Brachytherapy

Brachytherapy is a type of internal radiation therapy used to treat prostate cancer. Instead of directing radiation from outside the body, it places radioactive material inside or very close to the prostate, allowing a high dose of radiation to target the cancer while reducing exposure to nearby tissues such as the bladder and rectum.

There are two main types:

1. Low-dose-rate (LDR) brachytherapy (“seed implants”)
   • Tiny radioactive seeds, about the size of grains of rice, are permanently implanted into the prostate.
   • The seeds give off radiation over weeks or months, then become inactive while remaining in the prostate.
   • The procedure is usually done under general or spinal anaesthetic and often as a day case or with one overnight stay.
2. High-dose-rate (HDR) brachytherapy
   • Thin tubes (catheters) are temporarily inserted into the prostate.
   • A highly radioactive source passes through the tubes for a few minutes to deliver treatment, then is removed.
   • No radioactive material is left inside the body after treatment.
   • HDR may be given in one or more treatment sessions and is often combined with external beam radiotherapy for higher-risk cancers.

Who is it suitable for?

Brachytherapy may be recommended for men with:

• Low-risk or intermediate-risk prostate cancer (often LDR alone).
• Some higher-risk prostate cancers, where HDR is combined with external beam radiotherapy and sometimes hormone therapy.

It is not suitable for everyone. Factors such as the size of the prostate, urinary symptoms, previous prostate surgery, and the stage of the cancer influence whether it is a good option.

Benefits

• High radiation dose delivered directly to the prostate.
• Less radiation to surrounding healthy tissues.
• Usually a shorter treatment course than external beam radiotherapy alone.
• High cure rates for appropriately selected patients, comparable to surgery or external beam radiotherapy for many early-stage cancers.

Possible side effects

Short-term side effects can include:

• Frequent or urgent urination.
• Burning when passing urine.
• Difficulty emptying the bladder.
• Mild discomfort or bruising.
• Blood in the urine or semen.

Long-term side effects may include:

• Persistent urinary problems or, rarely, urinary blockage.
• Erectile dysfunction, which may develop gradually over several years.
• Bowel symptoms such as rectal bleeding or irritation (less common than with some forms of external radiotherapy).
• Urinary incontinence is generally less common than after prostate surgery but can occur, especially in men who have had previous prostate procedures.

Recovery

Most people return to normal activities within a few days after LDR brachytherapy. Urinary symptoms are common for several weeks or months and usually improve over time. Follow-up includes regular blood tests to measure prostate-specific antigen (PSA) levels, which help monitor how well the treatment has worked.

Brachytherapy Treatment for prostate cancer patients

The Brachytherapy Team at Radiotherapy at NHS United Lincolnshire Hospitals. Dr Manuel Pandades: Consultant Clinical Oncologist & Head of Service. Mr Ian Mark: Consultant Urologist Dr Thiagarajan Sreenivasan: Consultant Clinical Oncologist Lucy Darby :Advanced practioner in Brachytherapy Chris Clague: Patient Discuss Brachytherapy treatment and answer questions and patient Chris Clague relates his own recent experiences of his successful treatment.

What is High-dose rate (HDR) brachytherapy?

In this video one of Prostate Cancer Uk’s Specialist Nurses, Grace, explains what high-dose brachytherapy is and how it’s used to treat prostate cancer. She also talks through the side effects you might get from high-dose brachytherapy. For more information and advice take a look at our website: https://www.prostatecanceruk.org