I was diagnosed with gleason 9 prostate cancer , I had Brachytherapy , hormone deprivation therapy for 24 months and 5 weeks of external beam radiation , my psa dropped from 10 and stayed at 0.02 for 36 months then climbed to 0.05 with a slight testerone increase and then down to 0.04 for the last two blood tests , the oncologist seems happy with this , lets hope it stays this way

@user-io8ss3zd4s

5 ай бұрын

Gleason 9 prostate , does it mean you had a real large prostate hence the brachytherapy and hormone deprivation therapy.

Talk to Dr. Scionti at his clinic in Sarasota……I’m heading there on the first of Feb. .Amazing doctor!

I have to see the doctor tomorrow and make a treatment decision. I’m sure glad I found this video today. I sure wish this lady was the doctor I was going to see. Great information by both parties.

The guy is very well educated and informed... Very detailed informational questions.. answers are very detailed and very educational. Thnx

Had external beam radiation over a two week period, Gleason 4+3 , was the ash and have had no side effects. PSA is undetectable 5 years later

Great job young lady !

Make sure to use doctors with experience. I had brachytherapy and IMRT from a military radiologist at Walter Reed. He had no experience but assured me that his training was top notch, and that he was the quarterback of his high school football team. He basically ended my life with the treatments. Two months after the brachy I felt really sick for about 4-5 days, like I have never felt before. I'm almost positive that it was seed radiation emitting into my body, from outside the prostate capsule. My prostate capsule was rated A+ by Dr. Alan Parton at Johns Hopkins. The military guy, Joel Skinner, and his no experience assistant clearly poked the needles too far through the capsule and caused the cancer to escape the capsule. PSA went from 8, up to 38, within a couple months. I would have gotten treated at Johns Hopkins but the military wouldn't pay for a procedure outside of the military system. My life has sucked ever since then.

Well performed, both of you. I did HDR brachytherapy 1,5 year ago. Gleason 9, small prostate. Two treatments, combined with 25 days of external x-ray. Modern equipment, all over. Started with hormon therapy 8-9 months before brachytherapy. PSA decreased from 28 to 1,6. After brachy and X-ray, unmeasurable for over a year. Still on hormon therapy for another year.

@jerrymunroe5593

3 ай бұрын

Sounds like me. Just diagnosed with Gleason 9, My prostate has been somewhat enlarged. Next week I will have a Pasma Pet scan to see if it has spread. My urologist wants surgery (he is a surgeon). If it hasn't spread, I am thinking about this HDR brachytherapy, external xray and the doctor mentioned hormone therapy. I am of course worried about urinary and bowel problems. I guess my nightmare has begun.

@timferguson593

2 ай бұрын

@@jerrymunroe5593you will be fine. Good treatment choice.

Fantastic interview

@Malecare

Жыл бұрын

We’re happy that our discussion is helpful for you

Once they develop and identify the genetic marker that make some people very susceptible to radiation problems. This field will be off the charts.

The question I have is, what is the actual risk of incontinence, erection malfunction from brachytherapy compared to external beam radiation, starting from 100% functional beforehand. I have chosen to go with a combination of both because I have come across studies which indicate that the combination a) eliminates the risk of cancer surviving inside the prostate b) kills the cancer if it has spread to the nearby nodes, ducts etc. [I am Gleeson 9 but the PET-PSMA scan indicates that the cancer (7 lesions, prostate 3.2cm wide) has not yet spread. Of course, it cannot indicate with certainty that it hasn't spread.]

@jerrymunroe5593

3 ай бұрын

I am just diagnosed Gleason 9 and will have PSMA pet scan to see if it has spread and if not am considering what you said. What a nightmare I am sure I will be going through ahead

Great info

@Malecare

10 ай бұрын

Glad you found our talk to be helpful

One other interesting story, the seeds can sometimes dislodge, so some seeds are on a fiber there was a gentleman that was hyper paranoid about radiation, and he bought a geiger counter, and somehow one of the seeds dislodged into his heart and he was picking up radioactivity. It did not damage him, but obviously he was freaking out.

External Beam usually involves hormone suppression (begins prior to radiation and continues way after the radiation).... hormone suppression is a gentle term for chemical castration. This is often not mentioned when external beam therapy is discussed. The long term side effects of hormone suppression is much worse than the radiation.

@robertmonroe3678

11 ай бұрын

Yes. Many leading centers now combine SBRT (or IMRT) with HDR Brachy. In cases where they once prescribed IMRT plus ADT.

