Lithotripsy :: Chemotherapy :: Radiotherapy
Hormone Therapy :: Brachytherapy :: Surgery TURP
Prostate brachytherapy involves the placement of radioactive material directly into the prostate gland. These implants can be in the form or wires or radioactive iodine 'seeds'.
The seeds are about the size of a grain of rice and are inserted into the prostate through hollow needles placed through the skin bellow the scrotum. This procedure is generally performed under a general anaesthetic and is called an implant.
Slowly over a few months the seeds deliver a calculated dose of radiation to the prostate cancer.
Who can be treated using Prostate Brachytherapy?
There are strict guidelines that determine whether you are suitable for brachytherapy. These criteria include:
- Your level of fitness
- Your symptoms
- The size of the prostate gland
- The local extent of the cancer within the prostate- the cancer must be confined to the gland
- The aggressiveness of your cancer cells
If Brachytherapy is not suitable there may be other options for managing your malignancy including surgery, external beam radiotherapy and hormone therapy that may be more suitable.
What is the Brachytherapy Procedure?
Firstly you will need treatment planning using ultrasound and CT imaging of the prostate. By showing the size and position of the prostate gland, imaging allows computer calculation of precisely where to put the radioactive seeds.
Once planning has been undertaken, radioactive seeds are ordered for implantation. Seed placement occurs at a later date under anaesthetic. You will be admitted to hospital for at least one night after the procedure to ensure that there are no problems with urination.
About three weeks after the implant you will need a CT scan of the prostate; the scan allows doctors to determine the exact dose of radiation given to the prostate.
You will then be followed up every few months when examinations and PSA tests will be done to assess how effective the treatment has been.
What are the side effects of Prostate Brachytherapy?
When undergoing the procedure you will need to undergo at least one general anaesthetic and stay in hospital at least one night.
The level of radiation emitted by the seeds is very low, but as a precaution it is advised that pregnant women and young children maintain a distance of a metre from you (except for short periods - hugs and cuddles) for the first month after the procedure.
Initially you may have slight bleeding from the needle puncture sites and have swelling or bruising around the scrotum. Applying an ice pack can assist in bringing relief and reducing the swelling.
There may be some blood in your urine after your implant, but this generally settles down within a few days. Some men may develop short or long term urinary problems such as obstruction or incontinence. This is more common in men who already have severe urinary difficulties and is why these men are excluded from brachytherapy.
For a few weeks after treatments you may experience some bowel irritation, this may include frequent or loose motions and/or alight bleeding from the rectum. These symptoms usually resolve.
Sexual function is usually preserved initially but may deteriorate with time. Various treatments are available to help if this occurs.
Also, follow up tests may indicate that the brachytherapy implant has not adequately treated the gland and further options such as hormonal therapy may be required.