Brachytherapy

PhoenixM

I have recently been diagnosed with locally advanced prostate cancer. Gleason 9 stage 4a. My cancer has spread outside my prostate to a very enlarged lymph node in my pelvic region. I’m currently taking Orgovyx +Abiraterone and my Radiologist is recommending IMRT. Ive been doing research that suggests brachytherapy +IMRT+ADT will lead to a better outcome. My question is has anyone choosen brachytherapy + IMRT+ ADT as their treatment plan and what has been the outcome? I know brachytherapy has to be done by a very experienced Radiologist who does a high volume of these seed implants to be successful. Can anyone recommend a Radiologist who is an expert in brachytherapy?

centralPA

Are you thinking HDR or LDR brachytherapy? Or not sure?

vmen70

I am Gleason 8, and my radiologist would not do Brachy + IMRT + ADT. As I am 72 years old he felt the toxicity/side effects would be too much. Not sure but he is the expert. So just IMRT + ADT. I am just about completed the 2 year of ADT. Luckily my side effects been not too bad. Main effects is hot flashes and more times during the night peeing. Not sure its because I wake up do to flashes or not. Good luck to you!

PhoenixM

https://csn.cancer.org/discussion/comment/1714079#Comment_1714079

I’m not really sure. I have a virtual meeting set up with a Radiologist at UCLA who specializes in HDR. Have you had any experience with brachytherapy?

centralPA

https://csn.cancer.org/discussion/comment/1714121#Comment_1714121

Just deep reading.

Fox Chase has a nice webpage on it.

https://www.foxchase.org/clinical-care/conditions/prostate-cancer/treatment/radiation-therapy/brachytherapy

Otis335

I'm 71 and was diagnosed with 4+4 last fall. Negative PSMA scan. I'd been on AS for a couple years and did research to prepare myself in the event I needed treatment. I was impressed with how brachy is associated with better results - it makes a lot of sense to treat the prostate directly. I started Lupron on 11/1/23 and had one session of HD brachy later that month (not seeds). In December I had 16 IMRT sessions.

MO originally said 12+ months of Lupron. During this process, I finally got my second biopsy opinion (Johns Hopkins) which changed my diagnosis to 4+3. Now MO says 6 months ADT is ok, so won't get any more shots. It's obviously way too soon to give results, but my PSA has been undetectable since week 4 and my testosterone is in single digits. I had a follow-up with RO this week and she is very comfortable we treated it aggressively.

Brachy was done at UTSW, an NCI center in Dallas. It was a full-day process; the only drawback was needing a catheter for a couple days. No other complications. The IMRT and Lupron do present some side effects that I'm working through. But I believe this was the best treatment for me and I'm glad I did it.

Steve1961

If any of your cancer is cribiform be careful cribiform is radiation resistant I had I MRT and Breaky therapy. The side effects were not that bad . I got loose bowels now that’s about it but I have to take Flomax in order to urinate but it didn’t work so now I’m having surgery.

watertender

https://csn.cancer.org/discussion/327814/brachytherapy

Hello, Gleason 9 here T3aN0M0. Confined to prostate as far as I know. You are correct with your research as that is what I found also. I had HDR brachytherapy at UCLA Dr. Chang, one of the best in this procedure. Seems most are doing the seeds which can be somewhat more problematic.

After the brachy I then had 25 IMRT whole pelvic & lymph nodes followed by ADT. Just finished my 2 yrs and so far PSA still down. You may want to contact Dr. Chang in Radiology at UCLA for a second opinion.

Good luck to you.