Permanent seed brachytherapy, also known as low dose-rate
brachytherapy, involves having tiny radioactive seeds implanted in
your prostate gland. Radiation from the seeds destroys cancer cells
in the prostate. You may be suitable for this treatment if your
cancer is thought to be contained within the prostate gland (localised prostate cancer)
and:
If you have a PSA of between 10 and 20, and a Gleason score of
7, this treatment may still be an option for you as long as tests
show that the cancer is unlikely to have spread outside of the
prostate. Check with your doctor or nurse. It may not be suitable
if you have a large prostate gland, severe problems passing urine,
or have recently had an operation called a transurethral resection
of the prostate (TURP).
You may have this treatment on its own or together with external beam
radiotherapy and/or hormone therapy. It is just as good at
controlling prostate cancer as other treatments.
There is another type of brachytherapy called temporary
brachytherapy or high
dose-rate (HDR) brachytherapy. It is less common than permanent
seed brachytherapy.
What other
treatments are available?
Contents
Watch's Chris' story for one man's experience of
brachytherapy:
What are the advantages and
disadvantages?
Advantages
- You will be in hospital for just one or two days for the
treatment.
- Recovery is quick so most men can return to their normal
activities a couple of days after treatment.
- You will have a shorter period of anaesthetic with
brachytherapy compared with surgery as the procedure is quicker.
This means you may recover more quickly from the anaesthetic.
- The radiation is inside the prostate gland and does not travel
far, so there may be less damage to the surrounding areas.
- There may also be less damage to the blood vessels and nerves
that control erections than after other prostate cancer
treatments.
Disadvantages
- Brachytherapy can cause side effects such as urinary, bowel and
erection problems.
- It requires one or two anaesthetics, depending on the method
used. Anaesthetic can have side effects.
- It may be some time before you will know whether the treatment
has been successful. See the section onWhat happens
afterwards.
What might be an advantage for one person may not be for someone
else. You can talk to your doctor or nurse about your own
situation.
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What does treatment
involve?
You will have a planning session to measure the size and
position of your prostate to work out how many radioactive seeds
you need. This is also a final check that the treatment is suitable
for you. You may have a general anaesthetic so that you are asleep
during the procedure, or you could have a spinal or epidural
anaesthetic, so that you are awake but cannot feel anything.
The radioactive seeds will either be implanted on the same day as
the planning session (one-stage procedure) or they will be
implanted two to four weeks later (two-stage procedure). You will
have a general anaesthetic or you may have a spinal or epidural
anaesthetic.
You will have a computerised tomography (CT) or magnetic resonance
imaging (MRI) scan four to six weeks after the treatment to check
the position of the seeds. You will have regular follow-up
appointments after this to monitor your PSA level and any
side effects. If your treatment has been successful, your PSA level
should drop, although it may start to rise again because your
prostate will still produce some PSA. Some men may experience a
rise and fall in PSA at around one to two years after
treatment.
You can read more about what treatment involves in our Permanent seed brachytherapy fact
sheet.
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What are the side effects?
You may not have any side effects for several days until the
radiation from the seeds begins to take effect. Side effects are
generally at their worst a few weeks after treatment, when the
radiation dose is strongest, but should then improve over the
following months as the seeds lose their radiation.
The most common side effects are:
- Blood-stained urine or discoloured semen for a few days or
weeks.
- Bruising and pain in the area between your testicles and back
passage which can spread to your inner thighs and penis. This will
disappear in a week or two.
- Discomfort when you pass urine and needing to pass urine more
often, especially at night.
- Problems passing urine, erection problems, bowel problems and
tiredness.
Side effects will affect each man differently, and you may not
get all of the side effects.
Some men who have had brachytherapy and external beam
radiotherapy together may find that they have worse side
effects. If you already had urinary, erection or bowel problems
before treatment, these may be worse after treatment.
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Questions to ask your
doctor or nurse
- Which type of permanent seed brachytherapy will I have? The
one-stage or two-stage procedure?
- Will I have external beam radiotherapy as well as
brachytherapy?
- What are the chances of side effects such as urinary problems,
erection problems and bowel problems with this treatment?
- How will I know if the treatment has worked?
- What should my PSA level be after treatment and how often will
you measure it?
- If my PSA continues to rise, what other treatments are
available?
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