Brachytherapy

Brachytherapy is a form of radiotherapy in which delivery of radiation is targeted directly to the prostate gland by implanting small radioactive pellets. Needles are inserted through the skin of the perineum. These needles are used to deliver the seeds which can either be left in place permanently (low dose) or temporarily (high dose).

Low dose rate
The seeds used for low dose rate brachytherapy give off a low dose of radiation over several months, remaining in the prostate gland permanently.

 

High dose rate
In high dose rate brachytherapy thin plastic catheters are inserted through a template (the same as used for template guided biopsy), through the perineal skin, and into the prostate gland. They enter the skin below the scrotum and above the rectum. Radioactive seeds are then inserted into each catheter. After treatment the catheters are pulled out, leaving no radioactive material in the prostate gland.
Brachytherapy may be used as a primary therapy (monotherapy) or in combination with external beam radiation (EBRT) in high dose therapy.

Advantages
  • Treatment in hospital with temporary brachytherapy takes just one or two days. Brachytherapy delivers a high dose of radiation directly to the prostate gland. Normal tissues nearby may receive a smaller dose of radiation compared with treatment with external beam radiotherapy and therefore may be less likely to be damaged.
  • Recovery is quick, which means you can usually return to your normal activities within a few weeks of treatment.

Disadvantages
  • It can cause side effects such as urinary, bowel and erection problems.
  • You will need a general or spinal anaesthetic and you will need to be fit enough for this.
  • If you require more than one radiation treatment you may need to stay in bed for at least six hours between treatments whilst the tubes are in your prostate. Some men find this very uncomfortable.
  • You will need to stay in hospital overnight.
  • It may be some time before you will know whether the treatment has been successful.
  • With low dose rate brachytherapy the radioactive seeds stay inside the body and emit radiation for a few months.
  • You will need a catheter inserted into your bladder during the treatment.
  • With seed brachytherapy it is possible that one of the seeds will move out of the prostate.