Brachytherapy for Prostate Cancer

Brachytherapy is a form of internal radiation used to treat prostate cancer and other cancers. It involves placing low or high dose radiation implants close inside the body or right next to the cancer cells.

Prostate brachytherapy may either be temporary or permanent. Temporary prostate brachytherapy treatment involves inserting radioactive wires into the prostate for a specific period of time, usually several minutes, before the wires are removed. Typically, this type of treatment requires several sessions.

During permanent prostate brachytherapy treatment, radioactive material is sealed inside seeds or capsules and implanted in and near the prostate cancer through ultrasound-guided needles and left in the prostate. The seeds remain in place, and over the course of several months, the radiation will deteriorate. The radiation given off by the wires or seeds damages the DNA of the cancer cells, preventing further cancer growth and killing the cancer cells.

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Why Choose Brachytherapy for Prostate Cancer Treatment?

Prostate brachytherapy is a highly effective type of prostate cancer treatment. For some, it may be used as the only type of treatment. For other men, brachytherapy is used in combination with other cancer treatments such as external radiation or hormone therapy.

The radiation is often successful in treating the cancer cells, while nearby tissue only receives a very small amount of the radiation. This can be helpful in reducing the side effects that are experienced. Prostate brachytherapy is not usually recommended for prostate cancer that has spread to lymph nodes or distant areas of the body.

What to Expect During Prostate Brachytherapy

If you have been recently diagnosed with prostate cancer, it's critical to personally research prostate cancer treatment options to make an informed decision that is best for you and your family. With a few exceptions, your first treatment generally gives you the best chance for success.

The type of prostate brachytherapy treatment you chose, either high dose rate or low dose rate, will determine what you should expect during treatment. Here is a general overview of what to expect:

Low Dose Rate (LDR) Brachytherapy:

During this procedure, you may be placed under anesthesia so that you are in a deep sleep and unaware of any pain or discomfort.

A wand-like instrument is inserted into your rectum that is then used to create ultrasound pictures of your prostate. The pictures help to guide a long needle that's used to place small radioactive implants in your prostate.

The needle is then inserted through the skin between your scrotum and your anus (perineum) and into your prostate. The small implants, about the size of a grain of rice, will give off radiation in the prostate for a few months, and will eventually deteriorate to nothing. This type of treatment is often referred to as prostate cancer seeds.

High Dose Rate (HDR) Brachytherapy:

This type of treatment involves placing radioactive sources in your prostate for several minutes at a time rather than smaller amounts being released over the course of several months.

You'll first be put under anesthesia to keep you comfortable throughout the procedure. Thin tubes are inserted through the perineum and into your prostate. These tubes remain in place throughout your treatment. The tubes are connected to a machine that feeds wires containing radioactive sources into the prostate. The radioactive wires are left in place for several minutes and then removed after the treatment is complete. You may need to have several of these treatments depending on your radiation oncologist’s recommendation.

Prior to either treatment, you should expect to undergo blood tests and heart tests to ensure that your body is healthy enough to endure anesthesia. You'll also need additional imaging such as ultrasound, computerized tomography (CT), and magnetic resonance imaging (MRI) so that your medical team can plan the best radiation dose for your treatment.

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Potential Risks of Prostate Brachytherapy

While prostate brachytherapy is a part of prostate cancer treatment for many people, it does come with some potential side effects. These can include one or more of the following:

  • Difficulty urinating

  • Pain or discomfort when urinating

  • Blood in the urine

  • Need to urinate more often

  • Blood in the stool

  • Erectile dysfunction

These can often be treated with medication or other help can be offered. Talk with your cancer care team about your personal experience, and they will be able to offer the best recommendations for managing the side effects of brachytherapy.

Rare Complications of Prostate Brachytherapy

  • Narrowing of the tube that carries urine from the bladder to outside of the body

  • Abnormal opening in the wall of the rectum

  • Cancer in the bladder or rectum due to radiation

Speak with your radiation oncologist to learn about the entire list of potential side effects that you could experience from this type of treatment.


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