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Brachytherapy

What is it?

Brachytherapy delivers radiation internally. There are 2 main types: low-dose seed implant brachytherapy and high-dose rate brachytherapy (HDR).

Low-dose seed implant brachytherapy
  • Usually recommended to men with lowergrade cancers that are contained within the prostate gland.
  • Between 80 and 100 radioactive seeds, the size of a grain of rice, are implanted directly into the prostate.
  • Each seed releases low-energy level radiation steadily over several months.
HDR
  • Reserved for patients with high-grade cancers.
  • High-dose radiation is received through approximately 15 needles in the prostate, concentrating on the cancerous areas.
What is done?

Low-dose seed implant brachytherapy
  • The seeds are inserted through the skin in the perineum.
  • Procedure is performed under either general or spinal anesthesia and lasts approximately 1 hour.
HDR
  • Under anesthesia, approximately 10–15 needles are inserted through the perineum.
  • These needles are wired to the radiation source that delivers a high radiation dose to the prostate.
  • The needles are then removed.
  • The treatment takes 10–20 minutes.
What to expect?

Low-dose seed implant brachytherapy
  • A catheter may be used for a short time for urine drainage.
HDR
  • Often preceded or followed by a few weeks of external beam radiation.
  • Sometimes HDR treatments are given over a few days and the external beam radiation is not needed.
Side effects and risks
  • Side-effects of brachytherapy are similar to those of external beam radiation.
  • Brachytherapy differs slightly in the following ways:
    • Dominant short-term side-effect is irritation to the bladder and urethra
    • Acute urinary r etention may develop
    • Bowel irritation is relatively uncommon
    • Side effects may last months
Long term side effects
  • Very rare risk of incontinence of urine or chronic urinary obstruction (both less than 5%).
  • Erectile Dysfunction may occur, though many men will be able to achieve an erection with the use of prescription medication.

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