What is Brachytherapy for Prostate Cancer

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Facing a diagnosis of prostate cancer can be overwhelming and frightening. After your doctor informs you that you have cancer, your next step is to become an informed patient. Ask your doctor all of your questions and seek a second opinion. Your research will likely focus on treatment options, such as radiation therapy. One type of radiation therapy for prostate cancer is brachytherapy.

What is brachytherapy?

Whereas other types of radiation therapy send radiation to your body from an external source, brachytherapy devices are placed directly in your body. Also called prostate seed implantation, this cancer treatment involves inserting very small radioactive metallic “seeds” inside your prostate gland. They will be placed in the tumor or right next to it. These seeds will remain there permanently and will emit radiation for a period of time (usually a few weeks or months). Within one year they will then become inactive.

Who is a good candidate for brachytherapy?

This prostate cancer treatment is an option for men with early stage prostate cancer that has not spread beyond the prostate gland. It may also be considered for men who cannot comply with the daily treatments needed for traditional radiation therapy, as well as those who cannot undergo prostate cancer surgery. Talk to your doctor to determine if you might be a candidate for brachytherapy.

Preparing for brachytherapy

Prior to the procedure, your doctor will run a series of tests. Expect blood tests, a chest x-ray, and an electrocardiogram (EKG). You will also have a transrectal ultrasound. This provides an image of your prostate gland so that your doctor can plan the placement of the seeds.

Remember to give your doctor your full medical history and tell him about any medications and supplements you are taking. He may instruct you to stop taking certain drugs for a while, such as aspirin or blood thinners.

Expect to go on a liquid diet the day before the surgery. You will also be instructed to take laxatives and an enema. If general anesthesia is to be used, follow your doctor’s instructions carefully regarding when to cease consuming all foods and liquids.

The brachytherapy procedure

To prep you for the procedure, an intravenous (IV) line will be placed in your arm to deliver medications, and a catheter will be inserted through the urethra to drain urine. Anesthesia will be administered.

A probe will be placed in the rectum to allow for transrectal ultrasound images. These images ensure the correct placement of the seeds. A plastic device with very small holes will be placed against the perineum. Small, hollow needles will be inserted through those holes and into your prostate gland. The radioactive seeds will be transferred through the needles into the prostate. Expect the procedure to last about two hours, with additional time afterward to recover from the anesthesia.

Read more in our Prostate Cancer Health Center.