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Reoccurance of Prostate Cancer after Brachytherapy

MFR
MFR Member Posts: 5
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.

Comments

  • powellst
    powellst Member Posts: 5
    Brachy
    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
    Kongo Member Posts: 1,166
    Sorry
    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
    MFR Member Posts: 5
    Kongo said:

    Sorry
    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

    Thanks for your thoughts.
    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
    Samsungtech1 Member Posts: 351
    MFR said:

    Thanks for your thoughts.
    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.

    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
  • robert1
    robert1 Member Posts: 82
    Consult with Experience
    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.
  • derom_99
    derom_99 Member Posts: 6
    MFR said:

    Thanks for your thoughts.
    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.

    Locate research
    I would check out MD Anderson & John Hopkins web sites. I got so much info from these sites.
  • MFR
    MFR Member Posts: 5
    robert1 said:

    Consult with Experience
    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.

    Thanks. I will do some
    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
    MFR Member Posts: 5
    MFR said:

    Thanks. I will do some
    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.

    High Intensity focused Ultrasound
    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
    Kongo Member Posts: 1,166
    MFR said:

    High Intensity focused Ultrasound
    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?

    HIFU
    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 optimistic
    hopeful and optimistic Member Posts: 2,333 **
    Kongo said:

    HIFU
    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.

    clinical studies in the united states
    I wonder if HIFU is a viable choice for radiation salvage therapy. If so this would be wonderful.
  • PC5646
    PC5646 Member Posts: 2
    Following MFR from 2012

    I am new to this group. I would like to know "the rest of the story" for MFR. I had brachytherapy in July 2020. Highest PSA prior to seeds was  7.5. After seeds PSA was 3.5, then climbed to 8.1. July 2021 PSA down to 6.2.  Now trying to decide next step. More treatment or wait? Thanks

  • Old Salt
    Old Salt Member Posts: 834 **
    MFR

    hasn't been seen in a long time on this forum. But the consensus of prostate specialists is that HIFU is not recommended as primary treatment.

    No doubt that your outcome needs serious attention from your brachy doc.

  • PC5646
    PC5646 Member Posts: 2
    Old Salt said:

    MFR

    hasn't been seen in a long time on this forum. But the consensus of prostate specialists is that HIFU is not recommended as primary treatment.

    No doubt that your outcome needs serious attention from your brachy doc.

    Thanks Old Salt. I have

    Thanks Old Salt. I have another PSA scheduled at end of Aug. Will see the results and decide next steps

  • hopeful and optimistic
    hopeful and optimistic Member Posts: 2,333 **
    edited August 13 #15
    .






    does your radiation oncologist think that PSA bounce can be a factor in influencing your PSA levels. What does the RO say about your case?

    Experiencing a PSA bounce was associated with improved biochemical disease-free survival. PSA bounces are often seen after patients receive radiotherapy and are indicated by a temporary rise in the PSA level by at least 0.1 to 0.5 ng/mL without prostate cancer recurrence after radiotherapy.Oct 1, 2014






     





     

     

     

    People also ask



     




     

    How long does a PSA bounce last?

     

     








    It ranges from a minimum of 0.1 to 0.8 ng/ml above previous nadir in most studies. Bounces are often above +1 ng/ml, may last for more than a year, and are usually noted between 1 year and 4 years after therapy.Mar 16, 2018