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Medical Forum / Diseases and Disorders / Prostate Cancer / November 2004brachytherapy - best hospitals in northeast?
My brother-in-law has decided to have brachytherapy to treat his recently diagnosed prostate cancer. He wants to know what are the major research hospitals who perform this in the northeast. I found a listing by USNews that lists the top 50 hospitals for prostate cancer treatment. http://www.usnews.com/usnews/health/hosptl/rankings/specihqurol.htm Does anyone know info pertaining to brachytherapy? Thanks for any help! - Mark I had my seeds done about five years ago at Holy Family Hospital in Methuen, Mass. Dr. Santos Shetty trained in Seattle and by now has probably done over 500 procedures. I had to have a TUIP done first to prevent blocking from the swelling. Then I took hormones for three months to shrink the prostate. -MIKE Mike: Was just diagnosed with it last week. Gleason 6, PSA 4, T1C. I shall be seeing Dr. Shetty later this week. Wondering how it all went for you, and whether you explored HDR? I think HDR sounds more attractive, but dont know if they do it at Holy Family. Im 72 and in fairly good health (so far!!). John Baker >I had my seeds done about five years ago at Holy Family Hospital in >Methuen, Mass. Dr. Santos Shetty trained in Seattle and by now has [quoted text clipped - 3 lines] > > -MIKE > Mike: > [quoted text clipped - 4 lines] > > John Baker I had two HDR brachytherapies plus HT + 23 EBRT treatments. So far (fingers crossed and knocking furiously on wood) my PSA has dropped near zero and the aftereffects have been manageable. My HDR was done as part of a clinical trial at the National Cancer Institute in Bethesda. Treatment was 100% free. I believe they're still accepting patients if you're interested, but I think you need to be "intermediate" rather than "low" risk, i.e., PSA > 10 or Gleason > 6. I thought I didn't qualify but second opinions on my Gleason showed that it wasn't really 3+3 at all, but 4+3. In any case HDR has some advantages and some disadvantages as compared to permanent seeds. The advantages are - very accurate placement of the seeds (with permanent seeds they can move some after implant), very high dosage, and no radiation beyond the 15 minutes or so that the seeds are in place. One big disadvantage is that there are generally two or three hospital procedures instead of just one. For me, each involved general anaesthesia and an overnight stay in the hospital (one turned out to be two nights due to an unforseen reaction to flowmax). I recommend you do get a second opinion on your biopsy slides. If they were underdiagnosed - a very common occurrence - you may want EBRT and possibly HT in addition to seeding. Best of luck with whatever you decide to do. Alan Welcome to the club, John. No one here asked to be in the club, but now that you are in it, I think you will find it a superior source for support and information on prostate (and occasionally English sports cars). At 72 years of age, relatively lower Gleason and PSA, depending on what stage you are in (e.g., T1a, T2b....), you have a wide selection of options to research. If you are in good shape, surgery is an option. Surgery involves cutting out the prostate and, hopefully, all the cancer along with it. When I got mine, surgery was my only option due to my relatively young status. At the other end of the spectrum, you might be a candidate for watchful waiting (WW). PCa normally grows very slowly in men in their 80s, and sometimes in their 70s. If you have been getting regular PSAs, you can kind of track how it's been going. Otherwise, you can get quarterly tests and see how it is going. If it is not growing, or not growing quickly, you might be able to live the rest of your life without treatment. Depending on your marital and sexual status, hormone treatment may be an option. Shut down the testosterone, and you shut down the cancer. There are some that heat up or freeze the prostate, but these may (or may not) allow for too large a margin of error because the urethra has to be kept cool or warm. And then there are all types of radiation. The best thing is to research all of it. At 72, I think you can take your time.... at least several weeks... to come up with the best choice. They all have risks and side effects that you need to consider for yourself. Dr. Patrick Walsh wrote an outstanding (and easy to read) book called "Guide to Surviving Prostate Cancer". It is a must-read before making your decision. www.phoenix5.org is a tremendous site for everything you ever wanted to know. www.cancer.gov is another good site. As to HDR, I don't know enough about it, specifically, to comment, but others here will almost certainly. Good luck.  SignatureProstate Cancer Survivor (so far), not a doctor PSA 16 10/17/2000 @ 46 Biopsy 11/01/2000 G7 (3+4), T2c RRP 12/15/2000 PSA .1 .1 .1 .27 .37 .75 EBRT 05-07/2002 @ 47 PSA .34 .22 .15 .21 .32 Erection 05/12/2003 @ 48 HTbegins 07/21/2003 @ 48 PSA .07 .05 Lupron 7/03, 8/03, 12/03, 4/04 > Mike: > [quoted text clipped - 12 lines] > > > > -MIKE Hi John....... I am the one who mentioned *British* sports cars (G). I also have a husband of 72 years of age who had the HDR treatment last summer here in Toronto (Canada). Sunnybrook Hospital has been doing it for some 3 years now. Ron was PSA 10+, Gleason 4+3, Stage T2b, if I recall the stage correctly. Alan Meyer on this group had it done (in a different manner) at the NCI in the US and can fill you in on the "American Way"...... Ron definitely did NOT want surgery.....and his 3 doctors (urologist, regular oncologist, and the radiation oncologist) all recommended radiation.....we didn't find out that he was a candidate for this new HDR until we saw the rad onc. He had two HDR sessions.....day surgery for 6 