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Brachytherapy

Brachytherapy is a form of radiation therapy for prostate cancer. The entire procedure takes approximately 90 minutes. Most patients go home the same day. A radiation oncologist and urologist perform the procedure. Both physicians are actively involved in all aspects of the implantation, from the planning to the post-operative care. During the procedure, the urologist provides ultrasound guidance and the radiation oncologist places radioactive seeds.

When you get home:

Diet

Regular, unless you are on a special diet for other reasons.

Activity

Avoid heavy lifting or strenuous physical activity for the first two days, once you are home. After that, you may return to your normal activity level.

Medications

Take antibiotics as prescribed by your physician

Pain medication may be prescribed to you. For mild discomfort please take Tylenol or Ibuprofen/ Aleve as tolerated and prescribed

Alpha Blockers such as Cardura, Hytrin, Flomax or Rapaflo to aid in the emptying of your bladder as well as to improve the flow of your urine

Side Effects:

There are very few side effects from the implant procedure. However, minor burning with urination, urinating more frequently, mild pain or feeling unable to pass urine freely are common and usually stop in one to four months. You are likely to see blood in your urine after the implant for the first 24 hours. If, after 24-48 hours, visible blood persists or if you begin to pass clots, you should contact your urologist. Antibiotics are given after the implant to prevent infection. You should take the antibiotic as prescribed by your physician until the medication runs out. If you develop an allergic reaction, such as a skin rash, stop the medication and contact your physician.

Radiation Safety

Radiation safety is a concern of many of our patients. I-125 and Pd-103 are low energy radioactive materials and lose their activity quickly. The low energy of the seeds mean that their radiation is contained within the prostate gland, for the most part. However, some amount of the radiation is given off to structures very close to the prostate, such as the rectum. The precautions listed below, that we ask you to observe, are to ensure that those around you are protected from unnecessary radiation. Objects that you touch or items that you use are not radioactive.

Precautions

Any pregnant, or possibly pregnant, woman should avoid prolonged close contact with you for the first two months after the implant. She should not hug you or sit very close to you. She can greet you briefly and then move to a distance of 6 feet or more away. At a six foot distance, there is no limit to the length of time she can be in the same room. Children should not be allowed to sit on your lap during the first two months following the implant. Sexual intercourse with a condom may be resumed two weeks after the implant. Your sperm may be discolored dark brown to black. This is normal and is a result of bleeding that may have occurred during the implant and is now being released into the ejaculate. After two months, it will not be necessary to use a condom. After removal of the urinary catheter, and for up to one week after the implant, it is possible that you could lose seeds through urination or in the ejaculate following sexual intercourse. Because of this possibility, we ask you to strain your urine for the first week following the procedure. If you notice a seed and can retrieve it, please do so using a tweezers and place the seed into the packet provided. Return the seed to the office that implanted it

Possible side effects from the prostate implant:

  • Slight bleeding beneath the scrotum
  • Blood in the urine
  • Bruising and tenderness between the legs

These side effects are caused by the needles used to place the seeds. Usually twenty to twenty-five needles are used. The seeds themselves, the urine catheter and other instruments used during the procedure, also can contribute to these side effects. If you should experience severe pain or severe bleeding, you should call your urologist.

A catheter is placed into your bladder during the surgery and is removed several hours later. In some instances, it is left in overnight.

Follow Up:

Within several days of the implant, you will be asked to return to Radiation Oncology/Urologist for a brief visit and a CT scan. The CT scan will enable the physicians to determine the exact position of each seed in the prostate. This is necessary in order to determine that your prostate gland is receiving the proper amount of radiation throughout the entire gland. On rare occasion, it has been necessary to give an additional amount of radiation with either external beam or another implant. Follow-up with your urologist and radiation oncologist will be done on a regular basis. A sample follow-up schedule will be given to you at the time of your implant, but plan on a visit approximately every three to six months for the first five years. Physical examination, blood tests and rectal ultrasound tests will be done at certain intervals as part of your follow-up visits.