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Radiation Seeds For Prostate Cancer

How Long Does It Take To Recover From Radiation Treatment

The Difference Between Temporary & Permanent Seeds Brachytherapy | Ask a Prostate Expert, MD

Theres no doubt radiation therapy can make the difference between life and death for cancer patients, but unfortunately it often comes at a cost.

Radiation therapy is associated with harsh side effects, many of which dont emerge until months or years after treatment. Acute side effects occur and disappear within 14 days of treatment, but long-term effects like bone degeneration, skin ulcers, and bladder irritation take much longer to manifest.

The complications of radiation therapy are frustrating, painful, and often embarrassing, but using ongoing therapy, such as hyperbaric oxygen therapy , can accelerate your radiation therapy recovery in a natural way and stop your symptoms from defining your quality of life.

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Low Dose Rate Or Seed Brachytherapy

How it works

In this type of brachytherapy, small seeds of radioactive Iodine are placed into the prostate. Each seed is 5mm long and 1mm wide and 80 to 120 seeds would typically be used. These seeds deliver a high dose of radiation but do so over a long time . As they are placed within the prostate, this allows a high dose to be delivered directly to the tumour with minimal dose to the surrounding healthy organs, such as the rectum and bladder. Using this technique provides a very high chance of cure for suitable patients with reduced side effects.

Who is suitable?

This treatment is suitable for lower risk, localised prostate cancers. There are some requirements that the radiation oncologist will discuss.

What are the benefits and side effects?

The main advantage of brachytherapy is the reduced long-term toxicities. However, there is still a small risk of urethral scarring and long-term change in bladder habit. Like all other prostate cancer treatments, there is a chance that men can develop erectile dysfunction. However, it seems that this risk is lowest with seed brachytherapy. Approximately 30-40% of men will have some erectile problems after LDR brachytherapy.

One of the other big advantages of this treatment is convenience. It typically requires 2 3 visits to the hospital with up to 1 night in hospital.

What is the procedure for treatment?
Results of LDR brachytherapy

For more information about this technique watch the video.

What Are The Advantages And Disadvantages

What may be important to one man might be less important to someone else. Your doctor, nurse or radiographer can help you choose the right treatment for you. Theres usually no rush to make a decision, so give yourself time to think about things.

Advantages

  • Recovery is quick, so most men can return to their normal activities one or two days after treatment.
  • It delivers radiation directly into the prostate, so there may be less damage to surrounding healthy tissue, and a lower risk of some side effects.
  • You will only be in hospital for one or two days.
  • If your cancer comes back, you may be able to have further treatment.

Disadvantages

  • It can cause side effects such as urinary and erection problems.
  • You will usually need a general or spinal anaesthetic, which can have side effects.
  • It may be some time before you know whether the treatment has been successful.
  • You will need to avoid sitting close to pregnant women or children during the first two months after treatment.

If you are having external beam radiotherapy or hormone therapy as well as permanent seed brachytherapy, think about the advantages and disadvantages of those treatments as well.

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External Beam Radiation For Prostate Cancer

D de Jong, Prostate cancer brachytherapy

When most patients think of radiation therapy, they think of external beam radiation therapy , in which a beam of radiation is directed at cancerous tissue from outside the body. Technological advances, such as intensity-modulated radiation therapy and image-guided radiation therapy , allow radiation oncologists to use computer-controlled devices and image-guidance technology to see and target a three-dimensional image of the tumor, making the treatment more precise than ever before.

EBRT used to require 40-45 daily treatments. Now, 25-28 treatments are the norm. This type of protracted, fractionated radiation therapy, however, is now generally considered to be less appropriate for low-risk and favorable intermediate-risk patients. Instead, hypofractionated techniques and brachytherapy techniques are generally more advisable for many patients.

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Brachytherapy For Prostate Cancer

Brachytherapy is a form of internal radiation therapy. With this type of therapy, radiation is delivered to the prostate tumor inside the body via a catheter or another implantable device.

High-dose rate brachytherapy uses radioactive Iridium-192 to deliver high doses of radiation to the prostate tumor. Treatments are short, sometimes requiring as few as five sessions. Brachytherapy radiation more tightly surrounds the tissues were targeting, which may help spare normal tissues.

When Is Brachytherapy Alone The Right Choice

For a patient with disease that is confined to the prostate and not too aggressive, brachytherapy alone is a good option. With the use of sophisticated real-time computer-based planning, we can use brachytherapy to deliver radiation in an extraordinarily precise way, with minimal exposure to the surrounding normal tissues. It is also convenient for the patient as it is done in an outpatient setting and most people are able to get back to work the next day.

