Prostate Brachytherapy is a type of radiation therapy. In standard external beam radiation, radiation is beamed through the body at varying angles to concentrate the dose on the target organ. This still subjects the surrounding tissues to significant doses of radiation. In Prostate Brachytherapy, tiny radioactive seeds, each measuring less than 1/32" in diameter and 3/16" long are implanted directly into the prostate gland. The radiation from these seeds penetrates the surrounding prostate tissue for a distance of less than half an inch, so most of the radiation is concentrated within the prostate, with little spillage of radiation beyond the prostate. This means the rectum, intestines, and bladder receive much less radiation, and suffer fewer treatment side effects.
Under anesthesia, the seeds are implanted using special needles inserted through the skin behind the scrotum. Real time ultrasound guidance ensures precise placement of the seeds. A typical implant involves placement of between 70 and 130 of these seeds in 20 to 30 needles. These seeds are left implanted permanently, but the radioactivity in them decays fairly rapidly - depending on the type of seeds used.
The most commonly implanted isotopes are Iodine-125 and Palladium-103. The half-life of I-125 is 59 days, while the half-life of Pd-103 is 17 days. This means the I-125 seeds lose 80% of their radioactivity by 135 days, while Pd-103 seeds lose 80% of their radioactivity within 35 days. I-125 seeds are essentially biologically harmless after 275 days, and Pd-103 seeds after 102 days. I-125 seeds are used for low to high grade prostate cancer, while Pd-103 is used more for moderate to high-grade cancers with rapid growth rates. Prostate Brachytherapy is frequently combined with a reduced dose External Beam (look for IMRT) treatment plan for all cancers although some doctors will give seeds only for low grade patients - a practice that I believe to be ill advised.
Most patients experience very little discomfort following the procedure. The most common side effect of this type of radiation treatment is transient difficulty with urination due to prostate swelling induced by the treatment. Loose or frequent bowel movements are also common for a few months following the treatment. Urinary incontinence or loss of urinary control is almost non-existance. Impotence occurs less frequently than after radical prostatectomy surgery, although roughly 20% to 50% (depending on age) of patients opting for either form of treatment experience a significant decline in erectile function.
High Dose Radiation (HDR)
I am working on writing descriptions of this treatment. It is a type of Brachytherapy where temporary implants are done and radiated while the implants are there. They may be two or three of these treatments.
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Erectile Dysfunction
Brachytherapy / Seed Implants
Hormonal Ablation Treatment
Radiation External - All Kinds
Surgical Removal - All Kinds
Watchful Waiting
Other Conventional Treatments
