Brachytherapy: Is It the Best Option for Your Prostate Cancer?

Learn about the procedure, benefits and side effects

Have you been diagnosed recently with prostate cancer? Advances in screening and treatment in recent years are making it much more treatable.

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An outpatient procedure worthy of note is brachytherapy, which involves placing radioactive sources within your tumor to destroy the cancerous cells. It precisely targets the cancer with a high dose of radiation.

“This type of treatment is competitive to other options — surgery and external beam radiation — and the cure rates are similar,” says radiation oncologist Jay P. Ciezki, MD.

What are the benefits of brachytherapy?

If you want to avoid surgery or being treated with a radiation beam from a machine, then you might consider brachytherapy, Dr. Ciezki says.

It’s a relatively fast treatment that doesn’t require an incision or stitches. It typically has fewer side effects in the rectum and bladder, and it’s less costly than other radiation-based treatment options, he says.

“This is a very minor procedure and it is performed in one day,” he says. “Typically, the concern with external beam radiation is that you can get rectal and bladder bleeding. But the rates of those side effects with brachytherapy are much lower.”

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What are the possible side effects of brachytherapy?

A common concern among patients is whether they are radioactive after the procedure. The answer is yes — temporarily.

“That means that you should not have pregnant women or children in your lap for more than 20 minutes per hour for the first two months,” Dr. Ciezki says. “You can be around people for as long as you want. The only area of risk is the lap,” he says. “It’s a minor risk but we tell people about it.”

Some patients also may have trouble urinating or they may have the frequent urge to go. They may also experience a burning sensation when they urinate. In certain cases, patients may need to use a catheter because of temporary prostate swelling.

Who is a good candidate for brachytherapy?

Doctors sometimes use brachytherapy after a surgical procedure or external beam radiation. But it often serves as the sole treatment.

Also, according to Dr. Ciezki, anyone at any stage of localized prostate cancer is a good candidate.

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“The data is still evolving, but it appears that anybody who has curative prostate cancer can be treated with brachytherapy,” he says.

What are the different types of brachytherapy?

There are several types of brachytherapy to consider:

  • High-dose rate (HDR): A high dose rate of radiation is used for a short period of time — typically about 10 to 20 minutes per session.
  • Pulsed-dose rate (PDR): This delivers radiation in pulses about once per hour instead of continuously.
  • Permanent or permanent LDR: Doctors place tiny radioactive seeds, pellets or capsules inside the prostate and leave them there. After several months, the seeds lose their radioactivity, but can remain in your body without causing harm. 

Can prostate cancer come back after brachytherapy?

Dr. Ciezki says some patients worry they’ll need further treatment beyond brachytherapy. But he wants to dispel those fears. If the cancer comes back — which is extremely rare in the prostate — it’s typically treated with hormone therapy or chemotherapy because if the cancer recurs, it does so in the bone or lymph nodes.

“Needing surgery to remove the prostate after brachytherapy is rare,” he says. “It shouldn’t enter much into your decision-making because to most common site of failure in not the prostate.”

If you’re wondering if brachytherapy is right for you, ask your doctor. He or she can consider your medical history and let you know if it’s an option.

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