This Journal #2 is a companion to my pre-treatment Journal #1 called “My Brachytherapy Cancer Treatment Decision Process” found via the following link: py-cancer-treatment-decision-process/?ref=as.

I had a biopsy in November 2010. Before treating the prostate cancer, my Gleason Score was 3+3=6. My Prostate Volume was 39cc. Five of 12 biopsy cores were cancerous. Percent of cancer in each core: 70%, 70%, 60%, 40%, and 30%. All of the cancerous cores were from the LEFT side of my prostate gland and NONE of the cores from the RIGHT side were cancerous.

As described in Journal #1, my prostate cancer was treated with radioactive seed implants (“Brachytherapy” / “BT”) on April 13, 2011.

0.5 October 2013 (30-month follow-up)
0.8 April 2013 (24-month follow-up)
0.7 October 2012 (18-month follow-up)
0.6 April 2012 (12-month follow-up)
0.5 December 2011 (6-month follow-up)
0.7 October 2011
1.4 JULY 20, 2011 (3-month follow-up)
7.2 April 13, 2011 (Brachytherapy Treatment)
4.1 February 2011
3.3 October 2010 (Dr. prescribed a biopsy)
2.5 April 2010
3.8 October 2009 (Dr. prescribed strong antibiotic)
1.8 April 2009
2.1 October 2008
1.9 October 2007
1.8 October 2006

For me, making the out-of-town trip to Scottsdale AZ for treatment and follow-up have been well worth the effort. Dr. Grado’s primary focus was in 3 areas: PSA, DRE, and Side effects.

PSA was 1.4 which he was pleased with. He expects my long-term PSA to eventually reach less than 0.5.

DRE (digital rectal exam) was completely normal.

SIDE-EFFECTS: While it is apparently more the norm to have some level of continuing frequency, weak stream, difficulty emptying, burning, and/or getting up at night to urinate – in my case, any such side effects disappeared rather quickly. Slight burning with urination lasted a couple of weeks. Frequency and getting up at night lasted a few days. Bowel movements have been pretty much normal except for an occasional clear mucous. Blood in the urine continued for a few weeks. Blood in semen continues at this time. No problems with sexual function but first few ejaculations were painful.

Since my side effects were gone after the first couple weeks, I was able to make plans (during weeks 7-11 after the BT), to travel extensively without incident.

Dr. Grado explained that he normally does not suggest decreasing the daily Flomax at the 3-month mark but said I could I try taking the Flomax every other day for 2 weeks to see how it goes.

At 3 months, I decreased the Flomax to every other day without any negative results. I stopped taking it entirely by the 6 month mark. Getting up several times a night to urinate has never been a symptom for me - either before or after Brachytherapy. DRE was normal. Somewhat-achey orgasms seem to be decreased if Viagra is taken beforehand. Plus the achey pain seems to be less and less as times goes on. Dr. G says that he expects such achey pain to eventually go away.

Apparently it is typical to experience pain in the anus about a year after BT. I experienced this, along with urination pain and frequent loose bowels, which only made the anus more raw. Antibiotics for possible infection didn't help. Steroid foam/suppositories for anal pain didn't help much either. Advil was the most help. Pain symptons completely disappeared after about 6 weeks.

I realize there is no hard and fast scientific proof about diet and supplements. But after reading materials by Meyers and Sholz I figure it can't hurt and so I have been fairly faithful about the following since January 2013:

No Red Meat or Dairy – Lots of fruits and vegetables, chicken, fish
Vitamin D3 2000 IU day
Lycopene 10 mg with each meal
Omega 3 Fish oil 2000 mg twice a day
Selenium 200 MCGs
Vitamin E 200 IU day
Pomegranate Extract 200 Mg
Cialis 2.5 Mg

The increase in PSA from its low point of 0.5 to 0.8 was obviously concerning. My oncologist wondered about a recurrence until he saw that 2 follow-up PSA tests were also 0.8. Dr. Grado ended up being correct that it was the mysterious, but common, PSA "bounce".

