This question-and-answer section is designed to answer some preliminary questions that you may have concerning prostate brachytherapy. Please talk to your doctor for more information or for answers to your specific questions.
How does brachytherapy stack up against the other treatments of surgery and external beam radiation?
Are all brachytherapy seed implants the same?
Can I pass the seeds through sexual activity or urination?
What happens to the seeds in the prostate?
How long does the radiation last, and am I radioactive after the implant?
Why didn't my doctor tell me about brachytherapy as a treatment option? Why didn't he know much about brachytherapy when I asked about it?
Many doctors aren't well versed in brachytherapy, as it is a relatively new treatment method. Therefore, some doctors only discuss radical prostatectomy (surgical removal of the prostate) or external beam radiation. Often, men hear about brachytherapy through their families, or through the Internet.
How does brachytherapy stack up against other treatments of surgery and external beam radiation?
Clinical data indicate that the survival rates of patients who chose brachytherapy or radical prostatectomy are comparable after 10 years. Complication rates are lower with brachytherapy, as it is a much less-invasive treatment method than either radical prostatectomy, which is a major surgery, or external beam radiation therapy. The chances of permanent incontinence or impotence appear lower than with radical prostatectomy.
Are all brachytherapy seed implants the same?
No. There are several different types of seeds that are used in brachytherapy. Palladium seeds (Pd-103) produce radiation more rapidly and over a shorter period of time. Some researchers think that Palladium seeds are best suited to treat faster growing, more aggressive tumors. Iodine seeds (I-125) are usually recommended for use in the treatment of slow-growing tumors. Echogenic seeds have a special feature that assists your doctor in the placement of the seeds within the cancerous tissue.
Can I pass the seeds through sexual activity or urination?
It is possible to pass a seed through urination. This typically happens if a seed has been dropped in the bladder. Many doctors will check the bladder after the implant during a procedure called "cystoscopy" to avoid leaving seeds in the bladder. Your doctor should provide you with instructions if you notice a seed in your urine. It is also possible, though highly unlikely that you can pass a seed through ejaculation. It is recommended that you wear a condom for the first few climaxes, as this is when a seed would most likely be passed.
What happens to the seeds in the prostate?
Because the seeds gradually lose their radioactive properties and there is no evidence that there is a benefit to removal, the seeds remain in the prostate.
How long does the radiation last, and am I radioactive after the implant?
The radioactivity of the seeds decays very quickly with time. The radiation used for the treatment of prostate cancer is delivered during the first half life of the isotope, which is 60 days for Iodine-125. The radiation that the seeds give is of such low energy that the radiation is limited to millimeters around the seeds. So, even though very sensitive Geiger counters could detect radiation in your body, you would not be considered radioactive. Despite the very low risk, some doctors recommend that close contact with pregnant women and small children be avoided for some period of time after the initial procedure. Ask your doctor for specific instructions.
How long is the recovery time after the procedure?
Generally speaking, recovery time is very short. Most people are ready to resume normal activities in 3 or 4 days after the procedure.
