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Medical Forum / Diseases and Disorders / Prostate Cancer / November 2005one year after brachy
Last Wednesday was the first anniversary of my being seeded: Greg Louis At age 58, PSA 5.4 rising triggered biopsy 2004-06-22, Gleason 3+3, T1c, prostate volume 27 cc. Monotherapy, 55 I-125 seeds implanted 2004-11-16. Here's a brief review of the year. The actual experience was "a piece of cake." That was my comment to the next patient, who looked a bit nervous. Very little pain the next night, alleviated by a 400mg Advil, and none at all thereafter. I was working, though from home, the day after the procedure, and I resumed weight training on the fourth day. The usual urinary side-effects -- burning, frequency, urgency -- took effect and peaked at six weeks, just as expected. Less expected (by me anyway) was a turn for the worse starting around 14 weeks after implantation, mainly consisting of slow urination with a tendency to dribble afterward. The urologist doubled my FloMax intake, to 0.8mg/day from 0.4, and this seemed to help. However, I'm still on that 0.8mg dose after all this time; with 0.4, I get slow and dribbly. Never needed any sort of padding, though. Overall I'd say that the symptoms have been tolerable. Minor nuisances, not major woes. Right after the implant, sex was pretty normal except there was no ejaculate at all. In August I began to expel a few drops of thick fluid, and just a few days ago there was, for the first time, a nearly-normal volume. So far, at least, no sign of impotence. PSA values fell nicely from test to test until 10 months, which was 0.62 compared to the previous reading's 0.59. Nobody's worrying yet, but obviously the next few tests will be of interest. Next one's due in early February. FWIW I'd make the same treatment choice if I had to relive last year's decision making.  SignatureGreg > Last Wednesday was the first anniversary of my being seeded: > [quoted text clipped - 10 lines] > > Greg Volume of what? You can't be producing semen, with no prostate.... Signature"I'm not pompous and agrogant, I'm SNARKY" JK Sinrod Sinrod Stained Glass Studios www.sinrodstudios.com Coney Island Memories www.sinrodstudios.com/coneymemories >> Last Wednesday was the first anniversary of my being seeded: >> [quoted text clipped - 12 lines] > > Volume of what? You can't be producing semen, with no prostate.... Sounds to me like a semi-fried prostate. > >> Last Wednesday was the first anniversary of my being seeded: > >> [quoted text clipped - 14 lines] > > Sounds to me like a semi-fried prostate. After a year? Signature"I'm not pompous, I'm SNARKY" JK Sinrod Sinrod Stained Glass Studios http://www.sinrodstudios.com/ Coney Island Memories www.sinrodstudios.com/coneymemories/ >> >> Last Wednesday was the first anniversary of my being seeded: >> >> [quoted text clipped - 18 lines] > > After a year? I'm not in a position to examine the ejaculent, but I know that if the prostate is fried through and through, the sperm ducts, seminal vesicles and other contributory glands have no avenues for throughput. So, if he does not notice a differnece in pre- and post-brachy emissions, then some of his prostate has to be viable. Of course, I am not a doctor. > if the > prostate is fried through and through, the sperm ducts, seminal vesicles > and other contributory glands have no avenues for throughput. So, if he > does not notice a differnece in pre- and post-brachy emissions, then > some of his prostate has to be viable. Of course, I am not a doctor. That's my assumption also, pending discussion with the urologist. "No difference" would be an exaggeration, but the extent of recovery suggests that some prostate tissue survived and grew or recovered function over the year since seeding. Which suggests the possibility that some cancerous tissue survived too. My rad onc likes to get a biopsy done at two years; that and the ongoing series of PSA tests should tell us. SignatureGreg During the period of actual radiation, my orgasms (such as they were, I was also on Lupron) produced a very small amount of bloody ejaculate. Afterwards, the blood cleared up but the volume of ejaculate was tiny, occasionally non-existent. After another six months or so the volume began to increase, and although it feels like a lot, it's still significantly less than before and has an entirely different consistency. I also have wondered whether a functioning prostate is a good or bad thing after radiation. Radiation doesn't destroy the prostate the way surgery does. I think that it damages the DNA in the cells - the tumor cells more than the healthy ones. But isn't the prostate tissue is still alive? When I told my radiation oncologist that I was still producing some ejaculate he gave me an explanation that I can't remember, but he thought it was normal and not a problem. He said that he's never seen any evidence of disease progression that was not preceded by a rise in PSA. That's still the key marker. Alan > During the period of actual radiation, my orgasms (such as they > were, I was also on Lupron) produced a very small amount of [quoted text clipped - 11 lines] > > Alan I always thought that the entire prostate and all the tissue was shrunken and then completely destoyed by the radiation, and absorbed by the body? Signature"I'm not pompous, I'm SNARKY" JK Sinrod Sinrod Stained Glass Studios http://www.sinrodstudios.com/ Coney Island Memories www.sinrodstudios.com/coneymemories/ Alan Meyer wrote...snip... > I also have wondered whether a functioning prostate is a good > or bad thing after radiation. Radiation doesn't destroy the > prostate the way surgery does. I think that it damages the > DNA in the cells - the tumor cells more than the healthy ones. > But isn't the prostate tissue is still alive? I suspect that most forms of RT (SI+EBRT may be the exception) do leave some healthy prostate tissue behind after the RT has done its work. Although I don't "know", I suspect that tissue remaining behind, be it from RP, RT, cryo, etc., is not a good thing. What ever caused the PCa in the first place (genetic mutation and/or ...) has fertile ground to produce PCa cells again. I don't know if this could be clinically distinguishable from a recurrence, but it would produce the same results as a local recurrence. > When I told my radiation oncologist that I was still producing > some ejaculate he gave me an explanation that I can't > remember, The Cowpers gland can produce some semen like material. >> if the >> prostate is fried through and through, the sperm ducts, seminal vesicles [quoted text clipped - 10 lines] > My rad onc likes to get a biopsy done at two years; that and the ongoing > series of PSA tests should tell us. Yeah, who'dathunk that one might be concerned by potency? Good to hear from you Greg. It is very important for newly diagnosed patients to hear from someone like yourself. The good and the bad. Please keep the group updated on your progress. What has your doctor said about needing the FloMax this far out? Is that unusual? I was a surgical patient, so I am not that familiar with what you are going through. I hope you are able to wean off the medication soon. Good luck in February. I hope you see a nice reduction in that PSA. David S. > Last Wednesday was the first anniversary of my being seeded: > [quoted text clipped - 34 lines] > FWIW I'd make the same treatment choice if I had to relive last year's > decision making. > What has your doctor said about needing the FloMax this far out? Is that > unusual? Thirty percent of patients need it for more than 3 months, and the number drops slowly after that; two years seems to be the worst-case scenario, according to "Prostate Brachytherapy Made Complicated." > Good luck in February. I hope you see a nice reduction in that PSA. Many thanks. So do I <grin> -- as discussed elsewhere in this thread, the possible survival of some prostate tissue has its worrying side. SignatureGreg |
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