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HDR Brachytherapy treatment this week

grahambda
Posts: 21
Joined: Dec 2017

Well  after a year of being  diagnosed with Prostate Cancer following  a biopsy, I jumped into full blown analysis mode  and after many weeks of research re treatment options, side effects and visits to various oncologists, radioligists  this is the week I undertake my chosen treatment.. HDR with duraseal at Moffitt in Tampa.  Today was the Pre-op getting ready for the treatment on Friday. All very professional 4 hours of blood work, EKG and numerous meetings with nurses and lots of repeat forms to complete and prescriptions to get filled. My wife was with me and did well other then an emotional moment when discussing living wills and going over the potential and probable side effects.  It seems all very surreal, I have absolutely  no symptoms in fact following a few months of healthy eating and exercise I feel better now than I have felt for years. But when the blood tests came back from this mornings draw  with a PSA of 16.5 (up from 12.00 a few months ago) reality came to the fore and realization this has to be done. A few days of anxiety ahead of me but I’ll post again after the op to let you know how it went. (Round II of same treatment scheduled in 3 weeks). Whatever the happens I feel this is the right treatment  decision for me and I have comfort knowing I spent the time needed to research and that I am in control and educated (but of course have no control of the outcome).

Max Former Hodgkins Stage 3's picture
Max Former Hodg...
Posts: 3121
Joined: May 2012

gra,

High-dose brach is a reasonable first-line choice for PCa treatement, if the disease is not believed to be very aggressive or advanced.

Moffitt is very highly regarded, and is a popular choice for serious cases of PCa among guys in the Southeastern US.   You should get excellent treatment and feedback from your medical team.

It is good for everyone to have Advanced Medical Directives, but your PCa situation, as described, is most definitely not currently life-threatening, and might never be.

VascodaGama's picture
VascodaGama
Posts: 2945
Joined: Nov 2010

G

Best wishes for an eventless treatment. It took you one year to draw a decision and I think you did well researching for that one you trust the most. You are confident and surely chose the best. Now you need to think on how to deal with any eventual side effect. As you comment no one of us can predict on the outcome but I hope to read in the future about your remission levels.

Your story is here;

https://csn.cancer.org/node/313462

https://csn.cancer.org/node/315737

Let's hope for the best and peace of mind

VG

Old Salt
Posts: 755
Joined: Aug 2014

What's the purpose of the duraseal; could you please elaborate?

grahambda
Posts: 21
Joined: Dec 2017

its a gell like substance that is placed between the rectum and the prostate ahead of the HDR treatment, apparently has good results in lessening potential side effects by providing a buffer/protection for the rectum during the radiation. Apparently it is absorbed naturally after about a month, you may need a “top-up” for the 2nd session which are typilcally 2-3 weeks apart. Apparently it is not currently FDA approved for this specific use (although it has been approved for other areas of the body including the brain), you need to sign a separate waiver. 

Max Former Hodgkins Stage 3's picture
Max Former Hodg...
Posts: 3121
Joined: May 2012

I've heard guys mention use of Duraseal here for RT PCa treatments in the past (it's been a while however).  None that I can recall mentioned problems with it,

max

grahambda
Posts: 21
Joined: Dec 2017
Well 24 hours after the first HDR Brachytherapy treatment, all went well with the procedure after the normal pre- surgery  prep the Dr came in explained the whole procedure again with my wife and i and then off to the OR around 9.30am. General anesthesia for the initial procedure to fit the guide for the catheters all 18 of them and the placement of the gell and two gold marker seeds. Apparently this took just under 2 hours, then woken up wheeled down for a cat scan to fine tune the placement of the needles, this was the only painful part they had to adjust 3 times to get the needles just right but I had access to pain Med pump so not too bad.
 
Then waited for 60 mins or so as they planned  for the duration of the radioactive seed into each catheter. Leads were then attached from the afterloader, still awake, but felt nothing just heard the machine doing its thing. Took 15-20 mins or so. Then they sedated me to remove the needles and guide plate.  Back in recovery room around 3.00pm and drank what seemed to be gallons of water (can’t leave without peeing ) the sight of a dangling catheter was enough to get things moving!
 
Wife arrived got dressed wheeled down to the valet , in the car and off to the local hotel. Lots of meds to take Flowmax, painkillers (although didn’t need them) , Celebrex and stool softener. Urinated every couple of hours though the night, not painful just slow stream. Drinking lots of water. Walked around the hotel last night and 40 minute walk around the campus this morning. Lots of walking and lots of water was the intructions to strengthen the pelvic area and keep the urine clear and ensure no blockages.  Little sore and ice pack helps,the procedure was a lot less painful and stressful than I expected and the team at Moffitt are outstanding.
 
Off home later today back on Jan 25th to do it all again! Will keep you posted on side effects as the days and weeks go on. Then the all important PSA test in 6 months time.
Old Salt
Posts: 755
Joined: Aug 2014

for the detailed report. We haven't seen much about the HDR brachy procedure on this forum. And glad that the procedure went well.

I am sure your PSA will be down considerably once it's all over. 

Best wishes for the second step and thereafter.

VascodaGama's picture
VascodaGama
Posts: 2945
Joined: Nov 2010

G,

Great report. It will help the many to understand the HDR treatment, in particular those considering to have the same. I am surprise that you did not need pain killers 24 hours post administration. Overall seems that you are in the good path. Congratulations.

Hope things go smooth in the second step too.

Best,

VG

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