Prostate brachytherapy is a form of radiation therapy that involves placing devices containing radiation in the prostate gland close to the cancer cells. It’s often used to treat early-stage cancer, and in these cases may be the only treatment you will need. At later stages, it may be used in conjunction with other treatments, such as hormone therapy or external beam radiation.
Prostate brachytherapy procedures are likewise diverse, varying with the type of radiation involved. Radioactive wires may be placed in the prostate for a few minutes before being removed – a procedure known as temporary, or high-dose-rate prostate brachytherapy. Thin tubes are inserted through the perineum and into your prostate at precise locations. The tubes are connected to a machine that feeds wires containing radiation into the prostate. The radioactive wires are left in place for a set amount of time, typically several minutes. Then the radioactive wires are removed. The tubes are left in place, and you may spend the night in the hospital and repeat the procedure the next day. Most men undergo a few treatments. Once your treatments are complete, the tubes are removed.
Permanent prostate brachytherapy, also known as low-dose-rate brachytherapy or seed implants, involves placing radioactive seeds in the prostate gland permanently, where they slowly release radiation. After creating an ultrasound map of your prostate, a long needle is used to implant the seeds at key locations. The seeds are about the size of grains of rice and will remain radioactive for a few months, but will remain in your body permanently.
The delicate balance – the trick, if you will – of prostate brachytherapy is getting the radiation close enough to the cancer cells so it can do its number on the cancer cells without also causing damage to nearby healthy tissue. For this and other reasons, prostate brachytherapy is generally avoided in cases where the disease has spread to the lymph nodes or to distant areas of the body.
Prostate brachytherapy may cause a number of side effects, which include:
- Difficulty starting urination
- Frequently feeling an urgent need to urinate
- Feeling a burning sensation when urinating
- Blood in urine
- Needing to urinate at night
- Not being able to empty your bladder completely
- Narrowing of the tube that carries urine from your bladder to the outside of your body (urethra)
- Erectile dysfunction
- Bleeding from the rectum
- Blood in stool
The side effects will often lessen over time, and your doctor can prescribe meds to offset and reduce them.