Brachytherapy: patient experiences

 

Men from all walks of life may suffer from prostate cancer. Here, you can read the stories of men who decided that LDR brachytherapy (seed implantation) was the best treatment for their cancer.

 
 

Edward Boynton, 62

 

62-year-old Edward Boynton was the 3000th patient to undergo brachytherapy treatment at The Leeds Cancer Centre at St James’s University Hospital. Mr Boynton, who runs the Nag’s Head at Pickhill, near Thirsk, explained: “When my GP referred me to a specialist about my prostate after a routine health check, I was straight on the phone to a friend who is a retired doctor. He asked me what the Gleason reading was and advised me to ask about seed brachytherapy as an option which would least disrupt my life. I was delighted when they told me I was a suitable candidate to have the procedure and I’m hoping to be back at work within a day or so.

 

Read more about Edward's story

 

 

Alan Moore, 58

 

Alan is a 58-year-old great-grandfather from Derbyshire who was diagnosed with

prostate cancer in October 2014. After a routine blood test he was referred to the

Royal Derby Hospital where he was told he had an enlarged prostate and a prostate

specific antigen PSA level of nine (a normal reading is around 0-4).

 

Two weeks after undergoing a biopsy Alan was told he had prostate cancer and his

consultant suggested he had his prostate removed. Radiotherapy and hormone

treatment were also suggested but Alan was concerned about side-effects. Then one

of his consultants suggested low-dose brachytherapy which was being carried out at

St James’s Hospital in Leeds.

 

After meeting his consultant Mr Bottomley, Alan’s LDR brachytherapy procedure took place in June last year.

 

“I was told that after the operation I would feel some discomfort between my legs but nothing too severe,” Alan explains.

 

“I felt groggy after the anaesthetic but otherwise pretty good. I was told to walk around and get dressed, given pain relief and tablets to keep my waterworks functioning.

 

“I was told to drink plenty of water for about three weeks and to keep taking the waterworks tablets and that I might suffer with cystitis.

 

“At 5.30pm that day I was discharged and went home. It was tender but far from painful. I went to work the next day and was singing on stage that Saturday night.”

 

When Alan returned to Leeds a month later for a follow-up examination and a blood test to determine his PSA level, he was discharged back to the Royal Derby. He was thrilled to be told the treatment had been a success and that his PSA had fallen to 5.7.

 

He still has four-monthly check-ups and last November he discovered that his PSA level had dropped to three.

 

“My experience with this treatment was excellent,” says Alan. “And I’m over the moon with the result.”

 

Image courtesy of The Daily Mail Scotland. Details courtesy of The Express.

 

Alan Moore, 58

 

Alan is a 58-year-old great-grandfather from Derbyshire who was diagnosed with

prostate cancer in October 2014. After a routine blood test he was referred to the

Royal Derby Hospital where he was told he had an enlarged prostate and a prostate

specific antigen PSA level of nine (a normal reading is around 0-4).

 

Two weeks after undergoing a biopsy Alan was told he had prostate cancer and his

consultant suggested he had his prostate removed. Radiotherapy and hormone

treatment were also suggested but Alan was concerned about side-effects. Then one

of his consultants suggested low-dose brachytherapy which was being carried out at

St James’s Hospital in Leeds.

 

After meeting his consultant Mr Bottomley, Alan’s LDR brachytherapy procedure took place in June last year.

 

“I was told that after the operation I would feel some discomfort between my legs but nothing too severe,” Alan explains.

 

“I felt groggy after the anaesthetic but otherwise pretty good. I was told to walk around and get dressed, given pain relief and tablets to keep my waterworks functioning.

 

“I was told to drink plenty of water for about three weeks and to keep taking the waterworks tablets and that I might suffer with cystitis.

 

“At 5.30pm that day I was discharged and went home. It was tender but far from painful. I went to work the next day and was singing on stage that Saturday night.”

 

When Alan returned to Leeds a month later for a follow-up examination and a blood test to determine his PSA level, he was discharged back to the Royal Derby. He was thrilled to be told the treatment had been a success and that his PSA had fallen to 5.7.

 

He still has four-monthly check-ups and last November he discovered that his PSA level had dropped to three.

 

“My experience with this treatment was excellent,” says Alan. “And I’m over the moon with the result.”

 

Image courtesy of The Daily Mail Scotland. Details courtesy of The Express.

