@ThePCRI I had LDR Brachytherapy done in April of 24 by Dr John Sylvester in Sarasota FL. He is mentioned in this interview. At 9 months post PSA was 0.14. I am very happy.
YES! That interview clinched it for me. In the not-too-distant past I would avoid radiation as at all costs! I suffered one night with kidney stones (no ER with a CT scan) to the morning and a visit to my local doctor for a urine analysis to confirm the stones. Now, I'm on board for permanent radioactive seeds in my body forever? Maybe I'm taking a hallucinogenic and will recover soon? But seriously, thanks to KNOWLEDGE, which is power, I have elected to go this route. Again, thanks to PCRI for their tremendous work. The least I can do is to donate to such a worthy cause.
I am 57, I have 4+3 Intermediate PC with no metastasis shown on PSMA scan. I chose to have Brachytherapy with Dr. Einck at KU med center. I am on ORGOVIX for 6 months and having radiation done at my local Mercy hospital. I just finished my first week of Radiation and have 23 more to go. Praying for a good outcome! Thank you for your discussions, they help!
I have the same numbers/PSMA as you with a Decipher of .55. Spoke with a brachy expert at MSK and was told that I could go 6 mos. ADT with SBRT/IMRT, no brachytherapy. He recommended the ADT because of my Decipher. Curious as to why you are getting all three treatment types (ADT, Brachy, IMRT). Good luck.
Besides all the great information, Dr. Sholtz wears some awesome ties. Thanks for all of your videos. Each one has been very informative and it’s now time for me to make a decision with my oncologist urologist. I’m favoring Tulsa or MRI guided HDR Brachytherapy and possibly IRE but will discuss later this week with my Urologist.
I have some great news that may also be very helpful to others on this great site! Per ThePCRI's advice I stopped my vigorous freestyle swimming kick (2 1/2 hours per session twice a week) for one week and then had my PSA retested. My PSA dropped by 4.7 ng/ml! It appears that bicycling is not the only exercise that puts pressure on the prostate and causes the PSA to rise.
Your channel is amazing thank you ! I’m in remission with a Gleason 8 after a year radiation / only half the hormone therapy because it made me insane and suicidal but thanks to me deep diving into my disease using nutricutucals ( i.e. vit D3 10,000 IU Daily only to name this but many others ) I have managed to be now in 100% remission and waiting for six months when my testosterone returns if it ‘ lights up ‘ again but thanks to your amazing unbiased information I have now several routes to take if it returns ….. I know it won’t but am prepared to deal with this thank you again for your wonderful work ❤️🙏
About the risk for the urethra, I asked they would put less dose around the risky zones, and they said NO, they would put the same dose everywhere...I hope what they meant is included in a good global strategy, as they are one of the main centers for Brachytherapy in France! I will discover the implantation of the seeds on in the end of August, after a pelvic scan of control.
I'm 71 and had Brachytherapy last November at the Cleveland Clinic. I experienced ED prior to the procedure and the ED is worsened. I have had only small issues with urine flow and there is now no ejaculate upon orgasm. I'm told the Flomax that I take also affects the ejaculate. I understand that at this (eight months) point my seeds (iodine) are nearly burned out. My 6 mo PSA test was 0.23 with a range
I have been watching scores of videos here, on prostate cancer, made by doctors and patients alike. The COMMENTS on all of the vids are of particular interest: there seems to be no agreement as to WHAT TREATMENT works best with the side-effects most easily overcome with time and therapy of all kinds. . . and which one is the "worst" with the most horrendous outcomes. . . I am now in a thorough state of "perplexity."
If you have had a prior TURP procedure I believe Brachytherapy is not really an option, so that leaves either radiation or complete removal of the prostate perhaps (my situation). Prior TURP about 1.5 yrs. ago to deal with BPH, PSA is still elevated above 30 which has my urologist concerned.
Great information again... but there is a form of "Brachytherapy" that I received at Beaumont Hospital in Michigan that was called High Dose Radiation BUT only required 2 treatments and never left any implanted "Seeds" behind permanently. This was 12 years ago... Is this treatment still used?
