Brachytherapy for Prostate Cancer

What is brachytherapy for prostate cancer?

Brachytherapy for prostate cancer is a type of radiation therapy. It involves placing tiny, radioactive implants near cancerous tumors in your prostate. There are different types of prostate cancer brachytherapy. This article focuses on permanent (low-dose rate) brachytherapy.

In this treatment, implants release low doses of radiation over 10 to 12 months and then remain in your body. Radiation oncologists may use the term “seeds” or “capsules” when talking about the implants.

What happens during brachytherapy for prostate cancer?

The pre-operative nursing staff will prepare you when you arrive. Your anesthesiologist will give you medication to make you relax and stay comfortable during the procedure.

1. Your radiation oncology team will help you onto the treatment table. Your anesthesiologist will start medication so you don’t feel any pain during treatment.
2. Your radiation oncologist will place an ultrasound probe into your rectum. The probe displays the inside of your prostate gland on a television monitor. Your radiation oncologist uses the monitor to plan the placement and number of implants.
3. They’ll insert very thin needles carrying the implants into the skin of your perineum.
4. Your radiation oncologist will place between 50 and 100 implants in your prostate. The exact number depends on factors like the tumor location and size.
5. The treatment may take an hour to 90 minutes to complete.

How successful is brachytherapy for prostate cancer?

Brachytherapy for prostate cancer is very successful, but everyone is different. One analysis of long-term success found that 97% of people who received permanent/low-dose-rate brachytherapy were alive 17 years after completing treatment.

That said, people who have this treatment should have regular prostate cancer screening tests. Your healthcare provider will recommend how often you should see them.

What are the potential benefits and risks of brachytherapy for prostate cancer?

Low-dose rate brachytherapy targets cancerous prostate tumors and reduces the chance that radiation will harm nearby healthy tissue. This treatment causes fewer long-term complications and side effects than other types of radiation therapy.

What are the side effects?

Permanent/low-dose-rate brachytherapy may cause immediate, short-term and long-term side effects.

Immediate side effects

The treatment area may feel sore and swollen. You may notice bruising. These side effects are mild and go away within two or three days.

Short-term side effects

You’ll probably need to pee more often than usual or feel like you need to pee right away. There may also be a burning sensation when passing urine. These side effects usually become less noticeable over the next six to eight weeks.

You may have some slight bleeding. Contact your provider if you’re bleeding more than you expect or if you see large clots of blood in your pee.

Long-term side effects

The treatment may cause long-term side effects, including erectile dysfunction, radiation cystitis and radiation proctitis. Radiation exposure is another possible side effect.

Erectile dysfunction

Research suggests 25% of people who have this treatment develop erectile dysfunction (trouble maintaining an erection). It’s important to remember that prostate cancer typically affects people age 50 and older, and that people often live for many years after treatment. You could develop erectile dysfunction that’s not related to your prostate cancer treatment.

Radiation cystitis

Radiation cystitis doesn’t happen very often. But you should contact your provider if you notice blood in your pee.

Radiation proctitis

This condition is an uncommon complication. It affects less than 3% of people who have radiation in their pelvic areas, including the prostate. Radiation proctitis causes bleeding and inflammation in your rectum after radiation therapy.

Radiation exposure

The radioactive implants in your prostate will give off very small amounts of radiation. You may worry that you’ll spread radiation to other people, particularly small children or pregnant women.

It’s safe for them to be near you, but avoid letting them sit in your lap for extended periods. In general, it’s a good idea not to have a small child or pregnant woman sit on your lap for more than 20 minutes at a time for two months after your procedure. But everyone’s situation is different. Ask your radiation oncologist for guidance.

When can I go back to my usual activity after treatment?

Most people can get back to their usual activity within one to two days after treatment. In general, it’s a good idea to take it easy and let your provider know if you’re having trouble with daily activities.

Avoid activities that put pressure on your groin — like horseback riding or cycling — for two months after treatment.

When should I call my healthcare provider?

Contact your provider if your side effects don’t go away as soon as you expected or are more severe than you expected. You should also contact them if you notice new symptoms that could be signs that prostate cancer has come back.