 

 

Tom McGrath, 54

 

Tom McGrath was a fit and seemingly healthy 54-year old when he changed his doctor

to one closer to his home in Wellington, New Zealand.  His new General Practitioner

ran a comprehensive health check, including the prostate-specific-antigen (PSA) test

that indicates risk of prostate cancer.  When the test returned an elevated result

indicating cancer the news came as a shock for Tom.

 

"The scariest thing is if I had not changed doctor I might not even know now that I had

prostate cancer," says Tom.

 

A biopsy confirmed that the presence of a tumour that was still confined to the prostate gland.  Tom and his wife, author Julia Millen, began to assess treatment options.

 

Tom leads an active life with recreational interests of Latin American dancing, mountain biking and ocean swimming. He looked for a treatment with the best chance of preserving his quality of life as well as killing the cancer.

 

Despite LDR brachytherapy’s long history in New Zealand, Tom said he was not initially told it could be an option for him. He discovered the treatment through reading a book on prostate cancer.

 

“Many guys go for surgery. I was concerned about hospitalisation and the far reaching effects surgery might have.”

 

Julia was adamant about LDR brachytherapy.

 

“As soon as I read about seeds I knew this was it. I was worried Tom would get depressed with the other treatments as he is so active.”

 

This is a sentiment that Tom echoes.  “We understood that in terms of outcomes, LDR brachytherapy was similar to other treatments including surgery and conventional radiation therapy. The big difference for us was the minimal inconvenience offered by brachytherapy. Being told you have cancer can be frightening enough without the daunting prospect of a long recovery from treatment. The ability to get straight back into those pursuits that make me happy was a big factor in our decision.”

 

Tom was back at work the week after his procedure and within two weeks was competing in open water swimming events. His specialists advise that he is most likely cured.

 

The experience has inspired Tom to put words to paper and write a book as a way to record his experience. Blasted by Seeds is currently the only book in the world about LDR brachytherapy written from a patient perspective. Tom says he hope it helps men.

 

“There wasn’t a lot of information offered to me about brachytherapy. We had to actively ask doctors after we read about it. I think it’s important to know as much as possible about treatment options and the journey ahead and I hope this book is of use to both men and their partners.”

 

“It’s an account with a few unexpected turns in it and an outcome that is quite a lot better than some – its got a fair bit of good news”.

 

Image courtesy of The New Zealand Herald/newspix.co.nz

 

John, 47

 

John, an architect from London, was enjoying newly married life and a new job when

he was diagnosed with prostate cancer.

 

“I had recently got married and just changed jobs”, said John. Part of the package for

his new job was an annual health screen. When the first screen indicated a slightly

raised PSA, John was not concerned. “I was only 45 at the time” he said. “In my mind,

prostate cancer was an older man’s disease. My father had it when he was in his late

60s.” However, John was advised to see his GP and have his PSA level monitored.

 

After a year of regular monitoring, his GP was concerned that John’s PSA remained

elevated and recommended that John had a biopsy. “When the results came back that I had cancer, I was in complete shock”, said John. “I had not allowed myself to even think about that scenario.” Adding to his distress, it could not be confirmed at what stage the cancer was and whether it had spread.

 

John’s consultant arranged for a MRI scan, but the results were inconclusive as to whether the cancer had spread outside the prostate. The next decision for John was which treatment to have. ”My local hospital recommended surgery as I was still young and this would remove the cancer completely,” explained John, “but the more I read about the side effects, the more it felt as though my life would never be the same again. My wife is younger than me and we have not yet had children, so the thought that I would become infertile after surgery was another bombshell.”   

 

John was transferred to Guy’s Hospital with a recommendation for a radical prostatectomy, but whilst he was there a second MRI scan was taken which confirmed that the cancer was indeed still localised and John was informed that he may be suitable for a less invasive procedure known as prostate brachytherapy. In order to be sure that this was an option for him, brachytherapy template biopsies were taken which confirmed the results.

 

In August 2008, John successfully underwent prostate brachytherapy and 10 days later he and his wife went on holiday to Italy. “I had heard of prostate brachytherapy, but did not realise that I would be able to benefit from it until I was at Guy’s”, said John. “I am so glad I was suitable for this treatment as the recovery time is much faster than with surgery and my PSA level is now returning back to normal.” 

