Prostate brachytherapy

Alternative Names: Implant therapy - prostate cancer; Radioactive seed placement; Internal radiation therapy - prostate

Brachytherapy is a procedure to implant radioactive "seeds" into the prostate gland to kill prostate cancer cells. Implants may be short-term or permanent. They may give off high or low amounts of radiation.

Description of Procedure

Brachytherapy takes 30 minutes or more, depending on the type of therapy you have. Before the procedure, you will be given medicine so that you do not feel pain. You may receive:

• A sedative to make you drowsy and numbing medicine on your perineum (the area between your anus and rectum).
• Spinal anesthesia. You will be drowsy but awake, and numb below your waist.
• General anesthesia. You will be asleep and pain-free.

After you receive anesthesia:

• Your doctor will place an ultrasound probe into your rectum to see the area. The probe is like a camera connected to a video monitor in the room. Your doctor might also place a Foley catheter (tube) in your bladder to drain urine.
• Your doctor will use ultrasound or a CT scan to plan and then place the pellets that deliver radiation into your prostate. The pellets will be placed with needles or special applicators through your perineum.
• Placing the pellets may hurt a little.

Types of brachytherapy

• Low-dose radiation brachytherapy is the most common type of treatment. The pellets stay inside your prostate and emit a small amount of radiation for several months. You go about your normal routine with the pellets in place.
• High-dose radiation brachytherapy lasts about 30 minutes. Your doctor will insert the radioactive material into the prostate. The doctor may use a computerized robot. The radioactive material is removed after treatment.

Risks of Prostate brachytherapy

Risks for any anesthesia are:

• Allergic reactions to medicines
• Breathing problems

Risks for any surgery are:

• Bleeding
• Infection

Risks for this procedure are:

• Impotence
• Probelms emptying the bladder. You may need to have a Foley catheter (tube) in place to drain the bladder for a short period of time.
• Rare problems are ulcers (sores) or fistulas (openings) in the rectum, scarring, and narrowing of your urethra (the tube that carries urine from your bladder out of your body)
• Rectal urgency, or the feeling that you need to have a bowel movement right away
• Skin irritation in your rectum or bleeding from your rectum
• Urinary problems

Review Date: 1/13/2011
Reviewed By: Louis S. Liou, MD, PhD, Chief of Urology, Cambridge Health Alliance, Visiting Assistant Professor of Surgery, Harvard Medical School. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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