What is a brachytherapy?
Brachytherapy is an advanced cancer treatment where tiny radioactive seeds (or sources) are placed in or near the cancerous tissue itself, giving a controlled radiation dose to the cancerous tissue while reducing any radiation exposure in the surrounding healthy tissue. The term “brachy” is Greek for short distance. Brachytherapy is radiation therapy given at a very short distance. It is localised and very precise.
Why this procedure
Brachytherapy is ideally suited for the treatment of prostate cancer because the prostate gland is located under the bladder and in front of the rectum. It is therefore vital that the radiation therapy is focused in the prostate to avoid significant side effects. The prostate gland is also close enough to the skin that it can be easily reached by brachytherapy needles. The tiny radioactive seeds (or sources) give off their radiation at a low dose rate over several weeks or months, the seeds remain in the prostate gland permanently and the radiation gradually fades with time.
What is the procedure
The seeds are put in while you are under a general anaesthetic. An ultrasound probe is inserted into the back passage to show the prostate and when linked to sophisticated computer software it produces a 3D image and treatment plan of the prostate. Special needles are used to insert the radioactive seeds, through the perineum (the skin between your testicles and back passage, into your prostate gland. The needles are positioned using a template with a grid system (similar to the game of battleships). With focused brachytherapy the seeds are placed to specifically target only the cancerous area(s) of the prostate, making the procedure ultra precise and effective. Once the seeds are in place, the needles are removed, the whole procedure usually takes about an hour.
Before, during and after the procedure
You may be given an enema to make sure your bowel is empty so that the ultrasound picture is as clear as possible for the procedure. All the radioactivity from the seeds is absorbed by the cancerous tissue within the prostate, so it’s safe for you to be around other people. But as a precaution, you should avoid long periods of close contact with children and women who are, or could be, pregnant.
You’ll be given antibiotics after the procedure to prevent infection. Most men go home on the same day, as soon as they’ve recovered from the anaesthetic and are able to pass urine normally. You should avoid heavy lifting or strenuous physical activity for 2–3 days after the procedure.
Although the seeds stay permanently in the prostate gland, there is a tiny chance of a single seed being passed in the semen during sex. Therefore it’s advisable to use a condom for the first few weeks after the seeds have been put in. During this time, the semen may be coloured black or brown. This is normal and is due to bleeding that may have occurred during the procedure.