What is a Brachytherapy?

Brachytherapy is a minimally invasive procedure where the doctor implants tiny radioactive seeds (about the size of a grain of rice) into the prostate which irradiate the cancer from inside the gland. The implanted seeds are small enough that they will not be felt by the patient. Depending on your circumstances, either radioactive Iodine (I ‐125) or palladium (Pd‐103) will be used. Brachytherapy is also referred to as interstitial radiation therapy or seed implant therapy.

What is the purpose of a brachytherapy?

Brachytherapy seed implantation is an optional treatment for men with localized prostate cancer. It is best used for patients with low risk disease and normal sized prostates. Seed implantation requires no surgical incision and offers men a short recovery time. Brachytherapy can be an outpatient procedure, and most men go home the same day as their treatment. Additionally, most men can return to their normal activities a few days after treatment.

What are common symptoms following brachytherapy?

Urinary Side Effect

Urinary side effects are temporary but common for patients undergoing prostate cancer treatment. Brachytherapy side effects may include feelings of urgency, frequent urination, and slower and weaker urinary streams. These urinary side effects occur immediately following the seed implantations as well as in the weeks following, but usually subside within a few months. Rarely will symptoms of slow stream and urinary discomfort persist requiring a secondary procedure to help urinary flow.

Sex after Brachytherapy

The prostate gland and the seminal vesicles are responsible for creating the fluid that makes up semen. Consequently, most men report a decrease in their amount of ejaculation. Sexual side effects immediately following treatment are also common. Patients may experience erectile dysfunction or ejaculation changes. Long term, after treatment, some have reported a shortening of the penis. Some patients report pain with their first ejaculation after the brachytherapy seed implants. The pain, however, subsides with subsequent ejaculations. Ejaculation may also appear red or even brown the first few times, but this discoloration is normal and not a cause for alarm.

Seed Migration

Brachytherapy seeds usually stay in place, though minimal seed migration may occur. Seed migration occurs when a brachytherapy seed does not stay in place in the prostate gland and moves to another part of the body. Usually, brachytherapy seeds will migrate to the urethra or bladder, though rare, a seed may migrate to the lungs. There is no evidence that suggests that the lungs may be affected by a loose brachytherapy seed. If patients find that they pass a seed during urination, they should use a pair of tweezers to pick up the seed and wrap it tin foil. They should then return the seed to their doctor. If a seed is accidentally flushed down the toilet, the patient should not worry. A seed will not affect a municipal water supply. Patients may also rarely pass seeds during ejaculation.

When should I seek advice from my physician?

You should contact your physician if you develop any of the following:

  1. Fevers that are consistently above 101 degrees Fahrenheit
  2. Drainage of pus
  3. Large amounts of continuing bleeding and swelling
  4. Uncontrolled pain or nausea