@@bobtoner9820 I may be doing that same treatment, possibly at that same institution. Could you tell me what those post-HDR problems were, and how you addressed them? Also, what did you think of the treatment you received at UCLA? Would you do it again? And is there a doctor there that you'd recommend for HDR brachytherapy? Thanks for any details you can provide.
I would like to know how a patient can see if his lesions are either shrinking or even possibly an NED on a more consistent basis? Currently, I'm @ the junction of the 3 strikes aka ADT, Brachytherapy, and the final wack of external beam. What if after a period of time your PSA is either very low or non-existent say after Brachytherapy and the patient wishes to forgo the EBRT with the hope of an NED? Has this ever happened? Unlike it seems other cancers, which tend to be monitored with scans often, it seems not so common with prostate cancer. My oncologist found it "odd" I think that I would present this question. The reasoning is to possibly stop the long-term hormone therapy as well of course the large amount of radiation.
About that point (8:03 What about loss of orgasms without ED?) after 10 weeks from the BT, I have not complete "dry orgasms", there si some sperm with some little blood. The sensations, and the excitation are there, totally normal and strong ( they gave me some Tadalafil 5mg to protect the blood vessels and nerves). But at the moment of orgasm, something is locked inside, especially if I am sat. It then burns at middle of the perineum. I hope it is not a iodin seed blocked in the inside of the urethra (I saw a strange image on the control scan, in view with sections from top to bottom of the pelvis, a small radio opaque shape at the base and in the middle of my penis. I hope it is not a seed stuck in the tissues at that location.) When peeing I have lost 50 percent of the strength of the urine stream, sometimes 70 percent. I still hope this will calm down and improve in the next 6 months.
I had a brachytherapy 6 weeks ago, I was not on Hormon therapy since I was a favorable localised 7(3+4)gleason score, in a very small prostate. Since the procedure, I have lost the sensation of orgasm, although I have normal erections and normal sensitivity during the pré-orgasm phase. Of course the sperm is no more there, just some drops of very clear liquid. That doesn't bother me. At the begining it was as if some sperm would go out but was blocked and went backwards, and it was a strange feeling in my abdomen, a little bit desagreable, burning in the basis of the penis under the perineal area. For me what is tragic is this loss of pulsating orgasm. Maybe it will come back, when the inflammation of the prostate and all area concerned by the radiation from the seeds, will decrease, including the sphincters. But maybe it will not. I take Tadalafil not for the érections but for protection of the blood vessels and nerves, and to urinate easier, as it's tricky at 5th to 6th weeks from the LDD brachytherapy.
Im 56, Desert storm Vet and chose radiation for quality of life! I had LDR brachytherapy and EBRT last Jun/July. Viagra took care of my ED. My orgasms still have fluid, but not much, also I have a dull ache/pain in my prostate for about 60 seconds afterwards. Strange feeling of pleasure, then the pain. At least the pain goes away. My PSA has dropped from 13.5 to 2.5 after 8 months, so that's great!! I guess us men have to get used to many changes to our lives after this damn cancer gets us. Im glad to be alive and try to enjoy each day!! Thank you Dr. S and PCRI and the Minneapolis VA Oncology/Urology dept for their support!
@@themericanmilitary6963 VA is testing me every six months. Next test 21 Aug. 6 months ago I was at 2.5. When I started treatment in June of 2023 I was 13.5.
I'm 70 and diagnosed with Gleason 3+3. My urologist decided to send the biopsy slides for Genomic Decipher testing. That came back .59, the high end of intermediate risk. He is suggesting I have the seed implant procedure taking me out of active surveillance realm. Is that true?
Please talk about Genomic Decipher testing I am a 3+3 PSA score patient that was also tested by the Genomc Decipher method. It came back a .59 an upper intermediate score ??????
