Brachytherapy, or prostate seed implantation, is a type of radiation therapy in which radioactive metallic seeds – smaller than a grain of rice – are permanently placed inside the prostate gland. This therapy delivers a high dose of radiation directly to the prostate gland and sometimes to the seminal vesicles. The seeds give off their radiation slowly over several months and within one year, the radiation completely decays. The seeds can remain safely in place for the rest of a man’s life.
Brachytherapy has been used by doctors to successfully treat prostate cancer for many decades. Today, modern state-of-the-art technologies are used to help healthcare professionals deliver brachytherapy with a high level of precision. Brachytherapy is a very effective and highly convenient form of treatment for prostate cancer and is recognized as a standard treatment alongside surgery and external beam radiotherapy
Benefits of brachytherapy include:
- Effective as a cure: There are many studies that show patients continue to remain free of cancer after treatment with brachytherapy. Cure rates have been shown to be equivalent to external beam radiation therapy (EBRT) and surgery.
- Minimized side effects: The accurate and targeted nature of both low dose rate (LDR) and high dose rate (HDR) brachytherapy reduces the risk of side effects.
- Minimally invasive: Avoids the need for extensive surgery.
- Shorter treatment times and shorter recovery periods: Brachytherapy is usually given on an outpatient basis and completed in a couple of days. Patients are usually able to get back to their normal activities within a week.
Treatment planning. Prior to surgery, you will need to have a transrectal ultrasound, a 5- to 15-minute outpatient procedure that uses sound waves to create a video image of the prostate gland. This allows the doctor to measure the size of the prostate, plan for the implantation and place the seed order.
Before surgery. Two weeks before surgery, you will have routine blood work, an electrocardiogram (EKG) and a chest x-ray. The day before surgery, your doctor may put you on a liquid diet and have you take laxatives and an enema or suppository. This is necessary to clean the rectum for the transrectal ultrasound.
During surgery. Prostate seed implantation can be performed with either spinal anesthesia or general anesthesia. The day of surgery, an intravenous (IV) line will be started in your arm to supply you with medications during the procedure. You will be given enemas to clean the rectum. A catheter will be placed through the penis and into the bladder to drain urine. The catheter may be left in place for a few days until prostate swelling subsides. Most patients are discharged three to four hours after the implant procedure.
After surgery. There is little discomfort after the implant, except for some mild soreness in the perineal area lasting for one to two days. Sometimes some mild rectal bleeding or spotting will occur for about 24 hours in the area in which the needles were inserted. There may be a small amount of blood in the urine. This is normal and should stop in one to two days.
Follow-up Testing. A follow-up appointment will occur six to eight weeks after surgery. It will include x-rays and a CT scan of the pelvis to indicate the positioning of the seeds and help determine the dose of radiation the prostate is receiving. A combination of blood tests will be given every three to six months during the two years after treatment.
If you feel that you may be a candidate for Brachytherapy treatment for prostate cancer – or you would like more information on other forms of treatment – please call us today to schedule an appointment for an in-depth consultation.