5 and had new biopsy completed a couple of weeks ago, which showed risidual cancer with a gleason of 6. I am now researching my options for treatment. I would be interested in hearing from others who have been in my situation and learning what treatment they recieved and how they are doing. I am considering the temporary brachtherapy procedure or prostatectomy. There is so much research on success/failure, potential side-effects, that it's a bit overwhelming.

powellst
Posts: 5
Joined: Feb 2012

MFR,

I wouldn't jump the gun and rush into any treatment right away. I've talked with many men over @ seedpods, whose PSA didn't stabilize until 3 or more years after having seed implants. Have you had 3 increases in PSA levels over your nadir(lowest) level ? I talked to at least 3 guys who by definition had failed treatment, due to a several rising PSAs, but they waited the course, and all are at undetectable levels now.
Also, I heard that biopsy results can be very misleading after radiation, and it takes an expert to be able to interpret whether it is old PCa that is dying or dead, or new PCa.
Hang in there !, and get a couple of second opinions.

Kongo's picture
Kongo
Posts: 1167
Joined: Mar 2010

MFR, sorry to hear of your apparent recurrence. I'm wondering what your medical team is recommending at this point. Is another form of radiation a possibility? Did your most recent biopsy show any characteristics like PNI?

Could you share your history of initial diagnosis and evaluation, why you chose BT as a primary treatment option, and what the PSA history was that led to your present state?

Thanks in advance,

K

MFR
Posts: 5
Joined: Jul 2012

Thanks for your thoughts. After I had brachytherapy treatment, my PSA went as low as .7. After that, it has been a steady increase, with most recent up to 4.5. The Biopsy came back, showing cancer on the right side. What is PNI? Additional radiation treatment is available. Met with a radiologist who specializes in Robot Assisted Temporary Radiation Impants. He feels this could be successful, but of course, there are no guarantees. My concern is if I go this route and then it doesn't work, following treatment is minimal. I'm not crazy about the idea of being on hormones for the next 30 years. I also met with a urologist at the City of Hope, who feels I should have the prostate removed. My greatest concern is the damage to other areas that could occur, especially since it's a more difficult procedure due to having radiation. The reason I chose BT initally, was that my cancer was caught early and felt that treatment had a high success level and with minimal side effect. The side effects have been minimal - just didn't get all of the cancer. Just my luck. Any thoughts, ideas of where to research or speak to, would be greatly appreciated.

Samsungtech1
Posts: 350
Joined: Jan 2011

MFR,

There are several posts on this site about the types of test you should have and what they will show you. Unfortunately I am not the sharpest knife on this site. However there are several knowledgeable persons who do explain it very intelligently.
My suggestion would be to go over the old posts and see what type of tests you should do before you make a decision. You do not want surgery if it has spread beyond the prostate. Find out what is going on before you make any choices. Read the old posts.

Mike

derom_99
Posts: 6
Joined: Jun 2012

I would check out MD Anderson & John Hopkins web sites. I got so much info from these sites.

robert1
Posts: 82
Joined: Apr 2011

Hello MFR:

Has your Brachytherapy Oncologist given you any reasons for the rising PSA and recurrence?

I chose Brachytherapy because of its amazing long-tern track record, and it is amazing. In your shoes, I would seek out and consult with one of the best and most experienced professionals in this field before making a final decision.

There is a good chance that the procedure was flawed. Poor implantation (cold spots)may be the cause, but I would try to nail it down quickly before moving ahead with a more radical and potentially damaging solution.

Before pulling the trigger on any follow-up treatment, guys like John Sylvester, Michael Datoli and a group of other Raditation Oncologists, that have performed thousands of procedures, are your best bet. These guys will be your best guide because they have seen it all before.

I am sure its scarey, but you have options. When in doubt...consult the very best.

MFR
Posts: 5
Joined: Jul 2012

Thanks. I will do some research on these drs. I'm doing a lot of research,in hopes of making the best decision for my treatment. Not an easy task. Seems that the drs. advocate for the treatment they specialize in. Not surprising. Just wish there were some guarantees that what ever treatment I choose, will take care of the problem. But, there are no guarantees.

MFR
Posts: 5
Joined: Jul 2012

I continue to research possible treatment options. High Intensity Focused Ultrasound (HIFU) is being used in the UK and Canada. Appears to be having some success and is being used for patients who have previously had radiation. Am wondering if any of you know about this treatment or have recieved this treatment and if so, what do you think about it?

Kongo's picture
Kongo
Posts: 1167
Joined: Mar 2010

MFR,

HIFU is not available for regular use in the United States because it is not FDA approved. There are companies in the US that arrange for patients to travel off shore to various Caribbean islands or to Mexico for this treatment. Most insurance plans will not cover this treatment so most patients pay out of pocket.

There have been a very few posters in this forum several months to a year ago who tried this but there are no regular posters. I have read varying reports about the effectiveness and recurrene rates of this procedure. I do know that is can be used for recurrence issues and there is an investigative study ongoing now where you can actually get treated in the US but I believe it pertains to recurrence following external beam radiation, not brachytherapy.

You can check their claims out at www.ushifu.com.

Good luck.

hopeful and opt...
Posts: 1267
Joined: Apr 2009

I wonder if HIFU is a viable choice for radiation salvage therapy. If so this would be wonderful.

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