Seeds of hope: Brachytherapy is one option for prostate cancer patients

Aside from skin cancer, prostate cancer is the most common cancer for men. About one in seven men will be diagnosed with the disease in their lifetime, and prostate cancer is the third leading cause of cancer death in American men, according to the American Cancer Society.

The good news is that more men are surviving prostate cancer as treatments improve. Today, more than 2.9 million men in the United States diagnosed with the disease are alive today, the ACS reports.

Surgery and radiation are traditional ways of treating prostate cancer. But another option – prostate seed implants – has emerged as a powerful tool to defeat the disease and preserve quality of life.

“Prostate seed implants are a form of brachytherapy – a procedure that involves placing radioactive material inside the body,” says Neal Bhatt, MD, a radiation oncologist who treats patients at the Barbara Ann Karmanos Cancer Institute at McLaren Port Huron.

“In many cases, internal radiation can be more effective than external radiation for treating prostate cancer. Brachytherapy minimizes radiation exposure to surrounding organs. And because the prostate isn’t surgically removed, brachytherapy may be the best way to preserve the patient’s sexual function.”

In low-dose brachytherapy, a physician implants a permanent strand of 60 to 100 tiny radioactive “seeds” into the prostate. These seeds may also be loose.

Prostate brachytherapy has been a treatment approach to prostate cancer for more than 30 years. The treatment has grown more popular again with the advent of computer-based planning.

“Prior to performing brachytherapy, an ultrasound is utilized to image the prostate. These images are used to create a customized plan specific to a man’s prostate to treat the cancer,” Dr. Bhatt says.

“During the procedure itself an ultrasound probe is used to create a multidimensional view of the prostate gland on several TV screens. These images are used to place the needles while a computer continues to calculate and make the physician aware of the best spacing. The seeds are like batteries – their radiation charge slowly dies over time.”

High-dose brachytherapy is another internal radiation technique. Instead of implanting seeds, the physician inserts 15 to 25 hollow temporary catheters into or next to the prostate, and then uses a machine attached to the hollow catheters to deliver a high dose of localized radiation.

The physician removes the catheters after the procedure.

“The low-dose method is a one-time procedure, while the high-dose method requires two to four visits,” says Dr. Bhatt. “Depending on the size of the tumor and the disease location, patients can decide which method they prefer. High-risk patients may have seeds along with external radiation to keep the cancer from spreading.”

Prostate seed implants do not require incisions, so patient discomfort is usually minimal. Most patients are treated in the morning, discharged a few hours later and resume their regular activities within a day.

“The most common side effect is a temporary irritation of the urinary stream,” Dr. Bhatt says. “But patients can manage this by drinking plenty of water or taking medication.”

The best prostate cancer candidates for brachytherapy are patients at low or very early intermediate risk, and success rates are exceptional for both low and high-dose techniques.