The prefix brachy is a Greek word meaning brief or short. Brachytherapy refers to electromagnetic radiation treatment delivered by radioactive material placed in a short distance within the tumor.
The first step a physician will take in the Brachytherapy treatment is the use of an ultrasound to determine the position and shape of the prostate. The ultrasound procedure takes twenty to thirty minutes. Once the size of the patient’s prostate is figured out, the doctor calculates how many radioactive seeds are necessary to make the insertion into the prostate a success. The typical amount ranges from fifty to hundred seeds. The ultrasound also allows the doctor to reconstruct the spread of the cancer within the prostate.
Before surgery, the patient should follow a strict clear liquid die the day before the treatment. By doing this, it helps the physician better visualize the prostate. It is wise that the patient refrains from consuming solid food after treatment, at least until the following day.
The procedures entails the patient receiving a general or spinal anesthesia, then, the use of a fluoroscope and ultrasound help the physician to visualize the prostate. The next step involves inserting and guiding eight inch needles, which contain tiny, radioactive capsules, called seeds, into the cancerous prostate gland. Once the needles have reached their destination in the prostate, they are removed, leaving the seeds in place. The seeds release radiation for a number of months that kills the malignant tumor. The seeds are small enough not to cause any discomfort to the patient. Depending on the circumstances, either radioactive Iodine (I-125) or palladium (Pd-103) will be used. It is common that the patient will undergo a CT scan on the same day so that the physician can ascertain the position of the radioactive prostate seed implants and better analyze the quality of the brachytherapy to be accessed. The CT scan will be useful for future checks on the condition of the prostate cancer. This treatment is idea for men with small tumors confined to the prostate gland.
According to prostate-cancer-institute.org, new advances in seed technology have made available versions of seeds that allow doctors to securely place them at the border of and adjacent to the prostate to treat cancer that might have extended to the surrounding tissue.
Effectiveness of Brachytherapy
In 2004, the American Society of Clinical Oncology was presented with a 15-year data which demonstrated Brachytherapy effectiveness for treating prostate cancer. A published 12-year data also showed that disease-free survival rates were between 81% and 93%. The advancement of Brachytherapy included precision in the placement of stranded seeds.
When considering Brachytherapy treatment, there are risk factors which should be discussed between the patient and physician. The chances of developing impotence or incontinence with the brachytherapy procedure are less when compared to other treatments. Althought impotence has been reported by various groups of patients, most patients receiving brachytherapy have often reported similar levels of potency before their treatment. There is a risk of impotence increasing with age; however, impotence after brachytherapy can be treated with prescription drugs such as ViagraT, CialisT or LevitraT.
Brachytherapy can be an outpatient procedure that usually last around an hour. Seed implantation requires no surgical incision and offers short recovery time. Most patients go home the same day after treatment. Recovery usually takes a day or two with most patients returning to their normal activities a few days after treatment. However, physicians recommend waiting about two weeks until resuming sexual activity.
There may be some minimal side effects such as a burning sensation during urination or ejaculation, and possibly, an increase in urinary frequency. These side effects go away rather quickly. In few patients, it has been reported that temporary difficulty with urination was experienced for a few weeks to a few months after the implant.