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Monday 20 May 2019
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Raising awareness of brachytherapy: a case study

In 1976 Chris James successfully underwent an orchidectomy followed by external beam radiation therapy (ERBT) to remove his testicular cancer
 
Fast forward to 2016 and Chris began experiencing urinary incontinence, with an increased urge to go at night time. Having experienced similar symptoms during his first cancer diagnosis, he visited his GP to get checked. Following standard tests, his GP referred him to the Hospital’s Urology department. It was here that Chris had an MRI, blood tests and further PSA tests taken. He was diagnosed with prostate cancer, albeit non-aggressive.
 
For the initial treatment, I was put on active surveillance due to low PSA levels and carried on with this method for over half a year. As my symptoms became worse though, I sought advice from my urologist on alternative treatment options and was told active surveillance at this stage was in fact the best course as a biopsy could lead to complications.”
 
Chris continued on active surveillance for another three months and then sought out a second opinion. “After seeing a different urologist, I was advised a biopsy should be the next step and agreed to have this done,” he explains.
 
Due to the EBRT treatment I had for my testicular cancer, there was a lot of debate from my clinicians on what the best treatment option might be. A second dose of radiation is not typically advised due to higher risks of complications. So it was recommended we should try a prostatectomy to remove the prostate and the cancer. This was attempted in May but failed due to adhesions. My mood quickly dropped after this procedure and left me feeling confused on what would happen next.”
 
During Chris’ recovery, he was visited by his urologist where he was told about brachytherapy. “I was reassured that, although brachytherapy was the second option in my case, for a lot of men it is a successful first option,” Chris says. And, following researching the treatment with his wife and thanks to help of a Macmillans’ brachytherapy booklet, he felt comfortable with the low risk and was happy to go ahead with the procedure.
 
In November, I underwent the brachytherapy treatment. My recovery was good and within a couple of days, I was up and moving. That said, with the rollercoaster of the year that I’d had, I was fatigued and struggled to get my head around the second cancer diagnosis and the complications I had with treatments. Fortunately, largely thanks to the quick recovery from the procedure and the success of the treatment, this changed after a couple of months. It was even noted in my local ukulele club that I had my ‘spark’ back and I was able to start volunteering again at my local bereavement centre.”
 
Following his experience, Chris urges that men get as much advice on their treatment options as possible. “Men do have different lifestyles and different priorities and it is really important to assess all available options to you before you make a decision. After the variety of different routes and advice I was given, I would strongly recommend that other men speak thoroughly to their clinicians and nurses from the outset about the range of options that are available as well as the likely outcomes and potential side effects of each.
 
Fortunately, my story has a positive outcome, but it wasn’t without its complications which is why transparency and raising awareness is so important to me.”