alan meyer

For those considering high dose rate brachytherapy, here is my
experience so far, 2 days after the procedure.

My prostate region is tender. It hurts when I sit or when I cough,
but the pain is not bad. I rated it a 2 on a scale of 10 (let's say a
10 is getting your finger caught in a car door slam.) In my case
I had some kind of prostatitis going into the procedure and already
had some pain. The procedure has added to it, but it hasn't been
a problem. I am able to walk and sit, but I take things easy and
go slowly and carefully sitting down, getting up, getting into a car,
etc.

I also had a prostate biopsy taken while I was under the anaesthesia.
That's not part of my treatment - it's part of another clinical trial
I signed up for to enable the scientists to get pre and post radiation
tissue to examine. The biopsy is probably contributing a bit to
the pain.

I'm actually enrolled in four clinical trials. One is for treatment and
the other 3 just let the doctors draw extra tissue, blood and urine
for scientific research. I figure I've got some tissue, blood and
urine to spare and I might as well put it to some use.

So far, urinary effects have been slight. I had a Foley catheter
for the procedure but it came out 2 hours later. I was able to
urinate right from the beginning and I did not experience significant
incontinence (a few drops with the air puffs - see below)

There is still blood in my urine, but not much. I have had a few
small clots come out. I didn't really see them but believe they were
there because I saw red trails in the toilet water. I also had some
air in my bladder, apparently caused by introducing the catheter.
This has been coming out in little puffs, bringing a few drops with
it - which is the only incontinence I've had. I have experienced
a little more urgency in urination and it somehow feels a little
different, but I don't know how to describe the difference.

My bowel functions have not been affected at all.

For me, the biggest short term problems were headache and
some nausea from the anaesthesia - lasting about 48 hours,
and a bad reaction to Flowmax. Your mileage may vary on that.

Long term - we'll see. The doctor said she was able to avoid
any damage to the urethra or the rectum. But there are a bunch
of holes in my perieneum and some (hopefully) heavy duty
radiation burns in the prostate. I'm sure it will take a while to heal.

I can't say anything yet about erectile effects. I'll find out about
that a few months from now when everything is done and the
Lupron wears off.

I haven't experienced any other treatments. Compared to
pure EBRT, this is clearly more invasive and involves more
short term surgical side effects. Compared to prostatectomy
I presume that it is less invasive with fewer short term side
effects.

Of course the real issue for all of us is first, did we get a cure
and second, how much have we given up to get it.

Time will tell.

I hope this information is of some use.

Alan

louis v. spielman

I didn't have trouble sitting down, but have had flow problems since I
finished HDR in March 2002. Recently I has a TURP to turn the flow back on.

The good news is my PSA is down to 0.03 when it originally was 20.7 with a
Gleason of 4+5(9) and involvement of the seminal vesicles.

I had HDR in addition to 5 weeks of EBRT ad have been on Lupron for 3 months
before the radiation, during the radiation, and not scheduled to be off
Lupron until March 2004, PSA willing.

palmer_ent

a big congratulations to you louis. we've pulling for you. please keep
us posted what the march psa is.

~ curtis

knowledge is power - growing old is mandatory - growing wise is optional

alan meyer

I'm pleased to hear of your success in spite of the high risk nature
of you diagnosis (PSA=20.7, G=9, seminal vesicles).

I'd like to ask a bunch of questions if I may.

I'm also starting to notice flow problems - which I presume will get
worse over the course of my EBRT and/or after my second HDR.
I also had a bad reaction to Flowmax, which cuts down my
options somewhat. TURP may be in my future too. Was the
TURP very effective?

Was HDR specifically prescribed because of the aggessive cancer,
or did you choose it for other reasons? I presume that RP was
out of the question due to the seminal vesicle involvement, but the
other possible radiation options were pure EBRT, or EBRT +
low dose (seeds) brachytherapy.

Can you tell us about the number HDR procedures and
EBRT treatments you had? My doctor has prescribed:

2 HDR @ 1050 cGy each
23 EBRT @ 200 cGy each
Total = 6700 cGy.

The total dose is lower than the oft recommended 7500 cGy,
but the doc says that HDR has much more effect than EBRT
and the total dose does not need to be as high.

Also, can you tell us about the long duration Lupron prescription?
I know that Lupron is prescribed before radiation to weaken and
shrink the prostate prior to further radiation attack. Why did the
doctors to continue the Lupron for so long after, without waiting
to find out if your PSA stays low without it?

Thanks, and good luck with it. It sounds like you had a rip
roaring tumor. I'm hoping they burned the hell out of it and
got everything in time.

Alan