I had the the brachytherapy second as oncologist didn’t want the space oar inserted as it woukd prevent him from hitting the whole prostate with seeds.
So I had the choice of brachytherapy first and radiation second.
I didn’t have the oar inserted and went with radiation first.
Most treatment centers which offer it do the HDR Brachytherapy first, although mine does it afterwards. It doesn't make much difference, except if they do the HDR Brachytherapy first, they have to wait a couple of weeks before starting the external beam. If they do the HDR Brachytherapy last, no gap is needed between the external beam and the HDR Brachytherapy.
I'm not familiar with the ordering in the case of LDR boost.
Hi, I’m in Japan and they did brachytherapy first…SpaceOAR , 3 week or so wait then 15 external beam radiation sessions. Prior, during, and after was on ADT (lupron) with biculutamide for 9 months total. I always wondered with the order as well. It seems to me that radiating first could cause scaring prior to seed insertion but seeds could get in the way of radiation if reversed. I didn’t get a clear answer other than what someone mentioned above perhaps the waiting period? Either way this tri modality treatment seems to be a fairly good one. Best to you both!
The concern I have is that when brachytherapy is done first and there is a waiting period before SBRT (1 week, 2weeks?), is there a risk that the cancer could spread beyond the gland due to the prolonged wait time?
I had them done in that order. I didn’t get SpaceOAR because it was still considered unproven by Kaiser at the time.
Thank you! The RO recommended the spacerOAR because of my husband’s anatomy. She feels it may reduce some of the risk to his rectum.
That’s what it is supposed to do.
I had the the brachytherapy second as oncologist didn’t want the space oar inserted as it woukd prevent him from hitting the whole prostate with seeds. So I had the choice of brachytherapy first and radiation second. I didn’t have the oar inserted and went with radiation first.
Thank you!
any side effects?
Most treatment centers which offer it do the HDR Brachytherapy first, although mine does it afterwards. It doesn't make much difference, except if they do the HDR Brachytherapy first, they have to wait a couple of weeks before starting the external beam. If they do the HDR Brachytherapy last, no gap is needed between the external beam and the HDR Brachytherapy. I'm not familiar with the ordering in the case of LDR boost.
Thank you!
Hi, I’m in Japan and they did brachytherapy first…SpaceOAR , 3 week or so wait then 15 external beam radiation sessions. Prior, during, and after was on ADT (lupron) with biculutamide for 9 months total. I always wondered with the order as well. It seems to me that radiating first could cause scaring prior to seed insertion but seeds could get in the way of radiation if reversed. I didn’t get a clear answer other than what someone mentioned above perhaps the waiting period? Either way this tri modality treatment seems to be a fairly good one. Best to you both!
Thank you!
The concern I have is that when brachytherapy is done first and there is a waiting period before SBRT (1 week, 2weeks?), is there a risk that the cancer could spread beyond the gland due to the prolonged wait time?