But brachytherapy is not right for everyone. For some patients with less-aggressive disease, a watch-and-wait approach would also be very reasonable. At MSK, our philosophy is that when the disease is caught very early meaning a low PSA level, or nonaggressive disease as reflected by a Gleason score of 6 with evidence of cancer in only a few of the biopsy samples and no evidence from the MRI of a significant amount of disease then it would be very appropriate to do active surveillance and hold off on treatment.

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Dry Orgasm And Infertility

Both the prostate and the glands responsible for semen production are removed during surgery, which is a common prostate cancer treatment. If you received this treatment, youd still be able to have an orgasm but youd no longer ejaculate.

This means that youll no longer be fertile. If you plan to have children in the future, you may consider banking your sperm before your surgery.

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Will I Be Radioactive During Or After Internal Radiation Treatment

Prostate Seed Implants – Treatment of Prostate Cancer- Dr. Gregory Echt

With internal radiation therapy, your body may give off a small amount of radiation for a short time.

If you have a temporary implant, youll be asked to stay in the hospital and might have to limit visitors during treatment. You also may be asked to stay a certain distance away from them. Pregnant women and children might not be allowed to visit you. Depending on the type of implant, once it is removed, your body will likely no longer give off radiation.

Over a few weeks to months, permanent implants will slowly stop giving off radiation. The radiation usually doesnt travel much farther than the area being treated, so the chances that others could be exposed to radiation is very small. Still, your health care team might ask you to take certain precautions such as staying away from small children and pregnant women, especially right after you get the implants.

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Will Radiation Therapy Make Me Tired

Everyone have their own energy level, so radiation treatment will affect each person differently. Patients often feel fatigue after several weeks of treatment. For most patients, this fatigue is mild. However, a loss of energy may require some patients to change their daily routine.

If your doctor thinks you should limit your activity, they will discuss it with you.

To minimize fatigue while you are receiving radiation treatment:

  • Be sure to get enough rest.
  • Eat well-balanced, nutritious meals.
  • Pace your activities and plan frequent rest periods.

When You Might Have Permanent Seed Brachytherapy

Permanent seed brachytherapy is a treatment for early stage prostate cancer. This means the cancer hasn’t spread outside of the prostate.

If your prostate gland is too big you might need hormone therapy for 3 months before the radiotherapy treatment. The hormone therapy shrinks the prostate and makes it easier to put the seeds into the right place.

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Why Choose Brachytherapy For Prostate Cancer Treatment

Prostate brachytherapy is a highly effective type of prostate cancer treatment. For some, it may be used as the only type of treatment. For other men, brachytherapy is used in combination with other cancer treatments such as external radiation or hormone therapy.

The radiation is often successful in treating the cancer cells, while nearby tissue only receives a very small amount of the radiation. This can be helpful in reducing the side effects that are experienced. Prostate brachytherapy is not usually recommended for prostate cancer that has spread to lymph nodes or distant areas of the body.

What Is Prostate Seed Brachytherapy

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It is estimated that 1 in 9 men will develop prostate cancer during their lifetime. If prostate cancer is detected early, there are several methods of treatment currently available which provide a good chance of a cure. Choosing the treatment option that is best for you should involve obtaining enough information to allow you to understand what each treatment involves.

You should make an informed decision in close consultation and discussion with your doctor.

This procedure involves the insertion of radioactive seeds directly into the prostate gland where they remain. The seeds emit low level radiation for approximately 1 year after implantation. Each seed is 4.5mm in length and 0.8mm wide and resembles a grain of rice, grey in colour.

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Side Effects Of Brachytherapy

Brachytherapy causes the same types of side effects that external beam radiation therapy does, such as erectile dysfunction.

In some instances, side effects to the bowels may be less severe than those caused by EBRT. Side effects that impact the bladder, however, may be more severe.

High-dose brachytherapy may cause temporary pain and swelling. It may also cause your urine to look red or brown for a short period of time.

Brachytherapy presents with some risks that external beam radiation therapy does not. If you have permanent brachytherapy, you may emit radiation to others for several weeks or months. Your doctor may advise you to stay away from pregnant people and small children during this time.

Occasionally, the seeds may migrate away from their original placement. For this reason, you may also be instructed to wear condoms during sexual activity, to protect your partner.

Intensity Modulated Radiation Therapy

IMRT, an advanced form of 3D-CRT therapy, is the most common type of external beam radiation therapy for prostate cancer. It uses a computer-driven machine that moves around the patient as it delivers radiation. Along with shaping the beams and aiming them at the prostate from several angles, the intensity of the beams can be adjusted to limit the doses of radiation reaching nearby normal tissues. This lets doctors deliver an even higher radiation dose to the cancer.

