Readers following my earlier blogs to do with the progress of the assorted tests, prostate biopsy and end finding of cancer, may be wondering whatever happened to the HDR (high dose rate) brachytherapy treatment - which I assumed I'd have within a week or two. Well, not quite at the particular site chosen for this treatment! Evidently, they are backed up "for months" - based on a phone call yesterday from one of the staff drs. - but she also offered that the Chief Radiation Oncologist might be able to find a spot for me within 2-3 weeks. (Okay, 2 is probably optimistic.)
She emphasized that, having reviewed the pathology slides (sent to the site from the local urologist) there was "no need for urgency" and sometimes schedules were delayed for months. However, since my wife is already known at this particular site, there is the chance - actually good chance- we can get this taken care of before the month of September is out.
As some readers may know, I elected to have this (radiation) treatment rather than surgery because I'd read way too many accounts of long term (5-6) months' tortuous recoveries and side effects, including having to use catheters, incontinence, erectile dysfunction, dysuria and other problems - usually arising from the surgeons (even robotic) having to cut into key nerves and the urethra then patch it back. (After all they are removing a whole gland here). I wanted instead, a treatment that would free me up from such adverse effects within days or weeks, or eliminate them altogether. Hence, chose HDR monotherapy. I also elected this over the LDR seed variation for the reasons cited in this abstract.
Basically, it entails - to briefly summarize- first getting a whole bunch of medical interviews and exams done, then immediate preparations (including enemas, etc,....again!) followed by imaging - which may include Catscans, MRI - and definitely entails introduction of an ultrasound device as the prostate is located and Ir 192 needle placement computed and confirmed. After that's done, based on the model needle projected positions, a small "template" with the needle positions integrated into it, is "sutured" to the perineum.
The first treatment then follows with the 12 or so radioactive needles (enclosed in thin plastic catheters or 'sleeves') introduced through the template's holes into the prostate. Yeppers, it does or would hurt like holy hell, which is why they give you an epidural (local ) anesthesia. The treatment lasts 5-10 minutes (after all it is HIGH dose rate, so they can't leave 'em in too long!) and then you go back to your hospital room and wait for the next. Usually within 12 hours. All the time you cannot move about the place, or amble to the bathroom, so you have to have a Foley catheter inserted.
The same 5-10 min. treatment then follows, and usually - this is enough. You're then discharged once they determine that: a) you can pass urine without the catheter, and b) the urine is clear, no blood.
The chief radiation oncologist will return from vacation on Tuesday, and when he does it's likely we will be able to narrow the time for treatment, or when to expect it. Until then, I will keep the blog rolling!
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