Im suppose to go to that IRE procedure but the Urologist told me that i have 3 cancer cells in my prostrate that was seen in MRI. He told me also that re-occurrence is possible. Now im incline to go for BT , my questions is how many seeds do they implant normally? Thx
MRI showed there are no lesions of at least intermediate suspicion (PI-RADS 3 or greater). PSA 3.1 up .5 from 6 months ago. 54 yo. MPS2 came back at 85.3%. Biopsy is next. How often are ExoDx used in diagnosing prostate cancer?
btw - I'm now on Lupron and will be doing Zytiga/prednisone soon. Should be interesting to see who will go stark raving mad first - my wife or me. She's in menopause and I'm doing chemical castration. I'll sleep in the garage :)
My apologies as these are copied from another video on comparisons of procedures. - @jaktao6044 1 minute ago I interviewed with a doctor today (Fred Hutch) here in Seattle who has a good reputation (status etc. and good reviews overall) who essentially said that there are not enough studies that could conclusively show which external beam radiation was best, as in least side effects and longevity. He does both Proton and SBRT/IMRT. I have a Gleason 9 (4+5) with PSMA showing localized cancer. Half these doctors when interviewing have no clue with the Tri-modal approach. That is, ADT/ Brachytherapy/External BEAM. Yet, in their notes that is usually the recommendation. His suggestion was IMRT but left the decision to me as to which one (proton or) He states (please clarify) that Proton is possibly more precise and does NOT exit unlike SBRT etc, which does exit. (goes in and leaves on the other side). I'm not sure if this is a positive or negative or if it really matters. Unlike the first doctor there who felt that space oar wasn't necessary, I didn't inquire with this one. I did however find his suggestion for doing IMRT BEFORE Brachytherapy unsettling! Is this common? Can this be done, or should it be done beforehand? Mind you, I'm having Brachytherapy with the best down (I'm in Seattle) there in the Bay area and these guys don't( imo) compare to Dr. Kurtzman. His suggestion is ADT/Brachytherapy/EB. The proton issue needs precise pros/cons. It's been around for close to 20yrs? It sounds from one perspective to be a good choice. Why? Well, how about precision and no exit? Any which way you look at it - they all pass through other organs which could possibly have a long-term negative outcome. What would your suggestion be for my case? I'm somewhat confused as I had an ExoDX test which showed a borderline reading (urologist stated: threshold) and a genetic test which showed ZERO for cancer as well as a DRE which was states as benign. However, I did start out with a PSA of 13+. I really like your style with ties! I used to wear ties like that to the office as well. Your selection however tops my former attire. I'd like to thank you and Alex deeply for lessening the serious gravity of prostate cancer. I have followed your advice much to the chagrin of my wife who is rather limited in her thinking on these matters. Typical standard old school trust the doctor and follow directions and what not. Mind you, I had a difficult time locating a urologist who would do perineal vs rectal for the biopsy AND to do a true targeted biopsy. One well known doctor here advertises targeted biopsies. False. Just a play of words. When it came down to the interview and dealing with the gatekeeper (MA) it was pathetic. He would "target the two lesions of questions but do a random biopsy as standard procedure. It's always the same line "to locate any possibly rogue cancer". As I said, I've read your books and have communicated with one of your team as well as review all your videos and all I can say is I'm grateful for people like you and Alex. Even Dr. Kwon is hilarious! I do feel you might have done a flip-flop with your latest Brachytherapy video related to advanced cancer with either High or low intensity. I believe your initial stance was for permanent seeds and not the high dose. So now - we have PSMA. And you have my situation. What is your suggestion, if you don't mind stating?
#Brachytherapy For #ProstateCancer | Steven Kurtzman, MD & Ankit Agarwal, MD #pcri
ruclips.net/video/GZTK6IcGI-w/видео.htmlfeature=shared
@ThePCRI I had LDR Brachytherapy done in April of 24 by Dr John Sylvester in Sarasota FL.
He is mentioned in this interview.
At 9 months post PSA was 0.14.
I am very happy.
YES! That interview clinched it for me. In the not-too-distant past I would avoid radiation as at all costs! I suffered one night with kidney stones (no ER with a CT scan) to the morning and a visit to my local doctor for a urine analysis to confirm the stones. Now, I'm on board for permanent radioactive seeds in my body forever? Maybe I'm taking a hallucinogenic and will recover soon? But seriously, thanks to KNOWLEDGE, which is power, I have elected to go this route. Again, thanks to PCRI for their tremendous work. The least I can do is to donate to such a worthy cause.
