HDR Brachytherapy

stiva Member Posts: 2 Member

My question is to those who experienced HDR Brachytherapy, the treatment and the post surgery results.

Recently diagnosed with Pi-RAD 5 lesion. Extracapsular extension suspected. PSA went from 6.9 to 11.5 in 3 months but now 9.0. Urologist offered radical surgery. 2nd Urologist said I should do something so sent me to Tacoma Valley Radiation Oncology and to a local Robotic Surgeon. So far I have met the Radiation Oncologist who suggested many options. First was active surveillance, anything else he said would be a matter of preference on my behalf if not wanting to wait any longer. He also said, if surgery to consider robotic, if radiation then the 2 options are external radiation and HDR Brachytherapy. With my GI issues and all I am reading, the HDR Brachytherapy might be my best answer. He told me to go enjoy my vacation, take my time to seek an answer and then make an informed decision and he gave me plenty of resources. My robotic surgery consultation is not until after my vacation. Your feedback will be appreciated.


  • eonore
    eonore Member Posts: 182 Member

    Hey shiva,

    Did you have a biopsy? If so what were the results?


  • stiva
    stiva Member Posts: 2 Member


    Yes, I had a biopsy the end of February and the MRI in July. On the biopsy, 9 of 12 samples were Benign-negative for malignancy.

    Right mid-highly suspicious for adenocarcinoma

    Right apex-Prostatic adenocarcinoma, Gleason 3+3, grade group 1, carcinoma involves 1 of 1 cores, 10% of tissue Perineural Invasion not identified.

    Right lateral apex-Ditto above, but 5% of tissue.


  • Old Salt
    Old Salt Member Posts: 1,412 Member
    edited August 2023 #4

    Active Surveillance?

    I am aware that I didn't answer your question; Sorry!

    However, I can state that HDR Brachy is a specialty that requires a highly experienced practitioner. Not many around, it seems. Some have ascribed this to monetary issues...