It is worth knowing:

  • specialists perform brachytherapy using the ultra-thin needles, which allow for reducing the recovery time;
  • the operation takes no more than 1-2 hours;
  • directly upon the operation, you can return to the usual lifestyle;
  • brachytherapy for prostate cancer prolongs life and improves its quality;
  • in men younger than 70 years, such a side effect as an impotence are infrequent.

Why do patients choose brachytherapy for prostate cancer?

Brachytherapy is contact radiotherapy. This treatment options for prostate cancer involves the introduction into the prostate source of radiation (radium, iridium, iodine, cesium, and cobalt). The main advantage of the method is the maximum effect on malignant cells within the prostate gland with minimal impact on healthy tissues.

What is brachytherapy?

Radioactive "seeds" of the ice grain size are surgically placed inside the prostate gland. These seeds irradiate at a distance of not more than a few centimeters. It helps to prevent the harmful effects of radiation on healthy prostate tissue.

Brachytherapy of the prostate gland can be permanent (seeds remain inside the prostate forever) or temporary (seeds are extracted from the prostate after a while).


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Indications and contraindications of brachytherapy for prostate cancer comparing with other methods

Type of brachytherapy

Indications

Contraindications

Surgery is not recommended

A surgery is forbidden

High-dose brachytherapy (HDR)

T1-T3b clinical stage, in the rare cases - T4.

Gleason score from 2 to 10.

PSA-level - without upper limits.

An absence of remote metastases.

Problems with urination.

Vascular diseases.

Inability to conduct anaesthesia.

Inability of surgical access due to the high body mass.

Low-dose brachytherapy (LDR)

Life expectancy is more than 5 years.

Clinical stage T1b-T2c, in rare cases - T3.

Gleason score is from 2 to 10.

PSA-level is less than 50 mg/ml.

An absence of affected lymph nodes and metastases.

Problems with urination.

Preliminary radiotherapy of small pelvis.

Inflammatory pelvic disease.

Affected lymph nodes.

The presence of distant metastases.

Life expectancy is less than 5 years.

Advantages of brachytherapy comparing with other methods

  • Low-invasiveness
  • Quick recovery
  • Short stay in hospital
  • Low risk of postoperative infections
  • Less risk of side effects.

Which tests a patient has to do before brachytherapy?

A type of examination

Aim of examination

General blood test

Estimation of a patient’s organism condition

Biochemical blood test

PSA-level detection

ECG-analyzer

Exclusion of concomitant pathologies

X-ray of the chest.

Sources of radiation in case of temporary brachytherapy after a while are completely removed from the prostate after the procedure. Implants used for permanent brachytherapy have a low degree of radiation. Despite this, doctors recommend such patients to avoid close contact with children and pregnant women for 2 months after the operation. The half-life of radioactive iodine and palladium is 60 and 17 days correspondingly (half-life is a time for which the radioactive substance loses 50% of its charge). The period of complete inactivation is approximately 10 and 3 months correspondingly.

How is brachytherapy is conducted?

Brachytherapy of the prostate is an outpatient manipulation, so you do not need to spend the night before surgery in a hospital. The procedure takes about an hour. The most common method of anesthesia is a spinal one. Doctors install an ultrasound probe into the rectum. It allows visualizing of the prostate gland on the monitor screen. Seeds are placed inside the prostate with the help of ultra-thin needles. Depending on the individual characteristics of the tumor process in the prostate, the number of seeds can vary from 50 to 100. The type of seeds can also be different, but the most commonly used seeds are iodine and palladium ones. A doctor enters needles through the soft tissues of the perineum, gradually moving them to the prostate, then the seeds are introduced into the prostate through the needles. After the end of the procedure, a urinary catheter is placed.

A multidisciplinary team of doctors takes part in the operation: a urologist controls the operation, a radiologist calculates the necessary dosage of radioactive substances, an anesthesiologist is responsible for effective anesthesia.

What happens after surgery?

After the brachytherapy of the prostate, a patient stays in the ward. The action of anesthesia passes several hours after the end of the operation, immediately after that, sensitivity returns to the feet. The catheter is usually removed after the end of anesthesia, but sometimes it is left overnight. The next day, patients usually discharge home. After the procedure, a patient can return to the normal lifestyle. The only things that should be avoided the next week after surgery are intense physical activity and lifting of heavy objects.

Side-effects of brachytherapy

  • Pain and swelling in the prostate
  • Bleeding in the prostate area
  • Hematuria (blood in the urine)
  • Dysuria (urination disorders)
  • Impotence.

Impotence and dysuria can happen in patients over 70 years.

What happens with seeds left in the prostate gland?

Due to the seeds eventually lose their radioactive properties, and there is no scientifical information about the benefits of their extraction - they remain inside the prostate.