Q
: 1
12/11/2009 |
Is the seed implant used in patients with aggressive prostate cancer? My husband has been diagnosed with advanced prostate cancer and is currently doing well with hormone therapy.
Advanced prostate cancer implies that your husband's treatment team has identified disease that is or has a high probability of being outside the gland, either through the capsule, in the regional lymph nodes or beyond (bones). If that is the case, then a seed implant, which is used for cases where disease is felt to be contained within the prostate, would be a less appropriate treatment option.
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Q
: 2
12/08/2009 |
If I get seed implants in my prostate and I am cured, is my prostate no longer producing semen?
One of the consequences of radiation treatment to the prostate is dry ejaculate. You are correct that the prostate will be significantly less able to produce one of the constituents of semen.
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Q
: 3
12/04/2009 |
Can prostate seed implants raise your white blood cell count?
It would be unusual for a prostate seed implant to cause an elevation in one's white blood cell count unless infectious prostatitis or some other type of infection developed from the procedure.
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Q
: 4
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
: 5
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
: 6
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
: 7
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
: 8
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
: 9
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
: 10
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
: 11
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
: 12
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
: 13
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
: 14
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
: 15
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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