Incredible pain 8 weeks after brachytherapy

MACH1

Hello - I am a 79 year old male who got diagnosed with prostate cancer in August of 2018. My scores were Gleason 6, Grade group 1. PSA was 6.78. In December 2024 MRI showed a slight increase in lesion on one side. Subsequent biopsy showed Gleason 7 (3+4) Group 2 in two cores and all others remained Gleason 6 Group 1. PSA was 10. I had always told myself that if there was an increase I'd stop the watching and waiting and be proactive.

My urologist said I needed external beam, brachy and ADT and had me talk to a radiation oncologist. He said that I fell into a middle area where a single modality would work or we might need all three and suggested a decipher test. This showed slow growing and very favorable outcome with brachy or external beam. I really wanted to avoid ADT. After a ton of research and speaking with three different oncologists I decided on LDR brachytherapy. After the procedure I was handling any side effects very well for 10 days but then all hell broke loose. Started getting incredible pain that kept getting worse and was unable to urinate. It got to the point where after a month I had to go to urgent care and get a catheter inserted. I could no long suck it up as my urologist suggested. The urologist had the catheter removed after 12 days and we did a void test which I passed. That evening I was back to square 1 and two days later had another catheter inserted. Urine sample showed a UTI which they surmised might have been from the original catheter but that could not be. Was having the issue prior to catheterization. The month and a half intense pain has beaten me up and I see no relief in sight. My oncologist says the side effects should have gone away by now.

Has anyone else experienced this after LDR brachytherapy? What I've been going through is not and cannot be considered a normal post op reaction.

Thanks for listening to my story.

Old Salt

Yes, certainly not normal after seeds implantation.

Did something go wrong during the implantation of the seeds? I imagine that the urologist will be loath to admit this, but it's a question that should be asked. On top of that you have a urinary tract infection. I hope that the proper antibiotic has been able to eradicate the infection by now.

MACH1

Hello, Old Salt. Yes the thought of something going wrong has certainly crossed my mind. I sent a note to my oncologist via his intermediary and among other things asked that. My normal urologist was not in attendance and I've no way to ask that of the urologist who was. He's in my health plan group but not listed as one of my providers.

The antibiotics seem to be working as my blood panel this morning showed marked improvement with most everything in the green and the two outliers quickly approaching. Just hoping when I'm done with those and the catheter removed next Thursday I'll be in the clear. It's been a nasty ride.

centralPA

It certainly seems like infection-related.

I've never heard of a similar occurrence in my admittedly small data set of reading posts from patients.

Sending strength!

MACH1

Thanks, that is certainly my hope too. Felt really well yesterday after meeting with doc. She prescribed a low grade antidepressant to help[ me with the stress related issues I've been going through and now I've had diarrhea today and was sort of out of it this morning. It really set me back mentally one more time. I've asked if I should drop the med but haven not heard back.

Catheter induced pain has really gotten me. Hoping I can hold it together till next Thursday.

I see you are centralPA. I'm a Nittany Lion.

centralPA

https://csn.cancer.org/discussion/comment/1724569#Comment_1724569

What year? Last century, I bet. 🙂

I work there.

MACH1

Definitely 20th century. 1967 grad.