Brachytherapy is a form of radiotherapy (using radiation) to treat prostate cancer. The prefix "brachy", meaning short, refers to the short distance from the implanted radioactive seeds to their desired target (prostate cancer cells).
Who is a good candidate for brachytherapy?
Localised prostate cancer of all risk groups can be treated with brachytherapy. Patients with large prostates and difficulty urinating may be less than ideal candidates, in this case a laparoscopic or robotic prostatectomy may be a better option. Obese patients will benefit from brachytherapy since obesity make surgery challenging.
How is the operation performed?
The patients arrives in the ward the day of the surgery. The procedure is done under a general anaesthetic. A catheter is placed in the bladder. An ultrasound probe is inserted into the rectum. Images of the prostate are taken from the back to the front, generating a 3d image. The oncologist and physicist, using real-time computer imaging software, plan the radioactive seed implant. The urologist places multiple needles into the prostate and together with the computer plan, ensures that the seeds are placed in the perfect location. The implant is always done in such a way as to avoid excessive radiation to the urethra and rectum.
What can I expect after the procedure?
Most men are discharged the following day once the catheter is removed and they can void. All men are treated with a course of antibiotics and an alpha-blocker, to assist in urinating. There may be blood in your urine and rarely stool following the procedure. Perineal pain is common and is relieved by simple analgesia. Dysuria, or pain urinating, is common and may need further treatment. Difficulty urinating and even retention (inability to void) may occur requiring a temporary catheter.
Is brachytherapy combined with other treatments?
Intermediate and high risk patients will need hormonal treatment in the form of a 3 monthly injections, combined with extra radiation applied from outside (boost).