Brachytherapy (Seed Implantation)

Definition
Brachytherapy is the implanting of radioactive seeds (each about the size of a grain of rice) into cancerous tissue through hollow needles. They may be permanent or temporary. Because they are so small, they cause little discomfort and are simply left in place after their radioactive material is used up.

Treatment
Permanent seed implants involve injecting approximately 100 radioactive seeds into the prostate gland. They give off their radiation at a low dose rate over several weeks or months, and the seeds remain in the prostate gland permanently. The procedure follows “real-time dosimetry” techniques. This allows the physician the ability to optimize seed placement resulting in a better implant and expected outcome.

Brachytherapy is done with a concurrent ultrasound, allowing doctors to view the prostate in real time while performing the procedure.

This treatment is most appropriate for contained cancers ( i.e. prostate cancer that is confined to the prostate gland). Sometimes it is combined with external beam radiation therapy. Treatment is often given before or after external radiation to increase dosage directly to the tumor. This outpatient procedure can be done under general or spinal anesthesia. There is only minor discomfort, and this process has a lower risk of incontinence and impotence than surgery. Most patients return to normal activities immediately.

Side Effects
With Brachytherapy, surrounding tissue is exposed to less radiation than standard external radiation treatments and therefore there are fewer expected side effects. Brachytherapy can cause impotence, urinary incontinence and bowel problems. The risks are considered small. For about a week after the pellets are put in place, there may be some minor pain in the area and a red-brown color to the urine. Be sure to talk to your doctor if you have any of these side effects. Often there are medicines or other methods to help.