PSA is back to it Nadir (low point) of 0.5

Edited October 21, 2013 at 6:07 pm

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Paul - congratulations on the PSA reduction. I can bet that after your European travels, getting home and finding that good result was icing on the cake.

From what I've read, the PSA level can bounce around a bit, but you're looking for a general trend downward. I'll have my second 3-month test next week.

Thanks for sharing the side effect situation. I had issues very similar to yours, which are 95% gone now (six months after seeds). I was on two .4mg FloMax daily pretty much from the beginning. I began reducing the morning dose a few weeks ago, and now I'm on one a day. I'll start reducing the evening dose next week.

Best wishes to you.
PS - While enjoying the Widor and Vierne, don't neglect Buxtehude!

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I had 70 Iodine-125 seeds implanted on 20 July at the Chicago Prostate Cancer Center. I am a Gleason 3+3 with 2 of 12 samples cancerous. Less than 5% involvement in each. Side effects have been minimal except for some discomfort on the left side that feels like a pinch in that area. Blood in urine cleared up after Day Five, but first regular bowel movement was a little uncomfortable. I would highly recommend anyone who has brachytherapy should begin taking stool softener ASAP after the procedure. My PSA was already down to .9 because of the Proscar, but I hope to see it go much lower in three months at my next appointment. Looking forward to getting back to running possibly this weekend and then biking the weekend after that.

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Thank you for sharing your experience, which is very similar to mine. I had 88 Iodine -125 seeds implanted on June 20. First day I had blood clot and painful urination. There was blood in urine (small amount) during the first week. The frequency went up a little. Sometimes the flow is slow. I will go back for X-ray and CT scan on August 4 to evaluate placement of the seeds.

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Hello Paul,
Thanks for the detailed research and report on your decision path. As a result I have contacted Dr. Grado for an initial consultation on Nov 1, 2011. I will be travelling from New Mexico. My stats are Gleason 3+3=6( Aug 10, 2011), PSA 3.6, only one core out of 12 was cancerous, 15 % by volume and I am 67. Thought I would do active surveillance for a few months, then have seed implants if condition worsens. I now think I should have SI soon rather than delay the inevidiable! Local radiation oncologist has performed around 800 procedures. Do you belive that Dr. Grado would be a better option that the local DR. ? I will need to travel about 600 miles several times...Thanks

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I hesitate to discount someone who has performed 800 procedures. Maybe you will have a better feel for the comparison if you consult with them both. No harm in that. Very few docs in the Country would have as many procedures under their belt as Dr. Grado. Flights from Las Vegas to Phoenix are so frequent, I have had no regrets whatsoever traveling to Dr. Grado for my treatment. Keep in mind that I had "mono-therapy", or Brachytherapy only. Except for a day before the Brachytherapy, my treatment does not involve any additional external radiation treatment appointments.
Best Wishes!

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I would like to thank tou very much for sharing YOUR personal journey with pc. Your thoughtfulness in your research has helped me greatly with MY decision on treatment when world was crashing in on me! psa-4.4 biopsy 2 of 12 10% 20% gleason was 6 on june 12 I had my bt today and still read up on yours, especially glad your recovery going well! Thanks again Pee Sense - it does burn

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I spoke with DR. Grado's office manager and was told that Dr. Grado normally performs two EBRT before doing the seed implant. Your post indicates you may have had one EBRT prior to SI. Please clarify. I am not sure why! I have an appointment for consultation next week and may decide to proceed with treatment immediately.

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My wife reminds me that I had 2 EBRTs before doing the seed implant. I'll have to update my Journal #1 to clarify. If you look at Dr. Grado's website under "patient stories" a patient of, I think, 2003, also mentions receiving a couple external beam radiation treatments in the days preceding his Brachytherapy - and I think he includes the reason why. So he has been doing this for years. Reason? Check this with Dr. Grado, but I think it is to cover the general area with some radiation to prevent the remote possibility of cancer cell spread. But again, double-check this with him.
Best wishes!

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