I am 57, I have 4+3 Intermediate PC with no metastasis shown on PSMA scan. I chose to have Brachytherapy with Dr. Einck at KU med center. I am on ORGOVIX for 6 months and having radiation done at my local Mercy hospital. I just finished my first week of Radiation and have 23 more to go. Praying for a good outcome! Thank you for your discussions, they help!
I have the same numbers/PSMA as you with a Decipher of .55. Spoke with a brachy expert at MSK and was told that I could go 6 mos. ADT with SBRT/IMRT, no brachytherapy. He recommended the ADT because of my Decipher. Curious as to why you are getting all three treatment types (ADT, Brachy, IMRT). Good luck.
Another timely interview...always informative and realistic
Besides all the great information, Dr. Sholtz wears some awesome ties. Thanks for all of your videos. Each one has been very informative and it’s now time for me to make a decision with my oncologist urologist. I’m favoring Tulsa or MRI guided HDR Brachytherapy and possibly IRE but will discuss later this week with my Urologist.
What did you ultimately decide to do? And how well did it go? Any side effects?
HDR brachytherapy
51 years old, Gleason 3+4, PSA 4,
Very happy with results
No side effects other than mostly dry orgasm
PSA after 2 years is .4
Very timely. This is the treatment I will have starting in October
I have some great news that may also be very helpful to others on this great site! Per ThePCRI's advice I stopped my vigorous freestyle swimming kick (2 1/2 hours per session twice a week) for one week and then had my PSA retested. My PSA dropped by 4.7 ng/ml! It appears that bicycling is not the only exercise that puts pressure on the prostate and causes the PSA to rise.
Your channel is amazing thank you ! I’m in remission with a Gleason 8 after a year radiation / only half the hormone therapy because it made me insane and suicidal but thanks to me deep diving into my disease using nutricutucals ( i.e. vit D3 10,000 IU Daily only to name this but many others ) I have managed to be now in 100% remission and waiting for six months when my testosterone returns if it ‘ lights up ‘ again but thanks to your amazing
unbiased information I have now several routes to take if it returns ….. I know it won’t but am prepared to deal with this thank you again for your wonderful work ❤️🙏
YOUR DOCTORS ARE HARMING YOU. BE BETTER INFORMED
About the risk for the urethra, I asked they would put less dose around the risky zones, and they said NO, they would put the same dose everywhere...I hope what they meant is included in a good global strategy, as they are one of the main centers for Brachytherapy in France! I will discover the implantation of the seeds on in the end of August, after a pelvic scan of control.
Thank you!
I'm 71 and had Brachytherapy last November at the Cleveland Clinic. I experienced ED prior to the procedure and the ED is worsened. I have had only small issues with urine flow and there is now no ejaculate upon orgasm. I'm told the Flomax that I take also affects the ejaculate. I understand that at this (eight months) point my seeds (iodine) are nearly burned out. My 6 mo PSA test was 0.23 with a range
Recommend cialis....
I'm 74 and is going to schedule brachytherapy at the Cleveland Clinic before the end of this year. Thanks for your channel it's very informative.
PSA UNDER 10 IS OK.
YES TEN
@@KDean22 After treatment?
Who told you that?
@@thomaslehmann5981 I AM LIVING WITH PSA 264 AND ALIVE FOR 1 YEAR
I have been watching scores of videos here, on prostate cancer, made by doctors and patients alike. The COMMENTS on all of the vids are of particular interest: there seems to be no agreement as to WHAT TREATMENT works best with the side-effects most easily overcome with time and therapy of all kinds. . . and which one is the "worst" with the most horrendous outcomes. . . I am now in a thorough state of "perplexity."
If you have had a prior TURP procedure I believe Brachytherapy is not really an option, so that leaves either radiation or complete removal of the prostate perhaps (my situation). Prior TURP about 1.5 yrs. ago to deal with BPH, PSA is still elevated above 30 which has my urologist concerned.
