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Looking for Brachytherapy at Kaiser Roseville feedback

JoseSF
Posts: 4
Joined: Nov 2015

I am a newly diagnosed mid 40's guy, stage 1Tc. Seriously considering brachytherapy at the Kaiser Roseville location. Anybody that got treated there care to share their experience?

hopeful and opt...
Posts: 2218
Joined: Apr 2009

Jose,

From various posts that you have made, it appears that your are reviewing various options for treatment, and have an interest in brcahytherapy. That you are also a current patient of Kaiser in the San Francisco area.

First, if you will, please let us know the results of the various diagnostic tests that you have had; that is, for the biopsy, how many cores taken, how many positive--what was the Gleason score for each positive core, and the involvement, that is the percent of the core(s) that were cancerous. Any other information presented in the pathology results. Did you have a second opinion of the pathology by a world class pathologist that does not work for Kaiser(Doing the pathology is subjective, and it would be of benefit for you)

Was the digital rectal exam normal?

What is your PSA history.

Any other diagnostic tests.

Another point that you may be able to consider; this month, now is the time that you can switch health care providers effective January 1, 2016. A PPO or other providers offer a wider availability of diagnostic tests, ie. you will be able to obtain an MRI T3 that may provide insight into whether or not extracapsular extension exists. You will also be able to find top doctors, support medical personnel and state of the art facilities at centers of excellence such as UCSF, a world class operation.

I don't live in the SF area, but I read on this board that SBRT (cyberknife exists at Kaiser in the SF area), an ecellent choice is available at Kaiser. Of course Kaiser, offer surgery (which may have sever side effects, however these operation are more successful with younger patients such as yourself, than among older patients, brachytherapy can be a excellent choice- are you interested in temporary or permanent seed inplants? I remember reading that temp is a better choice.

If you are interested in having children, you may wish about storing for future use.

Best

h

 

JoseSF
Posts: 4
Joined: Nov 2015

Thanks for the reply. My stats are:

14 cores taken, 4 positive, all on the left side

1 is Gleason 3+3  3 mm

1 is Gleason 3+3  < 1 mm

1 is Gleason 3+3  5 mm

1 is Gleason 3+4  7 mm

Grade 3+4+7

Prostate Size 44

PSA Density 0.11

PSA 4.9

I am considering permanent seeds Brachytherapy or Robotic surgery. Kaiser does offer Cyberknife but was not offered to me as an option but have asked.

Thanks,

 

Jose

VascodaGama's picture
VascodaGama
Posts: 2961
Joined: Nov 2010

I wonder if you have any image study result.

Brachytherapy has high success rates within The treatment choices. However the protocol should involve the whole gland, not just one globe as it seems to be your case. I suggest you to discuss details of the seeds protocol with your radiologist and compare such with another radiation protocol administered externaly (EBRT). Cyberknife is equally efficient to HDR bracky.

Please read these links. There is a table regarding performance which may be of interest to you.

http://www.sharefaith.com/guide/Christian-Holidays/information-on-all-saints-day.html

http://www.prostatecancertreatmentcenter.com/prostate-cancer/the-big-picture/

Best wishes and luck.

VGama  

hopeful and opt...
Posts: 2218
Joined: Apr 2009

V.....Unless things have recently changed, Kaiser does not have MRI T3 available to patients. ....Jose, this MRI is fairly effective in determining if there is extracapsular extension.

I do not know about other image diagnostic tests that may be available at Kaiser.

H

 

PS. FYI........Brackytherapy is not offered to those with large prostates.

Max Former Hodgkins Stage 3's picture
Max Former Hodg...
Posts: 3230
Joined: May 2012

JoseSF,

My understanding matches what hopeful and optimistic wrote:  Seeding therapy (BT) is not recommended for men with significantly enlarged prostate. ("Normal" prostate size is reportedly about 25 gr; mine was aroound 52 gr when removed).  It is also counterindicated in men with urinary flow difficulties or previous TURP proceedures if you are having that symptom. 

This is the opinion given by Dr Peter Scardino, Director of Surgery at Sloan-Kettering Cancer Center, in his Prostate Book, but what constitutes "significantly enlarged" varies. Dr. Scardino writes that glands under 60 gr can be reasonable candidates BT (p. 356)

IGRT radiation delivery has success rates close to identical to Cyberknife, although Cyber is much quicker and more convenient.  Virtually any up-to-date radiation oncology center will at least have IGRT, along with Cyber. 

Regardless, you seem to have a pretty mild case of PCa, which should be cured by whatever first-line approach you choose.

 

max

Swingshiftworker
Posts: 1013
Joined: Mar 2010

I was screened for BT at Kaiser Roseville but did not go through with that treatment because, after doing my due diligence, I decided that CK (Cyberknife) SBRT (stereotactic body radiation therapy) would be better. 

Here are the pros/cons of these methods that resulted in my decision:

Low Dose BT:

The plan for the placement of the seeds can be wrong or done improperly causing damage to adjoining/non canceorus tissue including the rectum, bladder, seminal vesicles and urethra.  Urethral damage is most common and can result in urine blockage caused by scar tissue requiring a TURP (one or more times) which can also be very painful.

The seeds can move around causing the same problems noted above.

The seeds are in your body FOREVER.

The seeds have a 1/2 life of a year during this time you should NOT have close contact w/young children and/or pregnant women.  You may also set off geiger counters and metal detectors the airport (or elesewhere) and will have to make sure that you have your BT treatment card with you at all times.

Catheter has to be installed and may have to remain in for awhile; have to go back to the hospital to remove it.  May have to take time off from work/other activities to recuperate from the procedure.

Urinary and erectile dysfunction problems are NOT uncommon w/BT but not as several as w/surgery.

CK:

CK was modeled upon High Dose BT and achieves similar results with much LOWER risk of side effects.

Between LD and HD BT, HD is preferable because the seeds are NOT placed in the prostate permanently but the same risks associated w/LD BT also apply to HD BT.  I do not believe that Kaiser does HD BT.

The CK radiation plan is delivered by computer in 3 dimensions using an arm and table that moves in cooridation w/the plan, the computer adjusts for movement in the body and internal organs (treatment is stopped if movement causes the possibility in a mistake in delivery) and radiation is delivered at the sub-mm level which extreme accuracy; all of which contributes to minimizing any possible adjoiing tissue damage and reducing the potential for any side effects.

Only have to install 3 gold markers in prostate to facilitate treatment.  Need to do a follow-up MRI to 3D map the prostate using the markers as indicators.

Treatment is completed in 3-4 sessions (not usually done every other day) over a week.  No catheter or other medical device required.  Can have treatments done while still working.

Side effects are virtually non-existent IF the treatment plan is executed propertly.

---------------------------------------------

These are the reasons I chose CK over BT. 

FYI, I was a lifetime NorCal Kaiser member before I discovered that I had PCa.  Kaiser did not provided CK treatment for PCa at the time that I was diagnosed w/PCa in Jan 2010.  I understand that they have since changed this policy and now treat PCa w/CK at the SSF CK location.  I had to withdraw from Kaiser and enroll w/Blue Shield to receive CK treatment at UCSF in Sep 2010.  Although the process was slow for me, my PCa is now deemed to be in remission and I had NO side effects whatsoever from the treatment. 

So, I strongly URGE you to investigate the possibility of receiving CK treatment at Kaiser SSF of BT at Kaiser Roseville.

Good luck!

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