A Modern Technique, A Team Approach

Radiation seeds are placed in extremely close proximity to, or even within the targeted tumor. Used since 1965, brachytherapy has improved dramatically over the years. The introduction of transrectal ultrasound has vastly improved a physicians ability to guide the insertion of hollow needles into the prostate. New imaging technologies, computerized treatment planning and the advent of palladium in the early 1990s as a source for radiation have further refined the technique.

Brachytherapy Equipment

The comprehensive nature of brachytherapy treatment means that it requires a range of materials and technologies to implement.

• Seed implants (either iodine or palladium)—usually between 60 and 120 seeds for a typical case.
• Imaging equipment—an ultrasound rectal probe and a monitor allow the team to view and ensure the exact placement of each seed.
  
• Hollow needles through which the seeds are inserted into the prostate.
  
• A mapping template serves as a guide for needle placement and seed delivery to the exact site where each seed must be positioned.

Before The Procedure

Before brachysurgery, physicians like to do a series of routine tests including a blood test and chest X-ray. Also, you will have an ultrasound test to determine the exact size, shape and location of your prostate. This test basically creates a map of the prostate and helps physicians determine how many seeds will be needed.

The Procedure Itself

Brachytherapy is typically treated as an outpatient procedure. The procedure itself generally takes about an hour and a half. You will probably be given general or spinal anesthesia to ensure your comfort during the procedure. During the procedure the ultrasound probe is placed inside the rectum to make the prostate visible on a monitor. This allows the team to view the placement of each seed. The hollow needles that deliver the seeds are inserted through the skin between the scrotum and rectum, and the seeds are placed into the prostate. Once the seeds are planted, your physician will check the X-ray monitor to make sure that all the seeds have been properly placed.

After The Procedure

After the procedure is finished, you will be taken to the recovery room until the anesthesia has worn off. Before you leave the hospital, you'll be given specific instructions, usually advice about avoiding strenuous activity. Sometimes your physician will prescribe an antibiotic. But you should be able to resume your normal daily routine in just a few days. As for the seeds in the prostate, the radiation in the seeds expires after about six months