Brachytherapy Treatment for Prostate Cancer

Brachytherapy is a treatment option for prostate cancer that uses radiation to control the cancer. In the right setting, it can be a highly effective, minimally invasive, well-tolerated form of treatment.

Brachytherapy presents an attractive treatment option for many patients because it is relatively easy for the patient to endure. The treatment takes approximately one hour to complete and the patient returns home on the same day. The post-treatment recovery period is very short and the side-effects of treatment are less intense than those experienced with surgery or external beam radiation.

The urethra, which courses through the middle of the prostate, is at risk for radiation exposure and thus many patients will temporarily experience some degree of irritative voiding symptoms. For instance, waking up one or two extra times at night to urinate, an increased sense of urinary urgency, or feeling that they need to urinate more often. There may also be a small amount of burning or discomfort with urination. These irritative voiding symptoms are usually temporary on the order of a few months.

What happens during a brachytherapy?

The treatment session involves the placement of tiny radioactive pellets into the prostate. These pellets are placed through a special needle under ultrasound guidance.

The pellets (often referred to as brachy seeds) are highly radioactive, but their radioactivity drops off sharply in a very short distance and in a few months. The idea is to provide a high dose of radiation to the prostate and minimize the amount of radiation to neighboring anatomic structures. This form of treatment has been proven to be highly effective in certain types of prostate cancer.

Patients who are successfully treated with brachytherapy can expect their PSA level to drop to a low and non-rising number. In the first two years following treatment there can be considerable fluctuation in PSA and even spikes in the PSA level.

This phenomenon is known as the “PSA bounce.” It can often cause a degree of stress or concern in the patient; however it is a well-recognized pattern and does not represent recurrence of the cancer.

Not all prostate cancer cases are candidates for brachytherapy. It’s best to ask your doctor if this is a reasonable treatment option for you. Contact us to request an appointment with our urologists in the Bay Area to learn if you are a candidate.