Q
: 1
10/26/2009 |
Husband diagnosed 5 years ago w/prostate cancer. Opted for seed implants. Last year PSA started rising. Advised cancer returned. This time had cryrosurgery. Again this year told cancer still remains but contained in prostate. PSA 1.43. Doctor now wants to do hormone injections. Says that previous implants means radiation is no longer an option. We are looking for a cure but my understanding is that the hormone injections only delay growth, not cure. Are there any other options? Would the Calypso procedure be a possibility?
If indeed your husband's cancer has been deemed a treatment failure, then hormonal management is an option. You are correct that hormones will slow the growth and potential for spread, but not provide a means of curing your husband of disease. Without my knowing the details of your husband's case, I would be hard pressed to speculate on other management options. However, I would imagine that your husband's oncology care provider has discussed all appropriate alternatives with you. The use of Calypso, which is a GPS localization system for aiding in accurate targeting of the prostate for external beam radiation, has no role in your husband's care, if you have already been told he is not a candidate for more radiation.
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Q
: 2
10/14/2009 |
Are you impotent after you have prostate seed implants?
Impotence can arise as a consequence of any treatment for prostate cancer. With a prostate seed implant, one can expect the possibility of impotence to be influenced by the age of the patient at the time of diagnosis and the patient's pre-treatment erectile capability. Therefore, we expect that older men with declining erectile function will have a greater likelihood of developing impotence than a younger, well functioning patient.
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Q
: 3
07/14/2009 |
I had seeds implanted in October 2007. Since then, my PSA level has continued to rise. What should my next step be?
If the PSA rise has not been rapid and is still at a low level, then it is possible that the cancer may have returned in the prostate without spreading to the bones or lymph nodes. The only way to prove this is by doing a bone scan to rule out the spread of cancer to the bones as well as doing a CT/MRI of the pelvis and the abdomen to rule out the spread of cancer to the lymph nodes. If these tests are negative then the prostate will have to be biopsied. If the biopsy is positive, then salvage external beam treatments using IMRT (intensity modulated radiation therapy) can be done, as this technique allows radiation to go to the prostate without effecting the surrounding tissues. We offer this approach at our institution and I have used it to treat several patients. Rise in PSA could also result from an infection of the prostate, so it is important to know the serial values of the PSAs.
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Q
: 4
05/01/2009 |
In performing prostate seed implants, do you use pre-loaded needles or the Mick Applicator?
I have been using the Mick Applicator for real-time intra-operative planning ever since I started doing brachytherapy in 1988. Up to today, I still prefer using the Mick Applicator.
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Q
: 5
04/19/2009 |
What would cause blood in semen 6 months after prostate seed implants? Is this normal?
There could be infection or inflammation (swelling) of the prostate, urethra, seminal vesicles or epididymis. Also obstruction of the ejaculatory duct can be responsible. Blood in the semen can occur after seed implant, but it is quite rare. Reduction in the amount of the semen is more common. Depending on the other urinary symptoms you have, your doctor could try antibiotics and see if there is any improvement.
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Q
: 6
02/16/2009 |
I would like to know if the placement of the catheter is through the stomach or penis, and how long would the catheter remain in place after the procedure? How soon would a follow-up PSA be done and what results should be expected to consider the procedure a success?
The catheter is placed through the penis and remains in place overnight. Follow-up PSA is usually done after about 2 months. PSA needs to be watched for 1 to 1.5 yrs and should be around 1.
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Q
: 7
02/11/2009 |
My husband had the procedure done in September. He didn't have the hormone therapy or the radiation with it. He was early stage, and it lowered his numbers immediately. Now he has noticed what he thinks are enlarged lymph nodes under his arms. Would this indicate that the prostrate cancer is coming back?
Enlarged lymph nodes in the underarms are not from prostate cancer. He should get examined by a doctor to confirm enlargement and find other causes.
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Q
: 8
01/23/2009 |
I am a 39-year-old male diagnosed with early prostate cancer. My Gleason score was 3+3=6. I had approx. 20 biopsies done last week, of which only one came back positive, next to my right nerve. My urologist is recommending removal of the prostate and the right nerve. Is seed therapy not advantageous for someone my age, or is the cure rate more successful with removal of the prostate? What could be the long term side-effects of the seed therapy for someone my age? If I had seed therapy and the cancer comes back, can I still have prostate removal and/or further radiation? Appreciate your response.