Great information again... but there is a form of "Brachytherapy" that I received at Beaumont Hospital in Michigan that was called High Dose Radiation BUT only required 2 treatments and never left any implanted "Seeds" behind permanently. This was 12 years ago... Is this treatment still used?
HDR brachytherapy. I received HDR August 2023 at UCLA. Some problems at first but doing fine now
@@bobtoner9820 I may be doing that same treatment, possibly at that same institution. Could you tell me what those post-HDR problems were, and how you addressed them? Also, what did you think of the treatment you received at UCLA? Would you do it again? And is there a doctor there that you'd recommend for HDR brachytherapy? Thanks for any details you can provide.
I would like to know how a patient can see if his lesions are either shrinking or even possibly an NED on a more consistent basis? Currently, I'm @ the junction of the 3 strikes aka ADT, Brachytherapy, and the final wack of external beam. What if after a period of time your PSA is either very low or non-existent say after Brachytherapy and the patient wishes to forgo the EBRT with the hope of an NED? Has this ever happened? Unlike it seems other cancers, which tend to be monitored with scans often, it seems not so common with prostate cancer. My oncologist found it "odd" I think that I would present this question. The reasoning is to possibly stop the long-term hormone therapy as well of course the large amount of radiation.
About that point (8:03 What about loss of orgasms without ED?) after 10 weeks from the BT, I have not complete "dry orgasms", there si some sperm with some little blood.
The sensations, and the excitation are there, totally normal and strong ( they gave me some Tadalafil 5mg to protect the blood vessels and nerves).
But at the moment of orgasm, something is locked inside, especially if I am sat. It then burns at middle of the perineum.
I hope it is not a iodin seed blocked in the inside of the urethra (I saw a strange image on the control scan, in view with sections from top to bottom of the pelvis, a small radio opaque shape at the base and in the middle of my penis. I hope it is not a seed stuck in the tissues at that location.)
When peeing I have lost 50 percent of the strength of the urine stream, sometimes 70 percent. I still hope this will calm down and improve in the next 6 months.
I had a brachytherapy 6 weeks ago, I was not on Hormon therapy since I was a favorable localised 7(3+4)gleason score, in a very small prostate. Since the procedure, I have lost the sensation of orgasm, although I have normal erections and normal sensitivity during the pré-orgasm phase. Of course the sperm is no more there, just some drops of very clear liquid. That doesn't bother me. At the begining it was as if some sperm would go out but was blocked and went backwards, and it was a strange feeling in my abdomen, a little bit desagreable, burning in the basis of the penis under the perineal area. For me what is tragic is this loss of pulsating orgasm. Maybe it will come back, when the inflammation of the prostate and all area concerned by the radiation from the seeds, will decrease, including the sphincters. But maybe it will not. I take Tadalafil not for the érections but for protection of the blood vessels and nerves, and to urinate easier, as it's tricky at 5th to 6th weeks from the LDD brachytherapy.
Im 56, Desert storm Vet and chose radiation for quality of life! I had LDR brachytherapy and EBRT last Jun/July. Viagra took care of my ED. My orgasms still have fluid, but not much, also I have a dull ache/pain in my prostate for about 60 seconds afterwards. Strange feeling of pleasure, then the pain. At least the pain goes away. My PSA has dropped from 13.5 to 2.5 after 8 months, so that's great!! I guess us men have to get used to many changes to our lives after this damn cancer gets us. Im glad to be alive and try to enjoy each day!! Thank you Dr. S and PCRI and the Minneapolis VA Oncology/Urology dept for their support!
@@io3010 what is your PSA now? Thank you.
My PSA (after 3 month brachytherapy) was 2.5. Before was 8.
@@themericanmilitary6963 VA is testing me every six months. Next test 21 Aug. 6 months ago I was at 2.5. When I started treatment in June of 2023 I was 13.5.
im new to the prostate cancer for 2 months, but i would think you will need to make your final judgeme8nt after your body heals no?
