| Prostate brachytherapy (pronounced | | | | is taken to the operating room for the procedure, |
| bray-kee-ther-uh-pee), the implantation of radioactive | | | | where he undergoes either general or spinal |
| seeds into the prostate gland, is one of the standard | | | | anesthesia. Then, the radiation oncologist and the |
| methods of successfully treating prostate cancer. | | | | urologist work as a team to implant the seeds into |
| The tiny radioactive seeds are smaller than grains of | | | | the prostate, using transrectal ultrasound to guide the |
| rice. | | | | placement. |
| A prostate seed implant may be the only type of | | | | The Implant Process |
| radiation therapy needed by a man with low-risk | | | | Using the treatment plan and fluoroscopy (real-time |
| prostate cancer or it may be prescribed in addition to | | | | x-ray), the radiation oncologist places the seeds |
| external beam radiation therapy in men with | | | | within the prostate. The entire procedure usually |
| intermediate- and high- risk prostate cancer. The goal | | | | takes less than one hour. After the seed placement, |
| is to eradicate cancer cells while preserving healthy, | | | | the urologist performs a cystoscopy (a procedure in |
| surrounding tissue, such as the bladder, the urethra | | | | which a slender, flexible, fiber optic scope is inserted |
| (the tube that connects the bladder to the penis), | | | | from the penis into the bladder), to look for and |
| and the rectum. | | | | remove any seeds that dislodged in the bladder or |
| The advantages of prostate seed implants are | | | | the urethra. Within the few next days, a CT scan is |
| significant. Fist, the procedure requires only minor | | | | obtained to verify the placement of the seeds. |
| surgery, usually causing fewer side effects than | | | | Prostate Seed Implants: Recovery |
| other treatments. Also, it is generally a same day, | | | | Because prostate implants do not involve major |
| outpatient procedure. Men usually are able to return | | | | surgery, side effects are rarely severe. The most |
| to work within several days, as long as they feel well | | | | common side effects reported by men after |
| enough. In addition, recent reports suggest that the | | | | prostate seed implants are: |
| procedure, when performed on properly selected | | | | - Urinary frequency (60-70%) |
| men, is at least as effective as surgery to cure | | | | - Urinary burning (50%) |
| prostate cancer. Radiation exposure to other people | | | | - Urinary urgency (50%) |
| is minimal, so restrictions do not apply unless the man | | | | - Erectile dysfunction (30%) |
| is returning to a setting where a young child or | | | | - Blood in the urine (20-30%) |
| pregnant woman is present. | | | | - Increased bowel movements and bowel urgency |
| Treatment Planning | | | | (5%) |
| Men undergo a pre-implant ultrasound study to | | | | - Fatigue (20%) |
| determine where the radioactive seeds (and the | | | | - Pelvic pain (20%) |
| needles to implant them) should be placed. A | | | | - The need for temporary catheter placement |
| transrectal ultrasound, wherein an ultrasound probe is | | | | (10-15%) |
| carefully positioned in the rectum to view the entire | | | | - Urinary incontinence (less than 1%) |
| prostate, is performed. Images of the prostate are | | | | In addition, up to 20 percent of men are found to |
| taken and are transferred to a special treatment | | | | have seed migration into their lungs. However, no |
| planning computer, which evaluates the position of | | | | detrimental effects have been reported. Infrequently, |
| the prostate and generates a three-dimensional plan | | | | men have required trans-urethral resection, the |
| that dictates the precise placement of the seeds. | | | | "scraping" of the prostate gland via the penis, to |
| Preparation for the Procedure | | | | relieve urinary obstruction after the seed placement. |
| Most candidates for prostate brachytherapy undergo | | | | Follow-Up |
| blood tests, a chest x-ray and an EKG several days | | | | Men who undergo prostate brachytherapy report for |
| prior to the implant, in order to be approved for | | | | follow-up visits four weeks after the procedure and |
| anesthesia. On the morning of the procedure, men | | | | every three months thereafter. A PSA blood test |
| receive an enema to help optimize the quality of the | | | | and a physical exam are performed to assess the |
| transrectal ultrasound images. In addition, blood | | | | status of the prostate. |
| thinners are discontinued several days prior to the | | | | The good news is that prostate seed implants are |
| procedure to help diminish the risk of bleeding. | | | | usually successful at controlling prostate cancer within |
| Day of the Procedure | | | | the gland. Such local control of disease correlates with |
| Typically, men who are scheduled to undergo seed | | | | rendering men free from prostate cancer. |
| placement arrive early in the morning. Next, the man | | | | |