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Brachytherapy/Internal Radiotherapy

Brachytherapy/Internal Radiotherapy

Internal radiation therapy, also called brachytherapy or seed implantation, is a type of radiation therapy in which radioactive materials are placed, temporarily or permanently, inside the affected area. This form of therapy delivers a high dose of radiation directly to the cancerous area.

The materials, called “seeds,” slowly release radiation over several months. Within one year, their radiation completely decays. The seeds can remain in place for the rest of a person’s life.

Internal radiation therapy is most often used to treat cancers such as breast, cervical, ovarian, pelvic, head and neck, lung, perianal and prostate.

Depending on the form of cancer, the radioactive material may be injected directly to the affected area or put in a sealed plastic container (called an “implant”).

How is internal radiation therapy done?

A surgeon and a Radiation Oncologist will usually work together to perform the implant. While the details of your procedure depend on the location of the cancer, the surgeon is responsible for setting up a temporary guide for injecting the seeds. The radiation oncologist prepares (and in most cases, implants) the seeds. Most people leave the hospital within three to four hours after the procedure, although some cancers may require inpatient stays.

What are the benefits of internal radiation therapy?

Compared to external therapy, internal radiation therapy:

  • causes fewer side effects
    • provides a “boost dose” to minimize risk of recurrence after treatment, or a steady dose of radiation to the affected area
    • requires a limited number of visits, usually only one.

Your radiation oncologist will decide which treatment option is best for you. At Beacon we can offer our patient Prostate Seed Implantation.

Brachytherapy or prostate seed implantation

Brachytherapy, or prostate seed implantation, is a type of radiation therapy in which radioactive metallic seeds — smaller than a grain of rice — are permanently placed inside the prostate gland. This therapy delivers a high dose of radiation directly to the prostate gland and sometimes to the seminal vesicles. The seeds give off their radiation slowly over several months and, within one year, their radiation completely decays. The seeds can remain safely in place for the rest of a man’s life. Brachytherapy is given with external radiation, or by itself, depending on the stage of cancer.

How is prostate seed implantation done?

Brachytherapy works more effectively on small and moderately sized prostate glands. Men with large prostates often undergo a three- to six-month course of hormone therapy to shrink the prostate prior to implantation. A urologist and radiation oncologist work together to perform the implant. Prior to implant surgery, you will have a transrectal ultrasound. Transrectal ultrasound The consultant places a probe in the rectum to locate the prostate gland so that the treatment can be viewed on a monitor. This five- to 15-minute outpatient procedure uses sound waves to create a video image of the prostate gland and allows the radiation oncologist to:

  • measure the size of the prostate
    • plan for the implantation
    • place the seed order

Seed implant

This is performed under general anaesthetic as a day case procedure. The seeds are implanted in the prostate using thin hollow needles. The radioactive seeds are planted in the prostate about .5 to 1 centimetre (a little less than a ½ inch) apart. The entire procedure lasts about 90 minutes.

Most men can leave the hospital three to four hours after the implant procedure.

What can I expect after prostate seed implantation surgery?

In general there is little discomfort after the implant, except for some mild soreness in the perineal area, typically lasting for one to two days. You may experience mild rectal bleeding or spotting, for about 24 hours, in the area where the oncologist inserted the needles. There may be a small amount of blood in your urine. These side effects are normal and should stop in one to two days, should you continue to experience these or any continuing side effects, you will be provided with details of whom to contact. Between four and six weeks after implant surgery, you will have a follow-up appointment.

It will include x-rays and a CT scan of the pelvis to indicate the positioning of the seeds and help determine the dose of radiation the prostate is receiving.

What are the benefits and side effects of prostate seed implantation?

Unlike major surgery, daily radiation treatments, or external beam radiation therapy, seed implantation:
• causes little interruption in your daily activities
• usually preserves continence
• less frequently causes erectile dysfunction.

The radiation can cause side effects, which may last for two to 12 months after the implant and will decrease gradually as the seeds lose their radioactivity. Side effects, all of which are treatable, may include:
• discomfort during urination
• urinary obstruction
• erectile dysfunction