What are the results?
The success rate depends on the risk category of the prostate cancer and the type of success that is being measured. The most common measurement is related to PSA assessments after treatment. Using this method, the 5-year success rates for the various risk groups are:
- Low-risk (PSA < 10 ng/mL and a gleason score < 7) = 95%
- Intermediate-risk (PSA < 10 ng/mL and a Gleason score of 7 or PSA 10 ng/mL to 20 ng/ml and a Gleason score of 6) = 90%
- High-risk (PSA > 20 ng/mL or Gleason Score > 7 and any PSA) = 74%
It is important to know that these numbers are heavily dependent on how frequently the PSA test is drawn after therapy. We draw PSA tests every 6 months after therapy. In reports of similar rates from other sources, one must make sure that the PSA tests are being drawn at least this frequently or a comparison cannot be made.
What are the side effects?
Urinary symptoms are the most common side effects of the procedure. These symptoms include frequent urination and a need to get to the bathroom quickly. There might also be burning with urination and, in a few cases, an inability to empty the bladder completely. These symptoms can usually be managed with medicine, and improve over time. Temporary self-catheterization might be necessary to help drain the bladder if it cannot be emptied adequately, but this is rarely needed (about 5% of patients require it).
Urinary incontinence is rare in general. The risk might be somewhat increased in patients who have undergone a previous surgical procedure to remove a part of the prostate called a transurethral resection of the prostate (TURP). This risk can be minimized by performing a careful prostate ultrasound before the procedure to determine how much prostate tissue is still present to implant.
Rectal bleeding occurs in less than 1% of patients. Diarrhea is rare.
The impotence rate for those fully potent prior to the procedure at five years after the procedure is approximately 25 percent using brachytherapy alone. If hormone therapy is added, the impotence rate rises to 50 percent.