Some newer radiation machines have imaging scanners built into them. This advance, known as image guided radiation therapy , lets the doctor take pictures of the prostate just before giving the radiation to make minor adjustments in aiming. This appears to help deliver the radiation even more precisely and results in fewer side effects.

A variation of IMRT is called volumetric modulated arc therapy . It uses a machine that delivers radiation quickly as it rotates once around the body. This allows each treatment to be given over just a few minutes. Although this can be more convenient for the patient, it hasnt yet been shown to be more effective than regular IMRT.

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Questions To Ask Your Doctor Radiographer Or Nurse

  • Will I have a planning session at a different time to the treatment, or immediately before?
  • Will I have external beam radiotherapy or hormone therapy as well?
  • What side effects might I get?
  • How will we know if the treatment has worked?
  • What should my PSA level be after treatment and how often will you test it?
  • If my PSA continues to rise, what other treatments are available?

Study: Radioactive Seeds Beat Out Other Prostate Cancer Treatments

Prostate Cancer Radiation Seeds: After Surgery

Brachytherapy May Have Fewer Side Effects, Is Cheaper Than Surgery, External Radiation Therapy

Jan. 31, 2012 — For most men with prostate cancer, having radioactive seeds implanted in the prostate is associated with fewer serious side effects than either surgery to remove the prostate or having a beam of high-energy radiation aimed directly at the cancer, researchers say.

The analysis of the Medicare records of more than 100,000 prostate cancer patients also shows that treatment with radioactive seeds, called brachytherapy, is cheaper than surgery or external beam radiation therapy .

Studies have shown that all three treatments are “pretty much equally effective” for treating the 80% of prostate cancer patients diagnosed with low- and intermediate-risk disease, says researcher Jay Ciezki, MD, a radiation oncologist at the Cleveland Clinic.

“So it comes down to quality of life and cost. Based on our analysis, we have to conclude that brachytherapy is the optimal treatment choice,” he tells WebMD.

An expert not involved with the work says the new study would not influence his choice of treatment for his patients, however.

Ciezki presented the findings at a news briefing in advance of the fourth annual Genitourinary Cancers Symposium, being held later this week in San Francisco.

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How Will I Know That My Hormone Therapy Is Working

Doctors cannot predict how long hormone therapy will be effective in suppressing the growth of any individual mans prostate cancer. Therefore, men who take hormone therapy for more than a few months are regularly tested to determine the level of PSA in their blood. An increase in PSA level may indicate that a mans cancer has started growing again. A PSA level that continues to increase while hormone therapy is successfully keeping androgen levels extremely low is an indicator that a mans prostate cancer has become resistant to the hormone therapy that is currently being used.

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How Is Hormone Therapy Used To Treat Hormone

Hormone therapy may be used in several ways to treat hormone-sensitive prostate cancer, including:

Early-stage prostate cancer with an intermediate or high risk of recurrence. Men with early-stage prostate cancer that has an intermediate or high risk of recurrence often receive hormone therapy before, during, and/or after radiation therapy, or after prostatectomy . Factors that are used to determine the risk of prostate cancer recurrence include the grade of the tumor , the extent to which the tumor has spread into surrounding tissue, and whether tumor cells are found in nearby lymph nodes during surgery.

The use of hormone therapy before prostatectomy has not been shown to be of benefit and is not a standard treatment. More intensive androgen blockade prior to prostatectomy is being studied in clinical trials.

Relapsed/recurrent prostate cancer. Hormone therapy used alone is the standard treatment for men who have a prostate cancer recurrence as documented by CT, MRI, or bone scan after treatment with radiation therapy or prostatectomy.

Hormone therapy is sometimes recommended for men who have a âbiochemicalâ recurrencea rise in prostate-specific antigen level following primary local treatment with surgery or radiationespecially if the PSA level doubles in fewer than 3 months.

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Whos Eligible For This Procedure

Permanent implants are relatively low-energy sources, and therefore have limited tissue penetration. A well-done implant treats the prostate and the surrounding few millimeters of adjacent tissue.

The best candidates for this procedure are patients with a cancer within or near the prostate. Patients with prostate cancer thats invading nearby structures like the bladder or rectum arent appropriate for this technique.

About Prostate Seed Implants

PPT

Prostate seed implants are a type of brachytherapy, which translated from latin literally means short therapy. This describes that the radiation seeds deposit their radiation dose over a very short distance. In this technique the seeds are placed directly within the prostate gland. This allows a very high dose to be delivered to the prostate with a fast drop-off of dose outside the prostate, minimizing damage to surrounding structures. Radioactive seeds are about the size of a grain of rice. After delivering their radiation over weeks to months, the seeds are inert and remain in the body.

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