Ozzieville
Member
I was recently treated for prostate cancer at UCLA with a radiation therapy called brachytherapy. Nelson suggested I post a description of my experience for the benefit of this forum.
By way of background, I was diagnosed with prostate cancer (Gleason 3+4) three years ago, at age 65. I went on active surveillance for my prostate cancer, meaning I decided to monitor the cancer rather than go for immediate treatment, working with Dr. Mark Scholz, a prominent prostate oncologist. (The reality is that most men die "with" rather than "of" prostate cancer.)
Not long after my diagnosis, I went on testosterone replacement therapy. The reason: I had begun a new relationship with a very sexy woman, and my libido/erections weren't up to the opportunity. Although my total T was already on the high side of normal, my free T was low. So with the help of TRT, I was a stud again.
Of course TRT + prostate cancer is a controversial subject. Traditionally, adding T was viewed as fanning the flames of prostate cancer. That makes sense, in that androgen deprivation therapy can be an effective means of combating prostate cancer. But researchers such as Dr. Morgentaler have challenged that view, positing instead a "saturation model" that basically says once a saturation level of T is reached, additional T has no effect on cancer. Other researchers such as Dr. Friedman at U. Chicago have gone further and asserted that T actually can combat prostate cancer, and in fact T is being used in various treatment modalities.
In any event, I decided to take my chances. All was well until earlier this year, when an MRI and subsequent biopsy indicated that my prostate lesion had grown and become somewhat more aggressive (Gleason 4+3 rather than 3+4), even though my PSA level remained steady.
At that point, treatment of some kind was the smart path - but what treatment? Surgery (removal of the prostate) is one of many options, but can leave a man "limp and leaking." My oncologist Dr. Scholz wrote a book entitled "Invasion of the Prostate Snatchers," which reflects his view on prostate surgery. Dr. Scholz recommended Dr. Chang at UCLA to perform high dose rate (HDR) brachytherapy. I consulted with a urologist that Nelson kindly referred me to, and that urologist endorsed that option.
Brachytherapy is a radiation treatment that delivers radiation directly into the prostate, as opposed to external beam radiation. It comes in two flavors: high dose rate and low dose rate. LDR brachy involves planting permanent seeds in the prostate that deliver radiation over a period of weeks. HDR brachy involves delivering a higher dose of radiation via needles inserted into the prostate and then withdrawn. UCLA is only performing HDR brachy because of its precision (the permanent seeds can shift around).
Fortunately Dr. Chang was willing to perform "focal" HDR brachy - meaning targeting only the lesion itself. That's somewhat controversial, because prostate cancer is often regarded as multifocal. But I was a good candidate because of my single lesion, and I wanted to minimize side effects. Obviously the less of the prostate you treat, the less the risk of urinary, bowel or ED issues, all of which can occur with any prostate treatment.
Anyway, I got treated a week ago, and was in and out of the hospital the same morning. Other than some initial urinary irritation (which is typical and went away after a couple of days), and spectacular bruising of my perineum (where the needles are inserted), I'm not having any side effects. Although I haven't had sex yet (too early), my nocturnal erections are back. I've remained on TRT, which may have helped with my quick recovery. From here, I'll just have to watch my PSA level to ensure the cancer is eradicated.
By way of background, I was diagnosed with prostate cancer (Gleason 3+4) three years ago, at age 65. I went on active surveillance for my prostate cancer, meaning I decided to monitor the cancer rather than go for immediate treatment, working with Dr. Mark Scholz, a prominent prostate oncologist. (The reality is that most men die "with" rather than "of" prostate cancer.)
Not long after my diagnosis, I went on testosterone replacement therapy. The reason: I had begun a new relationship with a very sexy woman, and my libido/erections weren't up to the opportunity. Although my total T was already on the high side of normal, my free T was low. So with the help of TRT, I was a stud again.
Of course TRT + prostate cancer is a controversial subject. Traditionally, adding T was viewed as fanning the flames of prostate cancer. That makes sense, in that androgen deprivation therapy can be an effective means of combating prostate cancer. But researchers such as Dr. Morgentaler have challenged that view, positing instead a "saturation model" that basically says once a saturation level of T is reached, additional T has no effect on cancer. Other researchers such as Dr. Friedman at U. Chicago have gone further and asserted that T actually can combat prostate cancer, and in fact T is being used in various treatment modalities.
In any event, I decided to take my chances. All was well until earlier this year, when an MRI and subsequent biopsy indicated that my prostate lesion had grown and become somewhat more aggressive (Gleason 4+3 rather than 3+4), even though my PSA level remained steady.
At that point, treatment of some kind was the smart path - but what treatment? Surgery (removal of the prostate) is one of many options, but can leave a man "limp and leaking." My oncologist Dr. Scholz wrote a book entitled "Invasion of the Prostate Snatchers," which reflects his view on prostate surgery. Dr. Scholz recommended Dr. Chang at UCLA to perform high dose rate (HDR) brachytherapy. I consulted with a urologist that Nelson kindly referred me to, and that urologist endorsed that option.
Brachytherapy is a radiation treatment that delivers radiation directly into the prostate, as opposed to external beam radiation. It comes in two flavors: high dose rate and low dose rate. LDR brachy involves planting permanent seeds in the prostate that deliver radiation over a period of weeks. HDR brachy involves delivering a higher dose of radiation via needles inserted into the prostate and then withdrawn. UCLA is only performing HDR brachy because of its precision (the permanent seeds can shift around).
Fortunately Dr. Chang was willing to perform "focal" HDR brachy - meaning targeting only the lesion itself. That's somewhat controversial, because prostate cancer is often regarded as multifocal. But I was a good candidate because of my single lesion, and I wanted to minimize side effects. Obviously the less of the prostate you treat, the less the risk of urinary, bowel or ED issues, all of which can occur with any prostate treatment.
Anyway, I got treated a week ago, and was in and out of the hospital the same morning. Other than some initial urinary irritation (which is typical and went away after a couple of days), and spectacular bruising of my perineum (where the needles are inserted), I'm not having any side effects. Although I haven't had sex yet (too early), my nocturnal erections are back. I've remained on TRT, which may have helped with my quick recovery. From here, I'll just have to watch my PSA level to ensure the cancer is eradicated.
