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Posted by arawarren (U14030015) on Saturday, 20th June 2009
Following my previous posting; ( I am 69 yrs old and following a biopsy and MRIscan was diagnosed to have prostate cancer with a Gleason score of 3+4 and an 'organ confined disease)
I am now considering Brachytherapy as an alternative to Robotic Radical Prostatectomy.The procedure appears to be less disruptive and a quicker return to normal life. I would be interested to here from anyone who has undergone this procedure as to how effective it was and what side effects they had and for how long they lasted?If they could go back in time would they have still taken this course of treatment? Maybe I could go for Active Surveillance for a possible year or two but would the possibility of the cancer spreading outside the prostate be too much of a risk?
Posted by frankthedoc (U14026953) on Saturday, 20th June 2009
I am a urologist and have treated many men with brachytherapy. It is a day case procedure under general anaesthesia. The side effects are generally less than surgery and the recovery time short, making it an attractive treatment. Whether is is suitable for you requires a more in depth discussion with a urologist or radiotherapist. The size of your prostate is important, as are how many of the biopsies were positive for cancer, level of psa, general health, urinary symptoms etc.
Posted by arawarren (U14030015) on Sunday, 21st June 2009
To Frankthedoc. Thank you for your reply it was most encourging.
My PSA is 5.6 (It was 3.7 nine months ago), my Gleason is a 3+4. I have no urinary problems whatsoever. The cancer is Stage 2 moderately aggressive and apart from this condition I am very fit and healthy and keep to a well balanced diet.
Would these factors suggest my being a suitable candidate for a brachytherapy?
I shall hopefully be seeing a brachytherapy doctor in the near future but would find your opinion helpful.
Posted by Brian (U14034607) on Monday, 22nd June 2009
It is good to have a urologist visit the message board.
I have elsewhere warned about the metastasis risk associated with the biopsy procedure (I opted for PCA3 genetic marker screening). It may help others to learn what view you take on this.
Much corroborating information can be found online, but this (relating to breast cancer but, it seems to me, covers the risk principle) will serve.
"A June 2004 report from the John Wayne Cancer Institute in California has rekindled a long-standing debate over whether or not needle biopsies are safe. The paper set out to examine whether this technique, widely used to obtain specimens in cases of suspected cancer, might itself allow malignant cells to spread from an isolated tumor to nearby lymph nodes. The authors reluctantly conclude that a needle biopsy may indeed increase the spread of the disease by 50 percent compared to patients who receive the more traditional excisional biopsies (or "lumpectomies").
This is a rigorous study, and it comes with an excellent pedigree. The lead author, Nora M. Hansen, MD, was chief surgical resident at the University of Chicago (1994-1995) before coming to the John Wayne Cancer Institute in Santa Monica, Calif., in 1997. She is currently Assistant Director of the Joyce Eisenberg Keefer Breast Center, Saint John's Hospital and Health Center, Santa Monica.
Hansen and her colleagues wanted to discover whether the common method used to obtain specimens from a breast tumor influenced the subsequent spread of disease to the sentinel node (SN). She and her colleagues therefore studied 663 women who were known to have breast cancer. Of these, about half had been biopsied with a needle — either a fine needle aspiration (FNA) or a large-gauge needle core biopsy. The other half had undergone the physical removal of their tumor (i.e., an excisional biopsy or lumpectomy). The study found that women who had had either kind of needle biopsy were fifty percent more likely to have cancer in their sentinel nodes than women who underwent the surgical removal of the whole tumor with excisional biopsy." www.chetday.com/need...
According to the medical literature I have seen, isolated tumours are treatable. However, once metastasis occurs "Currently all treatments for the aggressive forms are palliative, not curative" according to this very recent successful Mayo Clinic trial report of a new prostate cancer procedure discoverysedge.mayo....
So ironically, it would seem that anyone unfortunate enough to have isolated aggressive prostate cancer is likely to have it spread prematurely by what is supposed to be a part of 'healthcare'.
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