I had Brachytherapy 10 years ago
for prostate cancer. I am now
having some issues related to
that procedure.
If you are specific what the issues are then can offer advice.
Thanks for responding. The issues that I am going through recently are with experiencing increased urinary frequency and urgency. In doing some research I found it is a known potential long-term (late-onset) side effect of brachytherapy. I am also experiencing what feels like inflammation in my urethra - discomfort when sitting too long - like working at my computer. My urologist that did the brachytherapy has retired, an he recommended another urologist to take over… but I’m not sure about this new guy. He doesn’t seem to understand what I am going through. He doesn’t offer me much in the way of solutions or advice. He prescribed tamsulosin and finasteride. I’m not sure it those are doing anything to help, but I am taking them. I take ibuprofen which seems to help somewhat. The discomfort seems to worsen when I do more strenuous activities and outside chores. I’ve read about radiation cystitis of the bladder - and he looks at me like a deer in the headlights. I’ve discussed this with my primary care doctor who is also a new guy. My regular PCP retired too. I feel like I don’t have anywhere to turn for advice and/or help.
Sounds like the prostate has swollen and is pressing on the bladder. Being more active may make that worse and so more painful. The radiation cystitis is also a real possibility and needs investigating. Any blood in urine would be a sign of that. The tamsulosin and finasteride are standard for a swollen prostate( BPH). Work quite quickly if having trouble urinating. Have you had your PSA checked?
Is a different urologist a possibilty? Would need cytoscopy/ultrasound to check for radiation cystitis. There is another possibilty, the nerves controlling the bladder can also be damaged and this can cause this problem even after a long time.
I would give the drugs a week or two to see if they help. Even a new urologist will probably want that.
Hope it helps, Here if you want to discuss some more
Michael
Thank you so much for taking the time to answer me back. I get my PSA checked regularly. The last PSA check was about 6 months ago that showed undetectable numbers… <0.01. I’ve never had blood in my urine.
It was 2016 when my PSA number was above 4. I think it was 4.5 at that time. My PCP sent me to a urologist/oncologist for further evaluation. He first prescribed an antibiotics to eliminate any infection. From there I got a biopsy that showed 2 areas out of 12 with cancer cells. 2% in one, 10% in another It was early stage and a non aggressive type cancer. I was offered several treatment options. Wait and see, radiation, Cyber knife, and brachytherapy… I met with an MD at a cancer center. He was a great man. He took the time to go over all treatment options, detailing the pros and cons of each. After much consideration, I decided the low dose radiation brachytherapy would be my best option with less chance of damage to surrounding tissue.
I do feel like something is swollen. I even wonder if it might be within my colon, a fissure or something like that. I am frustrated that my PCP and my urologist. I suggested that perhaps I should have a CT scan or MRI to look for a cause. The situation is not constant, but often enough to be concerning. I can tell when the condition is coming on… usually when I’ve been doing computer work for a longer period, or strenuous outside work. It starts with burning with urination… and a burning pain in my lower abdomen/bladder area… almost like a bladder spasm. My PCP prescribed Hyoscymine for cramping. I’ve taken one when I experienced the spasm or pain in my bladder. I’m not sure if it helped.
I have an appointment with the urologist in April and I will take the information that you have given me… and I appreciate this. I have considered another urologist, and that is still a possibility.
Thanks again, Charles
You are welcome and can contact me any time. I mysele had and have prostate cancer treated with brachterapy in 2013. All good till 2014 when PSA started to increase. Had hormone treatment to surpress it after a biopsy didn’t find it… Looking for more tests and treatment this year. Also had problem of prostate swollen and disrupting urination. But no burning sensation. You need cytoscopy and MRI to really know what is going on. Hope you get that sorted soon.
Good Luck Michael
I’m sorry to hear about your continuing problems with prostate cancer. It’s good that you are addressing the issues and staying on top of things. I hope everything will turn out well for you. Are you seeing the same doctor that did your brachytherapy treatment? I think it helps that someone understands the procedure and what might be causing the after effects. I am frustrated because both my urologist/oncologist and PCP doctors have both retired. Although both referred me to other capable doctors, they don’t seem to grasp what I am going through and my concerns. I do like my new PCP doctor who seems to listen to me and show more concern. The urologist on the other hand, I’m not so sure about. It was this group that my old urologist referred his patients to when he retired. The specific doctor he recommended only saw me once at my annual check up and PSA check. Several months later I called for an appointment when I was experiencing pain and burning. I was told he was too busy and the next available appointment he had was in 3 months. That should have been my queue to find another doctor. At that point I called my PCP doctor and saw him the next day. He prescribed antibiotics because I have been treated for prostatitus a few times in the past. Now I think perhaps they diagnosed that because they are not sure what is going on. I told my PCP how disappointed I was with the urologist putting me off for 3 months, especially since I told them that I was in pain. He recommended another urologist to me… and I went to him… but to my surprise, he was in the same group as the one who put me off for 3 months. Needless to say I am not impressed with this group… and fortunately my health insurance will let me go to another urologist of my choice. It’s hard to research and choose other urologists/oncologists that are experienced with brachytherapy treatment. I’m going to give the new guy another try in April when I have an appointment with him. I will take the notes I have from you and from the online searches I’ve done regarding the long term after effects of brachytherapy. Although I’ve never had a cystoscopy and I’ve heard that it is not pleasant, I do think it might be a good idea… along with an MRI. We’ll see how it goes then. If I don’t feel confident in him this time, I will put more effort into finding another guy.
I wish you the best too… and thank you for listening and offering your advice and opinion.
Charles
You are welcome, hope things improve. I am from the UK, but in Indonesia at the moment I have friends here. Will be returning to the UK in May to work my way through the NHS. I have a lot of experience with them, so know what to do. As a recurring prostate cancer patient will ( should ) be seen by specialist in 2 weeks. Lots of other issues too which will take longer.
In Indonesia you can get seen by a specialist on the same day if you want, and a MRI in just a few days. Not very expensive. Maybe you need a holiday…
Michael
Hello Michael, I just had a visit with the new urologist. I feel much more comfortable with this guy. He listened to my concerns and check my bladder and prostate. He asked me about ever having prostatitus, and yes I have. I remember being told that Prostatitis was hard to diagnose. Lab tests don’t show infection which is the case I have experienced in the past. After getting a urine sample which did not show any infection, the doctor have me a prescription for antibiotics. He said he was going to send the urinie sample to another lab for further testing. Sometimes infections of the prostate are more difficult to find. So he said he would contact me in a few days and if those tests indicated, he would prescribe another antibiotic. So I will wait and see how it comes out.
Charles
Good you felt comfortable with the new doctor, that means more than anything else. Prostatitis really is hard to find and deal with, I had Ciprofloflaxin for 30 days as a treatment… I don’t know if they still do it, but there was a method of massaging the prostate in order to get some prostate fluid out to test it directly…! Good luck, hope you get a result.
Ciprofloxicin 500 mg is what the doctor prescribed for me. 30 days. We’ll see how that works out.
Charles