Hi Fatcat,
I'm sure you will get many responses. But what I find is that there aren't
any reliable studies for many of the radiation treatments that are offered,
seeds included. If there were, someone would be more than happy to give us
a link so we could scrutinize it very carefully. It's my feeling that
posters shouldn't recommend or even support a treatment option with out
referencing reliable sources for there opinion. Otherwise, they are
passing themselves off as a medical professionals even when they attempt
to disqualify themselves by stating otherwise. Even if they have posted
links in the past it doesn't help a newby that doesn't have access to the
archives.

What you want to look for in any study is the length of time the patients
were monitored. Anything less than 15 years in my opinion is a wast of
time as most would agree that early localized prostate cancer will give
the majority of patients that long of time without any treatment. You will
find that most radiation studies will cover 5, 7 maybe 10 years at most.
They will then project the long term probability of survival from these
studies. You could do that with any of the alternative options.

It's impossible to find any long term studies for most of the radiation
treatments as they are being introduced every couple years. However, if
one goes back to the earlier radiation treatment regimes, you will find
that they market them as being as effective as surgery and convinced a lot
of people to be guinea pigs for those experiments. How can anyone with a
good conscience advocate a new procedure that hasn't had the test of time
and hasn't been supported by a valid study.
To me it is no different than all these alternative treatment approaches.
One might as well drink pomegranate juice, take saw palmetto and have a
little acupuncture. The side effects would be much easier to take for 10
to 15 years anyway. That would be as good as any study that I have read.

Ron S.

fatcat...I asume that IGRT uses additional cat scans to locate the
prostate.  This could have consequences in terms of an increase in
secondary cancers (see abstract below).  Just something else to factor
into the decision process...Best wishes and good health, ron

RADIATION-INDUCED SECOND CANCERS: THE IMPACT OF 3D-CRT AND IMRT
ERIC J. HALL, D.SC.* AND CHENG-SHIE WUU, PH.D.?
*Center for Radiological Research and ?Department of Radiation
Oncology, Columbia University, College of Physicians and Surgeons, New
York, NY

Information concerning radiation-induced malignancies comes from the A-
bomb survivors and from medically exposed individuals, including
second cancers in radiation therapy patients. The A-bomb survivors
show an excess incidence of carcinomas in tissues such as the
gastrointestinal tract, breast, thyroid, and bladder, which is linear
with dose up to about 2.5 Sv. There is great uncertainty concerning
the dose-response relationship for radiation-induced carcinogenesis at
higher doses. Some animal and human data suggest a decrease at higher
doses, usually attributed to cell killing; other data suggest a
plateau in dose.  Radiotherapy patients also show an excess incidence
of carcinomas, often in sites remote from the treatment fields; in
addition there is an excess incidence of sarcomas in the heavily
irradiated in-field tissues. The transition from conventional
radiotherapy to three-dimensional conformal radiation therapy (3D-CRT)
involves a reduction in the volume of normal tissues receiving a high
dose, with an increase in dose to the target volume that includes the
tumor and a limited amount of normal tissue. One might expect a
decrease in the number of sarcomas induced and also (less certain) a
small decrease in the number of carcinomas. All around, a good thing.
By contrast, the move from 3D-CRT to intensity-modulated radiation
therapy (IMRT) involves more fields, and the dose-volume histograms
show that,
as a consequence, a larger volume of normal tissue is exposed to lower
doses. In addition, the number of monitor units is increased by a
factor of 2 to 3, increasing the total body exposure, due to leakage
radiation. Both factors will tend to increase the risk of second
cancers. Altogether, IMRT is likely to almost double the incidence of
second malignancies compared with conventional radiotherapy from about
1% to 1.75% for patients surviving 10 years. The numbers may be larger
for longer survival (or for younger patients), but the ratio should
remain
the same.

The DaVinci generally doesn't take more than five days hospitalization.
While you may not be able to drive yourself for up to a week or so after
the operation, you can be driven without any problem. If I remember
correctly the HQ surgeon practices in Atlanta, a four hour drive from
where you live. If I were you the fact that one treatment alternative is
local and the other is four hours out of town would not carry any weight
whatsoever in making my decision. A small and irrelevant inconvenience
in light of the long term significance of your choice.

I can only tell you about EBRT of the prostate bed.  I did not have IGRT.
But, the prostate bed being attached to the colon, I suspect it's usable
data.

I had a problem with constipation (and resulting diverticulitis) for a year
before my PCa dx and three years before my EBRT.  I was taking Metamucil for
it when I began EBRT.  I stopped Metamucil half way through because of
diarrhea.  After that, I just had soft stool.  Well after EBRT was finished,
I had normal stool and never used Metamucil again as a daily regimen.

To combat most radiation problems, walk a lot (I was walking 3-5 miles a
day, 3-5 times a week), drink lots of water (I drank liters each day), and
get plenty of sleep (I added a 9th hour during my treatment regimen).