Brachytherapy treatment for prostate cancer

What is this?

This involves the insertion of radioactive seeds into the prostate gland with needles placed through the skin beneath the scrotum. This procedure may require telescopic examination of the bladder

What alternatives are there?

Active monitoring (watchful waiting), external beam radiotherapy, radical prostatectomy, laparoscopic prostatectomy, robotic prostatectomy & hormone therapy

What to expect before procedure

The day before your admission, you will be asked to take a laxative to clear the bowel. You will usually be admitted on the same day as your surgery. You will normally receive an appointment for pre-assessment, approximately 14 days before your admission, to assess your general fitness, to screen for the carriage of MRSA and to perform some baseline investigations. After admission, you will be seen by members of the medical team which may include the Consultant, Specialist Registrar, House Officer and your named nurse. You will be asked not to eat or drink for 6 hours before surgery and, immediately before the operation, you may be given a pre-medication by the anaesthetist which will make you dry-mouthed and pleasantly sleepy.

What happens during the procedure?

Normally, a full general anaesthetic will be used and you will be asleep throughout the procedure. In some patients, the anaesthetist may also use an epidural anaesthetic which improves or minimises pain post-operatively. You will usually be given injectable antibiotics before the procedure, after checking for any allergies. The procedure takes approximately 2œ hours. A catheter is passed into the bladder via the urethra (water pipe) and left in place until the following morning. An ultrasound probe is then inserted in the rectum and 15-30 needles are directed into the prostate through the skin between the anus and the scrotum (the perineum). The radioactive seeds, usually 60-90 in number, are then inserted along the needles into the prostate itself.

After the procedure

A dressing will be placed between your legs, to reduce the swelling caused by penetration of the needles, and held in place by some elasticated pants. The catheter will be removed the day after insertion of the seeds. The average hospital stay is 2 days.

Potential side effects