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Medical Forum / Diseases and Disorders / Prostate Cancer / January 2007Anyone get re-seeded?
On another thread ("What should I be asking the urologist tomorrow?") Ron raised the possibility of getting a contour map of the prostate showing where all the seeds were planned to go and where they actually are after seeding, revealing any "hot" or "cold" spots, i.e., spots getting more or less radiation than planned. Seeds show up easily on any kind of xray sensitive film or scanner, so it should not be hard to create such a map. For cold spots especially, Ron raised the question, why couldn't the doctor insert another seed or two to insure that all planned radiation targets were in fact hit. Have any of our brachytherapy patients had this done? Has anyone had a doctor produce a profile map of the prostate? Has anyone had a doctor go back to place any additional seeds? Thanks. Alan Hubby never lost a seed so no reseeding. Our doc does about 3 reseeds per year usually because someone has lost a seed or two. Also if he feels there is a cool/cold spot left he will add additional seeds. The prostate is scanned about 3 weeks after seeding and this is checked carefully against the map to make certain all seeds are accounted and for any shift creating a cool/cold spot. I remember the doc saying they want to see 94% coverage. Hubby had 98% on scan. I did get to see the map on a computer screen. It was interesting. I also saw the monitor during the 3 week check but I couldn't really say at what I was looking. Bev > On another thread ("What should I be asking the urologist tomorrow?") > Ron raised the possibility of getting a contour map of the prostate [quoted text clipped - 16 lines] > > Alan Hi Beverly, Wow, That is amazing technology! I am very impressed..... John Loomis, surviving RP/ > Hubby never lost a seed so no reseeding. Our doc does about 3 reseeds per > year usually because someone has lost a seed or two. Also if he feels [quoted text clipped - 32 lines] >> >> Alan > Hubby never lost a seed so no reseeding. Our doc does about 3 reseeds per > year usually because someone has lost a seed or two. Also if he feels there [quoted text clipped - 8 lines] > was looking. > Bev Son-of-a-gun. When Ron suggested this I thought, well, that's an interesting theory, but I'd never heard of it being done. But it looks like he was right on target. Sounds like your doctor is more thorough than the average bear. Alan On January 19, Alan Meyer wrote, in pertinent part: (snip) > For cold spots especially, Ron raised the question, why couldn't the > doctor insert another seed or two to insure that all planned [quoted text clipped - 4 lines] > Has anyone had a doctor produce a profile map of the prostate? Has > anyone had a doctor go back to place any additional seeds? I have seen a lecture by rad onc Gordon Grado (Scottsdale AZ) that included x-rays showing misplaced "seeds." As I recall, such blunders can be treated via surgery, but not easily. Regards, Steve J "We have not lost faith, but we have transferred it from God to the medical profession." -- George Bernard Shaw > On January 19, Alan Meyer wrote, in pertinent part: > [quoted text clipped - 11 lines] > I have seen a lecture by rad onc Gordon Grado (Scottsdale AZ) that > included x-rays showing misplaced "seeds." Seed migration is not uncommon. Various studies show as few as 1% to as many as 50% of patients have at least one seed migrate from the prostate to another organ, often the lung, but sometimes the heart. Normally there is no adverse effect on the other organs; the majore concern is the reduction in radiation to the prostate. There is more detail at www.oncura.com/PDF/EshlemanSeedMigrate.pdf and http://www.medscape.com/viewarticle/431747. Alex > For cold spots especially, Ron raised the question, why couldn't the > doctor insert another seed or two to insure that all planned radiation > targets were in fact hit. > > Have any of our brachytherapy patients had this done? No, the doc said I had perfect coverage. > Has anyone had a doctor produce a profile map of the prostate? Yes, it looks like an X-ray (I think it's really a CAT Scan) with topographic contour lines. > Has anyone had a doctor go back to place any additional seeds? No but I imagine they could. I "think" they do a better than 100% coverage and one or two misplaced seeds isn't an issue as the neighboring seeds still give 100% coverage. It's probably something like, they'd have to have several out of place before there's a problem. > Thanks. > > Alan -kh |
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