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Prostate Hormone Treatment Before Bracitherepy

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Hi, I am 52 fit and have no symptoms of prostate problems. On 28/5/07 i had a routine health check and had a PSA of 12.2 so had a biop and they found anenocarcinoma but due to incoputant private surgen in Pattaya Memorial hosp (dont go there its totaly crap) it was inconclusive. so I went back to uk where after another biop they found no significant pathology in the right lobe but in the left... 5 cores 26mm, in 2 cores it showed an infiltrating adenocarcinoma, gleason 6 (3+3) occupying 5% or total core volume. no vascular or perineral invasion. I had to return to Thailand after biop and went to Bkk/Pat and had an MRI and bone scan which were normal. My psa reading is now 13 and acording to the doc who gave me a digital exam the prostate was small, so the doc recomended a 6 month course of hormone then bracitheropy at a cost of 700,000 bht. I dont know if this is good advise so will be looking for a second opinion. Can anyone please advise. Many Thanks for you time.

Only a Urologist can really advise you. I spoke to the guy at BNH in Convent Road and he did say that brachytherapy is a very expensive option (although he did not quote figures) and I got the impression that in Thailand the overwhelming majority of treatments are the straightforward surgical removal of the prostate.

But just e-mail a few thai hospitals the details and ask for a quote, that seems to be the way they work.

I would say speak to several urologists before deciding, both BNH and Bumrungrad seem very competent. And the very best of luck.

Only a Urologist can really advise you. I spoke to the guy at BNH in Convent Road and he did say that brachytherapy is a very expensive option (although he did not quote figures) and I got the impression that in Thailand the overwhelming majority of treatments are the straightforward surgical removal of the prostate.

But just e-mail a few thai hospitals the details and ask for a quote, that seems to be the way they work.

I would say speak to several urologists before deciding, both BNH and Bumrungrad seem very competent. And the very best of luck.

I agree.

The OP's PSA of 12.2 and now 13 is rather high for his age.

In his case I would consult another Urologist back in the UK rather than Thailand before going into such an expensive and maybe unnecessary treatment, advised by this Dr.

Also, I don't understand why he advised a 6 months hormone therapy first and Brachytherapy after.... :o

http://en.wikipedia.org/wiki/Brachytherapy

LaoPo

The hormone treatment is to shrink the prostate so the radiation only has to cover a smaller area. It also slows or stops the growth of the cancer. If Dr. Jimmy was the doctor you saw at Bangkok Pattaya you then you can have confidence in his diagnosis. I saw him when my PSA was 6 something and the DRE was negative but my Free PSA was too high so he convinced me to have a biopsy. Cancer in both lobes with a Gleason of 6 and 7.

Do your homework before deciding on a treatment. After talking to 6 or 8 doctors and spending a lot of time on the net I opted for external radiation with image guided IMRT. For my stage of cancer it seemed to offer excellent results with a low risk of side effects. I was a little concerned about the bracitheropy because it's so dependent on the individual surgeon's skill. The IMRT is a hassle because it involves 5 treatments a week for 8 weeks but I had no side effects during or after the treatment. I had to go to Singapore to get it done because there were no machines for that in Thailand. But I think Bumrungrad has them now.

I've been very pleased with the results. It's been almost 2 years since the treatment and my PSA is around 0.5 and everything still works fine. The only side effects I had were from the 3 month course of hormone suppression I started before the treatment.

Good luck with which ever way you go.

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