 

Graham Robson, 53

 

As CEO of V.People, a successful man management company in Aberdeen, and with

four demanding children, Graham really did not have the time to be ill, so when he

got the results from a routine medical check-up that he had a PSA level of 6.5 ng/mL

he was shocked.

 

"I had booked in for a BUPA medical check last May just to make sure everything was

in working order before I embarked on a 120 mile charity bike ride" said Graham. "I

had trained hard for the ride and was feeling fit and healthy so when the doctor said

I had prostate cancer, I was totally taken aback."

 

"My initial reaction was to have surgery and just cut it out, but when I was told that it could take 3 months to fully recover and that there was a strong possibility that I would get erectile and urinary problems after surgery, I realised that my life may never be the same again."

 

Deciding that surgery was not an option, Graham was given the alternative choice of external beam radiation, which has a high success rate, but still has the same side effects as surgery. A friend, however, mentioned that he had read about the St Luke's Cancer Centre in Guildford which was pioneering research into prostate cancer.

 

"I looked them up on the web and read about LDR brachytherapy, a non-invasive treatment which injects radioactive seeds into the tumour", said Graham. "I had not heard of this treatment before but it sounded a good option to me."

 

Graham went to see Professor Stephen Langley at the Centre. "I was worried how successful the treatment would be and what would happen if it did not work and the centre was, of course, a long way from home." However, Professor Stephen Langley reassured Graham that LDR brachytherapy had a high success rate with fewer side effects than surgery and that he could be back home and at work again very soon.

 

"I went in for the brachytherapy procedure in the morning and was out of bed in the afternoon and home the next day. It was that quick and painless", said Graham.

 

Max Stinchcombe, 54

 

Max is a happily married man with two children. He has a rewarding career as a bank

manager in Southampton and likes to spend his weekends on the golf course. In fact,

it was on the golf course 4 years ago that he first learnt he had prostate cancer.

 

"I had just had a routine company medical which showed a slightly elevated PSA

(prostate specific antigen) score which I was told could be indicative of the early

stages of prostate cancer. My wife was very concerned and insisted that I go to the

GP to get it checked out. My GP immediately referred me to a urologist who took a

rather painful biopsy."

 

The results of the biopsy were due back on the day of an important golf match, so Max left his wife to take the call convinced nothing was wrong. "I will always remember my wife calling me on the first hole with the momentous words - Max, you have cancer", said Max. "I immediately went into the stereotypic man's response by denying anything was wrong and carried on playing golf as usual. I even stayed for the prize giving ceremony in the evening."

 

When Max got home he found his wife in tears and he realised the potential severity of his condition. "I decided to take control of this disease and went online to research possible treatment options", said Max. "I also contacted the Prostate Cancer Charity which had fantastic patient information and were extremely helpful. The treatment I decided I wanted was brachytherapy, a convenient `one-stop shop` which uses radioactive seeds to destroy the cancer cells. Results showed that the side effects from brachytherapy were less severe in terms of incontinence and impotence than traditional surgery and that was very important to me as I was only 50 at the time."

 

Max had his brachytherapy at the St Luke's Cancer Centre in Guildford performed by Professor Stephen Langley. "I was slightly sore and uncomfortable afterwards, but had no side effects and was back at work in 2 days. So far there is no sign of the cancer returning."

 

Max actually had to go to the USA 4 months after his treatment. "It was rather amusing", he said, "as the radioactive seeds were still active and I had to have a letter from Professor Stephen Langley at St Luke's Cancer Centre to get me through airport security - there was no way I wanted another body search!!"

 

Chris, 61

 

Chris and his wife Ivy were enjoying early retirement and had just bought a second

home in Florida when his GP diagnosed a borderline PSA score in January 2005

during a routine medical. Chris was referred to a urologist who reassured Chris that

at this stage no treatment was needed and that he would be actively monitored with

his PSA taken every 6 months to record any changes. “I was so unconcerned with the

results”, said Chris, “that my wife and I went off to Florida to enjoy our new home and

the sunshine and I completely forgot about my next 6 month blood test.”

 

It was later in September 2005, when he was back in the UK, that Chris had a second

PSA test and his urologist was concerned as his PSA level had risen to 10.9. A biopsy was taken which confirmed that Chris had localised prostate cancer and the urologist recommended that he underwent an immediate radical prostatectomy. However, Chris was not keen on the side effects from radical surgery and also the long post-operative recovery period.

