I had blood work done for another medical issue in February of 2015 and since it had been 3 years for PSA check, PSA was included. The PSA value came back 5.1 and flagged as abnormal. DRE was unremarkable. Another PSA test a few weeks later came back 4.8 so I wondered if there was an infection or trauma causing the abnormal PSA and that it might resolve on its own. My local urologist felt the matter needed follow up with a needle biopsy and called repeatedly to schedule but I resisted in denial thinking the PSA was in decline. A subsequent PSA test a few months later showed PSA level back to 5.1 so I submitted to the biopsy which occurred Nov 4, 2015 and revealed 5 'hot' needles out of 12. My diagnosis was prostate cancer, T1C, Gleason 6. My wife and I attended a follow-up consultation about treatment options with the local urologist before deciding to transfer my care to the Mayo Clinic in Rochester, MN.
Mayo reviewed my case and and confirmed the diagnosis and helped my wife and I choose the seed implant brachy treatment. I was then scheduled for 2 days of tests including bone scan, CT scan, ultrasound, cystoscopy and urine flow dynamic studies. We met with the doctor for follow-up consultation and he said the CT scan showed a sclerotic lesion on my iliac bone in my pelvis and a couple abnormally sized lymph nodes in the same region. An interesting biopsy specimen securing procedure yielded a sample of my pelvic bone that that when analyzed showed 3 nervous days later non-cancerous bone thickening. I am scheduled for a biopsy of the lymph nodes this week. If that comes back clean we will schedule the actual seed implantation procedure.
May 17, 2016 Since my last entry I had a deep tissue fine needle biopsy of an enlarged lymph node that also came back clean so we scheduled the brachy therapy implant procedure for this coming Friday 5-20-16.
We will go to Mayo in Rochester Thursday for 4 pre-op appointments. Barring any problems with the pre-op stuff, the actual brachy seed implants will be installed the next day. I anticipate (hope) being able to come home that same day.
I was conferring with another man with prostate cancer and he is going to have the brachy implants AND EBT. I'm just getting the seed implants without EBT and will be getting an isotope of Iodine while he will be getting Palladium seeds. I thought that was interesting. I guess the individual characteristics of the isotopes lend themselves to treating different levels of prostate cancer. I have also read some about a 'new kid on the block' isotope called Cesium that has supposedly has some potential advantages but is too new for general acceptance and integration into conservative established treatment protocols in place at most institutions.
I'll check in after the procedure.
I underwent brachytherapy on Friday May 20,2016. I had 70 seeds implanted approximately 5 mm apart fastened in strands from 16 needles. On the way home on the same day as the procedure, the Dr called and said he reviewed the post op scan and felt it showed he had done one of the best brachy procedures that he had ever done and that he expected maximum result with minimal collateral damage. To that end, I have had few if any side effects with the possible exception being some dizziness from the Flomax pills but I'm not 100% sure that was the cause of a few hour's dizziness 2 days after the procedure. I came home with a box of catheters but unless something changes I don't anticipate having to self-cath for which I am extremely grateful. I was told I'd be receiving a letter from the doctor to carry stating that I have radio active implants to show to TSA if I travel. I finished the cipro tablets today and now will continue on 30 days of Flomax. I switched taking the Flowmax in the evening just in case it was the cause of the dizzy spell I had experienced Sunday morning. So far so good. I highly recommend Mayo Clinic in Minnesota. This is sketchy but I can fill in the details if you have a specific question.
4-month check up after brachy procedure I had my 4 month post op check up yesterday. I had a chest x-ray and a blood draw for PSA and a consultation with the radiation oncologist. The x-ray showed no seed migration to my lungs and the PSA came back 1.8. down from pre-op 5.3. The doctor said things looked good and on track and going forward I would need to have a PSA check done locally in 6 months and a checkup back in Rochester a year from now.
My biggest issue is the nasal congestion caused by the flowmax. I had recently tried taking myself off it but after a night of hourly visits to the bathroom, I went back on it. I asked the dr about this and he said to wait a couple of months and try not taking it again as things could get better by then. At 4 months post op I still have apprx 25% of the radioactivity still going on. In 2 month it will be 13% so maybe I can quit then.
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