@iamric23

6 ай бұрын

Please elaborate about the side effects, you never offered a description.

@lindaweston4172

5 ай бұрын

my husband has just finished hormone therapy the course was two years. Hot flushes, weight gain and man boobs.... but he is still with us.

@pinotwinelover

4 ай бұрын

Everybody who's on adt typically it's metastasize so if you have localized prostate cancer rarely, do they ever put you on adt unless aggressive genetic markers

@jerrymunroe5593

3 ай бұрын

@@pinotwinelover Is adt hormone therapy? I am trying to figure out all of these abbreviations

My husband had brachytherapy last year, it affected him big time, he also had radiotherapy before, his bladder and bowels have never been the same.....BUT the cancer has gone his last PSA reading was 0.01

@jerrymunroe5593

3 ай бұрын

That is what I am worried about is urinary and bowel problems. I was just diagnosed and my nightmare has begun. Next week I have a PSMA pet scan to find out if my cancer has spread, If it has I have no idea what direction I can or will go,

Great video. Who would have guessed that WC Fields knew that much about PC?

Thanks you so much for the video. This is one of the best videos talking about Brachytherapy I even watched. I am a prostate cancer ( three gleason-7, one gleason-9, with extra-capsular extension). I am also a high-risk hypertrophic cardiomyopathy patient. Are there any extra things need to be taken consideration in the therapy process?

@Malecare

10 ай бұрын

We are glad our conversation was helpful

How does brachytherapy differ from ablation procedure?

can a HoLEP procedure be done after LDR Brachy?

Can a PMSA pet scan be overlayed onto the ultrasound in order to pin point the cancer areas? I had a MRI fusion targeted biopsy recently, and I was wondering why this was not mentioned about the PSMA pet scan replacing the MRI image.

@vespatrixie2555

5 ай бұрын

I am not an expert , nor a dr, IMO it's pretty damn hard almost impossible to have a metal free radiation operating room to have a PMAS pet scan in real time. MRI can now be real time with brachytherapy. Because your prostate is not nailed to a particular spot due to bladder and colon. A little movement in prostate can make brachytherapy a little bit off the mark in putting a seed in the lesion. MRi guided brachytherapy along w PMAS pet scan have changed the staging for the different levels prostate cancer

@manbearpig8691

4 ай бұрын

I think that this is right on the money. My PSMA PET was 2 weeks prior to my HDR treatment. Because of movement over that time, overlay wasn't an option. PSMA PET are extremely expensive and insurance will only pay for it sparingly.@@vespatrixie2555

I had a marginally large prostate, am 61, PSA of 525, Gleason 7, cancer metastatic (ribs, shoulders, lower back)...this was 7 months ago... Went on Orgovyx (ADT) and Nubeqa (ADT) plus Lutetium (trial). PSA now 2.3, prostate shrunk, no weight gain, exercising daily, eating plant-based, etc., physically fit and working as often as ever. Ultimately, despite metastasis, would like to go off ADT's and substitute with something with less side effects or try higher level Melatonin, etc. Side ffectrs, for me, mostly mental (some depression, amplified emotions, anxiety). The question I have is there anything else that can keep T lower once one goes off ADT's? And would Brachy also take care of residuals cancers after Lutetium? Most of mine have been significantly erased or reduced, but Brachy sounds like an interesting option.

If a patient gets HDR or LDR brachytherapy do they also get post procedure external radiation IMRT or SBRT for a period after?

@timpye6162

7 ай бұрын

Yes. That's what the oncologist told me and it put me off the idea, especially if ADT is also recommended

@manbearpig8691

4 ай бұрын

I had Gleason 9. PSMA PET showed it was contained. Started with ADT and then HDR. Without HDR I would have needed 6 weeks of external beam. With the HDR I was able to get by with 3 weeks of external beam with a slightly higher Grey value. That might not work for everyone, but it seems to have worked for me. @@timpye6162

Unfortunately many patients have a large prostate and Brachy therapy is not appropriate unless hormone therapy is done first.

@Malecare

9 ай бұрын

Indeed. An unexpressed issue that disappoints many

@vespatrixie2555

5 ай бұрын

Not a Dr or expert, there are some Brachytherapy Dr's that are actually tracing out the prostate enabling better seed placement. Combine this MRI real time guided brachytherapy seems to be pretty effective.

She has a brilliant IQ on the subject of seed inplant...

The recent 1st patient treated with Cu67 achieved a PSA of zero.

Not to.