hours.....a week apart. Followed up 2 weeks later with 25 EBRT. I can honestly say that other than the obvious aftereffects of the HDR, he really had very few side effects. A little tired.....has to get up once a night now to go. Minor stuff. Frankly, I was concerned at first and tried to talk him into surgery.....but the doctors convinced me that radiation was WAY less invasive and the outcome the same for over 70. He looks 60, btw. We are heading for the UK in 4 days, but I wanted to let you know that there are a couple of men on here who have had HDR.....apparently it costs close to $50,000 US.....so not many insurance plans are covering it is my guess. We have never looked back......never doubted that it was the right way to go. Ron is fine....at the very worst, he gets tired a little bit faster. But hell, he is also an old guy (G). Not really. His PSA dropped to 3.6 from 10.5 within 3 months......and stayed there 3 months later. His next one is in August..... Investigate it. Talk to Alan Meyer on this group too. Look into all the treatments and then go with your *gut hunch*. Ron went with what he felt was the right treatment for him......and that is the best advice I can offer you. If you want more details, drop me a line at home and I will try to answer them. My home email is "heatherfig at rogers.com"......change the obvious. Altho, I get so much damn spam now, I wonder why I bother, grin. All the best and know that you have some time to decide. Getting Pca at 70 is way better than younger. So now we are off on our 'trip of a lifetime' and Ron will be driving from Scotland to London. And let me tell you......the UK is horrendously expensive (the scottish frugality is taking a beating on this one!!) Cheers......Heather > Welcome to the club, John. No one here asked to be in the club, but now that you are in it, I think you will find it a superior source for support > and information on prostate (and occasionally English sports cars). > > At 72 years of age, relatively lower Gleason and PSA, depending on what stage you are in (e.g., T1a, T2b....), you have a wide selection of options to research. > As to HDR, I don't know enough about it, specifically, to comment, but > others here will almost certainly. [quoted text clipped - 20 lines] > > > > > > -MIKE > I had my seeds done about five years ago at Holy Family Hospital in > Methuen, Mass. Dr. Santos Shetty trained in Seattle and by now has [quoted text clipped - 3 lines] > > -MIKE Mike - I will pass your post and Glenn's along to my brother-in-law. Thanks, - Mark I had a friend who had brachytherapy and was happy with his treatment. His dr was Michael Zelefsky at Sloan-Kettering. > My brother-in-law has decided to have brachytherapy to treat his > recently diagnosed prostate cancer. [quoted text clipped - 7 lines] > Thanks for any help! > - Mark > I had a friend who had brachytherapy and was happy with his treatment. > His dr was Michael Zelefsky at Sloan-Kettering. Thanks Glenn. I'll pass this info on to my brother-in-law. Sloan-Kettering was one of the top 50 hospitals listed in general for prostate treatment. - Mark Hi Mark...Check out the listing of brachy artists at http://www.prostate-help.org/cabrach.htm Best wishes and good health, Ron > My brother-in-law has decided to have brachytherapy to treat his > recently diagnosed prostate cancer. [quoted text clipped - 7 lines] > Thanks for any help! > - Mark Thanks everyone for comments and suggestions. Getting seeded on nov 2 in Holy Family! The docs I talked to all recommended that based on my readings and general health. RP was considered to be more than was necessary, especially since I had open heart surgery 10 years ago and am still on meds for it. Best John >Hi Mark...Check out the listing of brachy artists at >http://www.prostate-help.org/cabrach.htm [quoted text clipped - 11 lines] >> Thanks for any help! >> - Mark Hi John, Good luck with the seeds. It's pretty easy as procedures go. I do recommend that you have something soft to sit on for a couple of days. I used a child's inflatable swimming tube. Worked great. Larry I had seeding at Holy Family about five years ago (Dr Shetty and Dr. Hurley). My PSA has risen gradually to about 3.3 and seems to be staying there. Dr. Shetty said that this was not unusual and I shouldn't be concerned. As far as something to sit on, most drug stores sell inflatable invalid tubes (about $10). Good luck. ---MIKE--- Larry, Please don't forget the chilled rice filled socks, Thanks Bev! Tom > Hi John, > Good luck with the seeds. It's pretty easy as procedures go. I do recommend > that you have something soft to sit on for a couple of days. I used a > child's inflatable swimming tube. Worked great. > > Larry Take a couple of old cotton socks and drop a cup or two of rice in the toe. Tie a knot at the top of the sock. Freeze the socks. Seems you can scrunch them around to fit just right. Two or more will guarantee you have a nice cold one to use at any given time. Socks can also be heated in the microwave for a minute or two and used as hot packs. Bev > Larry, > Please don't forget the chilled rice filled socks, Thanks Bev! [quoted text clipped - 6 lines] > > > > Larry Its now two weeks since seeding. I did set up some sox, but found I never really needed them. My wife found them great for her arm, however, so nothing was lost. Some peeing problems, but FloMax appears to have fixed them. Bought lead underpants because 15 month grandson visits often and often gets in my lap. Bottom line - thanks for the advice and comments -- so far going well! Best John >Take a couple of old cotton socks and drop a cup or two of rice in the toe. >Tie a knot at the top of the sock. Freeze the socks. Seems you can scrunch [quoted text clipped - 13 lines] >> > >> > Larry |
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