Temporary brachytherapy, also known as
high dose-rate (HDR) brachytherapy, involves inserting a source of
high dose-rate radiation into the prostate gland for a few minutes
at a time to destroy cancer cells. It is not available at every
treatment centre in the UK.
You may be suitable for this treatment
if your cancer is thought to be contained within the prostate
gland (localised prostate cancer)
and is 'medium risk'. Your cancer may be described as medium risk
if:
Some men whose prostate cancer is
beginning to spread to the area just outside the prostate (locally
advanced prostate cancer), or with higher Gleason scores, may
be able to have temporary brachytherapy. Check with your doctor or
nurse.
You may have this treatment on its own
or you may have it together with external beam radiotherapy and/or hormone
therapy.
There is another type of brachytherapy
called permanent seed or low dose rate
brachytherapy that involves implanting tiny radioactive seeds into
the prostate.
What other treatments are
available?
Contents
What are the advantages and
disadvantages?
Advantages
- Treatment in hospital with temporary brachytherapy takes just
one or two days.
- It delivers a high dose of radiation direct to the prostate
gland so healthy tissue nearby only gets a small dose of radiation
and therefore is less likely to be damaged and cause side
effects.
- Recovery is quick, which means you can usually return to your
normal activities within a week of treatment.
Disadvantages
- It can cause side effects such as urinary, bowel and erection
problems.
- You will need a general or spinal anaesthetic. See the section
'What does treatment involve?'
- If you require more than one radiation treatment you may need
to stay in bed for at least six hours between treatments whilst the
tubes are in your prostate. Some men find this very uncomfortable.
See the section 'What does treatment
involve?'
- You may need to stay in hospital overnight.
- It may be some time before you will know whether the treatment
has been successful.
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What does treatment
involve?
It is likely that you will have a general anaesthetic so that
you are asleep during the procedure. Another option is to have a
spinal or epidural anaesthetic, so that you are awake but cannot
feel anything. The specialist team will discuss the different
options with you.
The specialist passes thin plastic or metal tubes through the area
of skin between your testicles and opening of the back passage
(perineum) into the prostate gland and the surrounding tissues. You
will then have a computerised tomography (CT), magnetic resonance
(MRI) or ultrasound scan. This allows the specialist to plan the
doses of radiation needed for your treatment.
You may have your treatment while you are still under anaesthetic,
or you may have it once you have woken up. During treatment,
flexible tubes from the brachytherapy machine are attached to each
of the tubes that are inside you. A highly radioactive pellet then
travels down each of the tubes in turn. You may have just one
treatment or you may have two or three treatments in total.
You will have a follow-up appointment a few weeks after your
treatment, to check your PSA level and discuss any side effects. You
will have regular appointments after that to monitor your PSA level
and any side effects. If your treatment has been successful, your
PSA level should drop.
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What are the side effects?
The most common side effects include tiredness, problems passing
urine, erection problems, and bowel problems. These will affect
each man differently, and you may not get all of the side
effects.
Some men who have temporary brachytherapy and external beam
radiotherapy together 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
- Will I have external beam radiotherapy before or after
temporary brachytherapy?
- Do I need hormone treatment before and/or after
temporary brachytherapy?
- What are the chances of side effects such as urinary problems,
erection problems and bowel problems with this treatment?
- How many treatments will I have? Will I be asleep or awake
during treatment?
- How long will I need to stay in hospital for the
treatment?
- How will we 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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