 

Luckily, Chris has American relatives and he decided to ask them for advice. They suggested that Chris enquired about brachytherapy (or seed implantation as it is called), a procedure routinely carried out in the USA. Chris mentioned this to his urologist who agreed that he was a suitable candidate, but that this treatment option was not available in Devon. Having researched brachytherapy on the internet, Chris and his wife Ivy decided that this was definitely the treatment they both wanted as the risk of impotence was minimal compared to surgery and their physical relationship was very important to them.

 

Chris eventually decided to pay privately for brachytherapy and his treatment was carried out at Guy’s Hospital in London in November 2005. “I decided to stay in for a couple of nights as it is a long way back to Devon, but I could have gone back the same day as the procedure if I had wanted. Although I was uncomfortable for a few days after the procedure, I have no physical side effects and my wife and I can just go on with enjoying our lives.”

 

Brian, 62

 

It has been six years since Brian underwent brachytherapy for localised prostate

cancer but he can still remember the shock of being told he had cancer.

 

“I was fit and healthy, played golf regularly and travelled the world with my job”, said

Brian. “I had just changed my GP and the new practice offered me a health screen

which my partner said was a good thing to do. Everything was normal apart from a

slightly raised PSA but I was told that it was probably nothing to worry about. However,

the GP thought it best if I was referred to a specialist for a routine biopsy.”

 

Brian was devastated to be informed that he had prostate cancer at what he considered was a young age. “I was in complete shock, I thought it was an old man’s disease” said Brian. “It was so unexpected as I felt fine and had no real symptoms. I immediately went home and onto the internet.”

 

At first, surgery seemed like a good option, but it meant a three month recovery period which was not ideal for Brian’s work. “Although I am quite squeamish about surgery”, said Brian, “it was my concern about the possible long term side effects that made me look closely at the other options.”

 

Compared to surgery, prostate brachytherapy offered a fast recovery period with minimal side effects and seemed to fit in well with Brian’s busy lifestyle. The procedure was carried out at Mount Vernon Hospital six months after his diagnosis.

 

Brian stayed in hospital for one night and was back in the office two days later. “Although the actual procedure was quick and pain free, the main problem for the first ten days or so after the implant was the regular need to visit the toilet and the pain which accompanied it. Although this took some time to clear completely it steadily improved over the following months.” 

Brian was back on the golf course within four weeks and travelling long haul not long after.  “Although I carried a card with the date and details of the procedure, the seeds have never set off the airport security alarms.”

 

There have been none of the side effects often associated with surgery and Brian continues to lead a very active life. “My PSA count is almost zero and the shock of discovering I had cancer is in the dim and distant past. At one time I couldn’t discuss my illness with anyone outside my immediate family but now want others to know, that if caught in time, prostate cancer need not be life threatening and can be successfully treated.”

Brian, 62

 

It has been six years since Brian underwent brachytherapy for localised prostate

cancer but he can still remember the shock of being told he had cancer.

 

“I was fit and healthy, played golf regularly and travelled the world with my job”, said

Brian. “I had just changed my GP and the new practice offered me a health screen

which my partner said was a good thing to do. Everything was normal apart from a

slightly raised PSA but I was told that it was probably nothing to worry about. However,

the GP thought it best if I was referred to a specialist for a routine biopsy.”

 

Brian was devastated to be informed that he had prostate cancer at what he considered was a young age. “I was in complete shock, I thought it was an old man’s disease” said Brian. “It was so unexpected as I felt fine and had no real symptoms. I immediately went home and onto the internet.”

 

At first, surgery seemed like a good option, but it meant a three month recovery period which was not ideal for Brian’s work. “Although I am quite squeamish about surgery”, said Brian, “it was my concern about the possible long term side effects that made me look closely at the other options.”

 

Compared to surgery, prostate brachytherapy offered a fast recovery period with minimal side effects and seemed to fit in well with Brian’s busy lifestyle. The procedure was carried out at Mount Vernon Hospital six months after his diagnosis.

 

Brian stayed in hospital for one night and was back in the office two days later. “Although the actual procedure was quick and pain free, the main problem for the first ten days or so after the implant was the regular need to visit the toilet and the pain which accompanied it. Although this took some time to clear completely it steadily improved over the following months.” 

