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Prostate Cancer Treatment: Interstitial Brachytherapy

Radiation therapy is one way to destroy cancer cells. Cancer cells continue to die for months after the therapy ends. Radiation can be delivered either as a beam from outside the body with a machine (external beam radiation) or from material placed inside the prostate gland (internal).

The internal method is called interstitial brachytherapy. During this therapy, “seeds” (tiny pieces of radioactive material) are implanted in the prostate. These seeds can be either permanent or temporary. The advantage of brachytherapy is that the radiation is limited to the small area where it is needed without involving any surrounding normal tissue.

Closeup cross section of bladder, prostate, and rectum. Radioactive seeds are implanted throughout prostate.
Radioactive 'seeds' are implanted throughout the prostate.
Permanent seeds

The placement of permanent seeds is referred to as low dose rate (LDR) brachytherapy. LDR can be completed during an outpatient visit under light anesthesia. During this procedure, using a needle, tiny radioactive seeds are permanently implanted into the prostate gland. The needle is guided using images from a transrectal ultrasound. You can most likely go home soon after the seeds are implanted. You may return home when the implants are removed.

Temporary seeds

Temporary seeds release a single high dose of radiation (HDR). In this procedure, small, hollow, catheters are implanted into the prostate gland and radidoactive seeds are loaded into these catheters. The HDR seeds emit a higher dose of radiation over a shorter amount of time than do the LDR seeds, usually over 1 or 2 days. You may stay in the hospital for a day while one or more doses of HDR are given. 

Before, during, and after treatment

  • Before treatment. You may be given hormone therapy to shrink the prostate. Ultrasound or a CT scan is then used to map the size and shape of the prostate.

  • During treatment. You are given anesthesia to keep you free from pain during the procedure. The procedure takes about 1 to 2 hours.

  • After treatment. Soon after treatment, or discharge from the hospital, you can resume normal activities. Your health care team will help you to manage any side effects. With permanent seeds (LDR), you may need to restrict contact with young children and pregnant women for a period of time. Discuss these precautions with your healthcare team. 

 

Risks and complications of interstitial brachytherapy

Most complications are related to other organs that are near to the prostate and may be affected by the radiation.

  • Erectile dysfunction

  • Incontinence of urine or stool

  • Frequent urination, possibly with a burning feeling

  • Pain in the perineal region

  • Bleeding or inflammation of the bladder or rectum

  • Urinary obstruction

  • Bowel problems

  • Movement of seeds out of prostate

 

Online Medical Reviewer: MMI board-certified, academically affiliated clinician
Online Medical Reviewer: Welch, Annette, MNS, OCN
Last Review Date: 10/23/2013
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