Does brachytherapy ever have serious complications?

Replicant · Moderator Joined: 01 Nov 2006 Posts: 744

There have been complications after brachytherapy resulting in hospitalizations. This is normally a very safe procedure, but the assertion that there has never been recorded instance of complications requiring hospitalization is false. Simply Googling the topic will tell.

Doctors sometimes make mistakes in seed placement, as was revealed this summer at a VA hospital. http://www.nytimes.com/2009/06/21/health/21radiation.html

But even aside from such egregious malpractice, complications requiring hospitalizations do occur. In 2004 a study showed that 1% of brachytherapy patients developed rectal fistulae, and I bet those guys had to be treated in a hospital.
"Rectal complications after prostate brachytherapy."
http://www.ncbi.nlm.nih.gov/pubmed/15486745

The American Cancer Society, in its section on brachytherapy side effects, notes:
Urinary problems: Severe urinary incontinence is not a common side effect. But frequent urination may persist in about 1 out of 3 patients who have brachytherapy. This is perhaps caused by irritation of the urethra, the tube that drains urine from the bladder. Rarely, this tube may actually close off (known as urethral stricture) and need to be opened with surgery.

So I think the statement that brachytherapy treatment has never resulted in serious complications is an exaggeration of the fact that the therapy has a low rate of serious side effects.
_________________
Replicant

Dx Feb 2006, PSA 9 @age 43
RRP Apr 2006 - Gleason 3+4, T2c, NXMX, pos margins
PSA 5/06 <0.1, 8/06 0.2, 12/06 0.6, 1/07 0.7.
Salvage radiation (IMRT) total dose 70.2 Gy, Jan-Mar 2007@ age 44
PSA 6/07 0.1, 9/07 (and thereafter) <0.1
http://pcabefore50.blogspot.com

johnT · Senior User Joined: 27 Apr 2009 Posts: 176

Replicant,
The data comes from Grimm and Blasko and refers to the safety of the actual procedure itself and not to later side affects that may be caused by the radiation. I should have been more specific.
The Va case wasn't a case of a doctor making a mistake; it was serious malpractice that was intentially covered up by the doctor.
The total side affects from Brachytherapy are still the least of all treatments when we consider average and normal side affects for all treatments. All treatments have certain serious side affects that impact a small % of all those treated.
JohnT
_________________
psa at diagnosis 40 in nov-08
gleason 6 and 7
Treatment choice seeds and IMRT

Replicant · Moderator Joined: 01 Nov 2006 Posts: 744

Thanks for the clarification, John.
_________________
Replicant

Dx Feb 2006, PSA 9 @age 43
RRP Apr 2006 - Gleason 3+4, T2c, NXMX, pos margins
PSA 5/06 <0.1, 8/06 0.2, 12/06 0.6, 1/07 0.7.
Salvage radiation (IMRT) total dose 70.2 Gy, Jan-Mar 2007@ age 44
PSA 6/07 0.1, 9/07 (and thereafter) <0.1
http://pcabefore50.blogspot.com

G2e4n3e4 · Regular Joined: 13 Apr 2009 Posts: 25

Hi Replicant and John T.,

Well. There ARE serious side effects from brachytherapy! At least for me. I have had intermittent rectal bleeding - usually with the first BM and mostly with a hard stool. So far, 5 incidents - 2 in July, 2 in August, and one today 3 Sept. I've resolved to religiously take Metamucil EVERY day no matter what since that seems to prevent the bleeding. I am very fortunate not to have much discomfort and not much bleeding either - mostly on the toilet paper - have passed 2 or 3 small blood clots.

Now comes the interesting part. My rad onc referred me to a hyperbaric oxygen facility at the Baltimore Washington Medical Center in Glen Burnie, Md. I have had 4 two hour treatments at 2.5 times atmospheric pressure. Getting somewhat used to them although I'm claustrophobic - listening to CD's during the two hours. The staff is wonderful! I'm not looking forward to an additional 36 or more sessions. But I sure prefer that to the alternative - never healing.

The good part is that the procedure increases the amount of oxygen in the blood that circulates throughout the body and is thought to promote healing of wounds inside the rectum. The down side is that it may take 40 or more treatments to bring about healing.

