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LDR Brachytherapy, Davekc10’s treatment journey

User
Posted 21 Jan 2023 at 13:49

Thanks for the update.

Dave

User
Posted 21 Jan 2023 at 15:33

One becquerel is a level of radioactive decay where one atom is decaying every second on average. This is a really low number and the naturally occurring radioactive elements in your body means the whole of your body has a natural level of many thousands of becquerels anyway. Nevertheless, the LDR is going to increase that by probably a million times in the prostate. 1.67GBq is 1,670,000,000 atoms decaying per second and giving off their radiation as a result.

The becquerel is not a very useful unit for treatment effect for a several reasons...

It says nothing about the energy of each radioactive decay, which vary over an enormous spectrum between different isotopes of different elements. Brachytherapy uses low energy radiation so it doesn't travel far in the body (I think not much more than 1cm), and the treatment is thus limited to the area around the seeds. The energy of each decay for Iodine125 is 35keV (kilo electron volts), although mostly from an intermediate decay product. In contrast, the energy of the radiation in external beam which has to pass through much more tissue than 1cm to even reach the prostate is 6MeV, which is 170x more energy per photon. (It would in theory be possible to work out the equivalent becquerels for external beam, but I've no idea what the beam intensity is in terms of photons/second.)

A more useful unit for treatment effect is the Gray (Gy), and this is a measure of the radioactive energy absorbed by a kg of tissue. A prostate LDR brachy is usually 150-170Gy in the case of using Iodine125. This is a high figure compared with any of the other radiotherapy treatments (EBRT 60 or 74Gy, SABR 37Gy, HDR 32Gy) because more energy is required for the same treatment effect the longer the treatment takes, and it's about 200 days for LDR brachytherapy using Iodine125 before the rate of radioactive decay in the seeds drops too low to be treating any more.

User
Posted 21 Jan 2023 at 16:40
Phew! Thanks Andy I hope there is not going to be a written exam after this. I used GBq because that’s the only reference point I have. Not much information has been forthcoming from my doctor🤔

Rgds

Dave

User
Posted 01 Mar 2023 at 17:32

Update! Today I had my first clinical review since my procedure in November. My PSA has fallen from 8.6 to 0.8 in just over three months. My Consultant was very, very pleased and said he very rarely sees such a quick drop ( he said he usually plans for 9-12 months ) and his aim is to get the PSA under 1.0
All my other bloods were ‘normal’.
The Consultant told me he does not really need to be involved any more ( although he will be available if required ) and I will be handed over to a CNS at my local hospital ( so no more excellent empire biscuits for me ☹️)
I can try stopping my Tamsulosin to “see what happens”.
Next check in about six months.
Although I am very happy at the moment I keep having the thought of I hope nobody cocked up the blood test 🤔
Rgds
Dave

Edited by member 23 Apr 2023 at 22:55  | Reason: Not specified

User
Posted 11 Jun 2023 at 14:43
Just bumping this up to the top as recently there have been a few queries about Brachytherapy and I can’t work out if I can make an internal link.

Rgds

Dave

User
Posted 28 Aug 2023 at 17:58
Update.

Today I had my 6 month review ( 9 months after the procedure ) PSA has fallen from 0.8 to 0.5👍 I am still feeling fatigued so I am going to arrange a general blood test to see if that flags up anything.

I currently have some intermittent light blood indications after a bowel movement. I have been told to keep an eye on it. I was told it could be a fissure ( most likely ) or haemorrhoids ( unlikely no discomfort at the moment ). The elephant in the room ( bowel cancer ) was not mentioned.

Next blood test in 4 months.

Rgds

Dave

User
Posted 29 Aug 2023 at 13:45

Congrats on the low PSA Dave. I only had the Brachy procedure done ten days ago and do feel a little more tired than normal. Hopefully it won't get any worse than that. I hope your blood test helps you. I just also wanted to say that I once suffered from a fissure and it was the most horrendously painful thing that has ever happened to me, so for me there would be no mistaking it for something else. I had mine surgically repaired. 

All the best with it

Tom

User
Posted 29 Aug 2023 at 14:30

Hi Dave,

Don't worry it does get better as days and weeks pass and it will take time for the bruising to go i was black & blue, my psa dropped slowly at every monthly then yearly checks and i did get some blood in poos but was having the normal yearly check ups for cancer from my GP that where coming back clear.I was offered Robotic surgery or Brachytherapy in 2016 and leaned towards Brachytherapy because a friend had the same and had very good results and was back to work very soon after.

I am 7 years on and psa is 0.10 and all good so far.good luck .

John.

User
Posted 07 Feb 2025 at 12:29

Hi Dave, thanks for putting your post on and thanks too to the other contributors, it’s all very good information for me.

After a year on AS I’m now told I need treatment and LDR BRACHYTHERAPY seems to be top of my list, I still need to be fully assessed with the flow test etc but if that goes well then it looks likely this is the way I’ll go and that has been due mostly to the posts on this forum.

Thanks again to you all and best wishes for your continued recovery, kind regards, John

 
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