Brachytherapy is often referred as “prostate seed therapy”, and describes the procedure where a radioactive material is inserted into the prostate often directly into the tumors. The radiation from these “seeds” often cause the tumors to shrink and die. Brachytherapy is quite common and has been used in the US since the late 80s.

There are two types of brachytherapy treatment: High Dose Rate (HDR), and Low Dose Rate (LDR). LDR brachytherapy is the most commonly used of the two.

Low Dose Rate (LDR) Brachytherapy

LDR Brachytherapy involves low dose radioactive “seeds” being permanently implanted into the prostate. The “seeds” are smaller than grains of rice, and radiation from the seeds wear off after several months. The intended result is a destroyed tumor in the area where a seed has been placed.

LDR Brachytherapy is performed under anesthesia, and radioactive “seeds” are each placed in needles that are inserted into the target through the perineum (the area between the legs, scrotum and anus). Once at the target, the seed is left and the needle is withdrawn. This procedure is repeated until all of the seeds are placed at their targets.

There are few long term risks associated with LDR brachytherapy treament.

High Dose Rate (HDR) Brachytherapy

HDR Brachytherapy utilizes a highly radioactive source that is placed temporarily into the affected areas of the prostate. This high intensity radiation is timed over a period of minutes and often repeated two or three times over several days.

HDR Brachytherapy is performed under anesthesia, and catheters (hollow plastic tubes) are placed through the perineum to give access to the target areas. A remote device is used to place the radioactive material at the target for the intended period of time and then withdraw it. The catheters stay in place over the next few days during the repeated treatments. The patient is then awakened and returned to their room.

Brachytherapy Side Effects

Urinary irritation is a very common side effect of brachytherapy. The urine stream becomes blocked by the swollen prostate about 5-15 percent of the time, and a foley catheter is placed to allow urine flow. Obstruction usually subsides after several weeks allowing removal of the catheter.

Bowel side effects (like diarrhea and cramping) are relatively uncommon with brachytherapy. Erectile dysfunction is always a concern with radiation treatments.

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