I'm 70 and diagnosed with Gleason 3+3. My urologist decided to send the biopsy slides for Genomic Decipher testing. That came back .59, the high end of intermediate risk. He is suggesting I have the seed implant procedure taking me out of active surveillance realm. Is that true?
Please talk about Genomic Decipher testing
I am a 3+3 PSA score patient that was also tested by the Genomc Decipher method. It came back a .59 an upper intermediate score ??????
Can one do targeted brachytherapy for a single tumor that was identified on an MRI?
Im suppose to go to that IRE procedure but the Urologist told me that i have 3 cancer cells in my prostrate that was seen in MRI. He told me also that re-occurrence is possible. Now im incline to go for BT , my questions is how many seeds do they implant normally? Thx
MRI showed there are no lesions of at least intermediate suspicion (PI-RADS 3 or greater). PSA 3.1 up .5 from 6 months ago. 54 yo. MPS2 came back at 85.3%. Biopsy is next. How often are ExoDx used in diagnosing prostate cancer?
btw - I'm now on Lupron and will be doing Zytiga/prednisone soon. Should be interesting to see who will go stark raving mad first - my wife or me. She's in menopause and I'm doing chemical castration. I'll sleep in the garage :)
My apologies as these are copied from another video on comparisons of procedures. -
@jaktao6044
1 minute ago
I interviewed with a doctor today (Fred Hutch) here in Seattle who has a good reputation (status etc. and good reviews overall) who essentially said that there are not enough studies that could conclusively show which external beam radiation was best, as in least side effects and longevity. He does both Proton and SBRT/IMRT. I have a Gleason 9 (4+5) with PSMA showing localized cancer. Half these doctors when interviewing have no clue with the Tri-modal approach. That is, ADT/ Brachytherapy/External BEAM. Yet, in their notes that is usually the recommendation. His suggestion was IMRT but left the decision to me as to which one (proton or) He states (please clarify) that Proton is possibly more precise and does NOT exit unlike SBRT etc, which does exit. (goes in and leaves on the other side). I'm not sure if this is a positive or negative or if it really matters.
Unlike the first doctor there who felt that space oar wasn't necessary, I didn't inquire with this one. I did however find his suggestion for doing IMRT BEFORE Brachytherapy unsettling! Is this common? Can this be done, or should it be done beforehand? Mind you, I'm having Brachytherapy with the best down (I'm in Seattle) there in the Bay area and these guys don't( imo) compare to Dr. Kurtzman. His suggestion is ADT/Brachytherapy/EB. The proton issue needs precise pros/cons. It's been around for close to 20yrs? It sounds from one perspective to be a good choice. Why? Well, how about precision and no exit? Any which way you look at it - they all pass through other organs which could possibly have a long-term negative outcome. What would your suggestion be for my case? I'm somewhat confused as I had an ExoDX test which showed a borderline reading (urologist stated: threshold) and a genetic test which showed ZERO for cancer as well as a DRE which was states as benign. However, I did start out with a PSA of 13+.
I really like your style with ties! I used to wear ties like that to the office as well. Your selection however tops my former attire. I'd like to thank you and Alex deeply for lessening the serious gravity of prostate cancer. I have followed your advice much to the chagrin of my wife who is rather limited in her thinking on these matters. Typical standard old school trust the doctor and follow directions and what not. Mind you, I had a difficult time locating a urologist who would do perineal vs rectal for the biopsy AND to do a true targeted biopsy. One well known doctor here advertises targeted biopsies. False. Just a play of words. When it came down to the interview and dealing with the gatekeeper (MA) it was pathetic. He would "target the two lesions of questions but do a random biopsy as standard procedure. It's always the same line "to locate any possibly rogue cancer".
As I said, I've read your books and have communicated with one of your team as well as review all your videos and all I can say is I'm grateful for people like you and Alex. Even Dr. Kwon is hilarious! I do feel you might have done a flip-flop with your latest Brachytherapy video related to advanced cancer with either High or low intensity. I believe your initial stance was for permanent seeds and not the high dose. So now - we have PSMA. And you have my situation. What is your suggestion, if you don't mind stating?
MY biggest issue after brachytherapy was the constant hourly urge to urinate. JLH