(Source: American Brachythearpy Society)
Derived from ancient Greek words for short distance (brachy) and treatment (therapy), brachytherapy, also known as ‘seed implantation’, is an outpatient form of radiotherapy used in the treatment of different kinds of cancer. With brachytherapy, radiation is delivered within the cancerous area – rather than externally applied to the area - to alter a cancer cell's genetic material, rendering continued growth impossible.
How Brachytherapy Works
Radioactive “seeds” are carefully placed inside of the cancerous tissue and positioned in a manner that will attack the cancer most efficiently, minimizing the risk to normal cells near the cancer. Because brachytherapy precisely targets cancer cells, there is less damage to normal cells and therefore it generally causes fewer and less serious side effects than conventional radiotherapy. Used to treat a number of cancers, this therapy can be a highly effective tool and a vital component in your comprehensive treatment plan.
There are two different kinds of brachytherapy: permanent, when the seeds remain inside of the body, and temporary, when the seeds are inside of the body and then removed. Diseases treated with temporary implants include many gynecologic cancers. For prostate cancer, The Cancer Center at Lake Manassas uses permanent seeds, and over the course of their radioactive lives, the seeds will continuously emit low levels of radiation several millimeters within the prostate.
Not all patients meet the criteria to receive prostate brachytherapy, as there are many variables involved with this treatment option. The Cancer Center at Lake Manassas is currently working with local Urologists with the brachytherapy program, and provides these services at both Prince William and Fauquier Hospitals. For more information about prostate brachytherapy services, please call The Cancer Center at 703-753-4045.
Brachytherapy for Prostate Cancer
Prostate brachytherapy is a type of radiation therapy used to treat prostate cancer. The procedure involves inserting approximately 80-130, rice-sized radioactive seeds into the prostate during an out-patient procedure.
If you have early stage prostate cancer, brachytherapy may be the only treatment used. For larger prostate cancers brachytherapy may be used along with other treatments, such as external beam radiation or hormone therapy. Prostate brachytherapy is generally not used for advanced prostate cancer that has spread to the lymph nodes or to distant areas of the body.
Preparing for Brachytherapy:
To prepare for brachytherapy you will:
Meet with your physicians
Your urologist will evaluate and meet with you to discuss potential treatment options. The radiation oncologist will explain the available procedures and the possible risks. Together you can decide whether prostate brachytherapy is the best treatment for you.
Undergo scans to plan for treatment.
Before you begin treatment, you'll undergo imaging scans of your prostate, such as ultrasound, computerized tomography (CT) and magnetic resonance imaging (MRI). These scans help your radiation oncologist and other members of the treatment planning team decide the dose and positioning of the radiation.
During Prostate Brachytherapy
Prostate brachytherapy that stays in your body permanently is called low-dose-rate brachytherapy or seed implants. During this procedure, you may be placed under anesthesia so you aren't aware during the procedure and won't feel pain. A wand-like instrument is inserted in your rectum. This instrument creates ultrasound pictures of your prostate. The pictures help guide a long needle that's used to place many seed-like radioactive implants in your prostate. The needle is inserted through the skin between your scrotum and your anus (perineum) and into your prostate. The seeds, about the size of grains of rice, will give off radiation for a few months and will remain in your body permanently.
Once the seeds are placed in your body, you'll spend some time in a recovery area, and then you can go home. The low levels of radiation in the seeds generally aren't harmful to others, but as a precaution, avoid close contact with children and pregnant women for a short time. Your doctor may advise you to wear a condom during sex.
After Prostate Brachytherapy
After prostate brachytherapy you can expect some pain and swelling in the perineum where the radiation needles were inserted. You may find relief by placing an ice pack over the area or taking acetaminophen (Tylenol, others). Tell your doctor if these measures aren't controlling your pain.
You can resume normal activities when you feel up to it. Avoid strenuous activity, such as running, or activities that may irritate the perineum, such as riding a bike, until the area where the radiation was inserted is no longer tender.
You may undergo follow-up blood tests to measure the level of prostate-specific antigen (PSA) in your blood. These tests give your doctor an idea of whether treatment has been successful. Ask your doctor when you can expect to know whether your prostate cancer is responding to treatment.