For those of you who experience rectal bleeding as a result of brachytherapy, there is a long account by a man named Bob Wall detailing how he dealt with his bleeding. It is much too long to post here. I will see if I can get a URL to post - subject to moderator deletion or modification.

I know this is a long post, but I wanted to give others with my side effects something positive to look forward to.

Hugs and Prayers to All of You.
Gene in Md
_________________
Age 70 Dx Dec 07 PSA 8.4 DRE positive. Gleason 6 (3+3), T2 PC confined to prostate. Brachytherapy Jan 2008 failed rising PSA's. Began Lupron 30 MG ea 4 mos. hot flashes, fatigue. Occasional urinary and rectal bleeding. Aug 09 - PSA 0.5. Lupron is working!!! Aug 21, 09 - 2nd Lupron shot. Continuing hot flashes. Doc recommends weight lifting - 20 to 30 lbs. July, Aug, Sep. rectal bleeding - hyperbaric chamber treatments.

Hawk · Senior User Joined: 22 Nov 2006 Posts: 406

I just had my 6 months SRT doctor's appointment today. He asked if I had rectal problems. I have not. He indicated they are uncommon but peak at around 8 months if they are going to happen and that they have hyperbaric oxygen chambers that work well if I develop any issues. First I had heard of that treatment for such problems and then you bring it up a few hours later.
_________________
History: PSA's 6.7 neg. biopsy - PSA 16.6 neg. biopsy - PSA's 8.2, 8.1, 8.7 - Biopsy. 4+4 Gleason 8. Lap RP Apr 2004, age 52 All neg margins, nodes, and structures. (T2a). Post RP PSA: every 6 mo. <.1 until Feb, 08 (46 mos) PSA .1 - I then got sensitive tests (all in 2008) showing:
Feb .06, May .09, Jun .10, Aug .10, Nov .15 -SRT

johnT · Senior User Joined: 27 Apr 2009 Posts: 176

A small amout of rectal bleeding; spots on toilet paper ect are normal. This is the blood vessles in the rectum repairing themselves from the radiation. I've had this for years before any treatments because of hard stools. Seems to have gone away soon as I changed diet 4 months before treatment. Since treatments I have had no problems, but religiously took Metemucil daily during treatment.
JohnT
_________________
psa at diagnosis 40 in nov-08
gleason 6 and 7
Treatment choice seeds and IMRT

G2e4n3e4 · Regular Joined: 13 Apr 2009 Posts: 25

Hi Johh T.,

Thanks for the post. My bleeding started about 18 mos after seeds. Your comment about diet is on target. I'm going to read the account by Bob Wall after I log off and see what I can adopt from his advice. I agree that Metamucil of its equivalent is a must. My Prim Care Doc says that Citrucel is less irritating so I started that today. Will see how it works.

For what it's worth, my Prim Care Doc also told me that there is a vein, called the hemorrhoidal vein (no surprise there) that is more prone to bleeding as we age. At age 70, I guess I've arrived there. In any case, I AM a positive type and DO expect to manage the situation and improve over time.

So far, no indication that I need or am a candidate for IMRT. I hope it doesn't come to that, since I am already in hot water for the side effects.

Good luck with your treatment and thanks again for the info.

Gene in Md
_________________
Age 70 Dx Dec 07 PSA 8.4 DRE positive. Gleason 6 (3+3), T2 PC confined to prostate. Brachytherapy Jan 2008 failed rising PSA's. Began Lupron 30 MG ea 4 mos. hot flashes, fatigue. Occasional urinary and rectal bleeding. Aug 09 - PSA 0.5. Lupron is working!!! Aug 21, 09 - 2nd Lupron shot. Continuing hot flashes. Doc recommends weight lifting - 20 to 30 lbs. July, Aug, Sep. rectal bleeding - hyperbaric chamber treatments.

	Cancer Forums Forum Index -> Prostate Cancer Forum	All times are GMT - 5 Hours
Page 1 of 1

A website for discussions about any type of cancer, including lung cancer, breast cancer, mesothelioma, prostate cancer, laryngeal cancer, leukemia, lymphoma, multiple myeloma and others