Brian was back on the golf course within four weeks and travelling long haul not long after.  “Although I carried a card with the date and details of the procedure, the seeds have never set off the airport security alarms.”

 

There have been none of the side effects often associated with surgery and Brian continues to lead a very active life. “My PSA count is almost zero and the shock of discovering I had cancer is in the dim and distant past. At one time I couldn’t discuss my illness with anyone outside my immediate family but now want others to know, that if caught in time, prostate cancer need not be life threatening and can be successfully treated.”

 

Chris, 58

 

Chris, a web site developer and composer from London, was diagnosed with prostate

cancer in October 2007 after he consulted his GP following some urinary problems.

"My father has a benign enlarged prostate and suffered similar symptoms, so I

assumed that was what I had," said Chris.

 

However, an above normal PSA score and resulting biopsy confirmed that he had

prostate cancer. Unfortunately, Chris suffered an adverse reaction to the biopsy and

was poorly for six weeks. "Not only was it a shock to hear I had cancer," said Chris,

"but I was fit and well when I went to see my GP and to be so ill after the biopsy was

not pleasant, although I understand it is a very rare occurrence".

 

More worryingly, Chris's consultant decided to do an MRI scan to make sure the cancer had not spread. The results came back showing a slight shadow in one seminal vesicle and, more alarmingly, in the bones, although they could not be absolutely certain the shadow was cancer. Mercifully, a nuclear bone scan came back clear within a few days, but the question remained over the seminal vesicle.

 

Chris was, therefore, told that his only options were radical surgery or external beam radiation (EBRT) and warned of the possible side effects of impotence and incontinence. "You can imagine how I felt," explained Chris, "Things just seemed to be going from bad to worse."

 

However, a friend who had had brachytherapy suggested that he seek a second opinion and Chris's GP referred him to a London brachytherapy centre where a more sensitive transrectal ultrasound scan showed  that his cancer was confined to the prostate and Chris was told that he was a suitable patient for LDR brachytherapy.

 

In April 2008, Chris underwent the brachytherapy procedure and was home the next day. "I'm experiencing some urinary symptoms, but they are only what I was led to expect and I'm confident they will improve. In general, I can just get on with enjoying my life and work," said Chris.

Paddy Kelly, 52

 

Paddy Kelly is an airline pilot with a leading airline. He had never even heard of the

prostate until a routine medical check and blood test by his GP in December 2005

revealed high PSA (prostate specific antigen) levels. Paddy's PSA was 27 ng/mL. The

normal range is between 0–4 ng/mL. A high PSA level such as this is often caused by

prostate cancer.

 

Paddy was referred to a urologist in Ireland who took eight biopsies (samples of

tissue from the prostate). "Not a pleasant procedure", Paddy remembers. The results,

however, came back clear and Paddy was put on a "wait and see" policy even though

he had other urinary symptoms. Not reassured by this diagnosis Paddy requested a second opinion in the UK and, in February 2006, 14 more biopsies were taken, this time under general anaesthetic. Once again they came back clear, but his PSA score was still too high. Paddy also had a bone scan, which came back negative. His doctor gave him a course of antibiotics in case it was just a urinary infection.

 

"I was becoming increasingly concerned", said Paddy. "My mother had died of cancer and my sister had breast cancer, so I decided to go online and do my own research."

 

Luckily, Paddy came across the St Luke's Cancer Centre in Guildford run by Professor Stephen Langley, a urologist specialising in prostate cancer. "I read that Stephen performed a different type of biopsy which was more accurate and so I made an appointment to see him. This time the results of the biopsy were all too clear - I had bilateral prostate cancer with a Gleason of 6/7 and needed to make a decision about treatment without much delay. This was now June 2006, 6 months since my initial PSA check."

 

Paddy was given hormone treatment and external beam radiation before receiving LDR brachytherapy in December 2006, a treatment which places radioactive seeds in the prostate to destroy the tumour. "The short term side effects from the hormone treatment and EBRT were not great but apart from feeling a little uncomfortable from the brachytherapy I had no other long term side effects from this treatment. It was so convenient - I was back at work almost immediately."

 

Paddy was advised not to have surgery to remove the prostate as incontinence is a common side effect; "That is something I simply cannot afford to suffer from as a pilot. My career is very important to me".

Paddy now has a PSA level of 0.08 and is optimistic that he is clear of prostate cancer.

 

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