Cure rates are the same for seeds, surgery or external beam radiotherapy. Long term side-effects of seeds are quite minimal, unlike surgery where the risk for urinary incontinence is greater. If seeds do not work, then salvage external beam radiation can be done using the latest IMRT techniques.
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Q
: 9
12/23/2008 |
I had prostate seed implants 2 weeks ago. I was doing fine,
with some swelling and soreness. About 3 days ago I started getting urgency, both for urine and bowel movement at the same time. My doctor has said that everyone reacts differently in the healing process. I am wondering how long this will last. I have searched the Web and have had so many different answers, I am confused.
Your symptoms should dissipate in six to eight weeks.
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Q
: 10
12/17/2008 |
I am 57 years old and in good health. I just recently received a pathology report in which only one (1) of the nineteen (19) biopsies showed adenocarcinoma. This is a solitary microscopic focus approx. 2 mm diameter occupying the tip of the needle core (right-mid-lateral. The finding was confirmed using the prostate cancer triple immunostain. The Gleason score is 3+3=6. The reason for the procedure was that 18 months ago, my PSA was 1.5. My primary care doctor's reading recently was 3.1. One month later, my urologist's reading was 3.4. I am currently researching my options to determine the next step. Thank you for sharing as much as you can, given the information provide herein.
First of all, you have to decide whether you want any definitive treatment now, or whether you want to be watched with regular PSAs, since you have only one sample positive for cancer. This puts you in a very low-risk category. However, the most likely the other choices of treatment would include surgery, seeds or external beam radiation. All give equally good results.
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Q
: 11
12/06/2008 |
Is it possible that the combined effect of two Iodine-125 prostate cancer brachytherapy treatments given three months apart could cause radiation damage to the femoral heads?
I do not think the brachytherapy procedures would cause damage to the femoral heads.
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Q
: 12
12/02/2008 |
Have you had any cases of prostate brachytherapy leading to hip osteonecrosis (avn)? How about if the seeds were implanted twice?
I have not seen any prostate brachytherapy cases leading to osteonecrosis of the hips.
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Q
: 13
11/24/2008 |
I have been diagnosed with Prostate Cancer. I am 60 years old and I have a Gleason score of 7. My PSA level is 9.65. I am deciding if I should pick Radiation Seed Implant or Robotic Surgery to remove the Prostate completely.I would like some information on the Radiation Seed Implant and how it compares to the complete removal of the prostate as far as cure rate and return of the cancer. Thank you for your help.
Both will give equally good results. You really need to sit down with a radiation oncologist for a full discussion. I would be happy to talk with you to discuss the options; please feel free to call me if you wish to do so at 410-328-6080.
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Q
: 14
11/15/2008 |
Will the brachytherapy treatment make cancer cells spread? What are the adverse reactions, short and long-term.
Brachytherapy does not make cancer cells spread. Adverse reactions are minimal.
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Q
: 15
09/29/2008 |
I am about to do a second biopsy as my PSA has elevated to 10+ after radiation in 2007. I am 57 years old. Would radioactive seeds be a good alternative to freeze therapy?
Also, do you insert a tube in the penal track during procedure?
Greetings Dr Amin,
I am about to do a 2nd biopsy as my PSA has elevated to 10+ after radiation in '07.
I am 57 years. Would radioactive seeds be a good alternative to freeze therapy???
Also, do you insert tube in penal track during procedure?
Seeds is a very good alternative as a salvage treatment if done by a well-experienced team. Our team, including myself, has done these procedures for the last several years. Of course, the risks of side effects to the urethra and rectal wall are higher. Freeze therapy is also possible, but it needs to be done by a well-experienced urologist who does these procedures many times a year, as damage to the urethra and rectum can be quite grave. I personally think seeds is safer and more effective. However, one has to be absolutely sure your recurrent disease is only in the prostate and not also in the lymph nodes and/or in the bones. Thus you need a CT scan of the abdomen and pelvis and a bone scan to rule out the above possibilities. Second prostatic biopsy must show new or growing cancer and this can be difficult to differentiate from the original cancer that is dying. This is because it may take 1.5 to 2 years for cancer to disappear. Thus your second biopsy may be too early to interpret the pathology (biopay). Also the PSA could be from prostate infection and thus a trial of antibiotics could be tried. What was the pre-radiation PSA, Gleason Score and clinical stage? As you can see, there are a lot of factors that need to be considered to declare that radiation has failed. I can give you a better answer if you are able to supply me with more information. I hope at this point I have helped you with your question. Please feel free to contact me for further clarification.
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