How brachytherapy is done

Permanent brachytherapy (seeds)

Temporary brachytherapy

• Also called low-dose-rate (LDR) brachytherapy.

• Most suitable for people with few urinary symptoms, and small tumours with a low PSA level (less than 10) and a low to intermediate Gleason score or Grade Group.

• Multiple radioactive “seeds”, each about the size of a grain of rice, are put into the prostate under a general anaesthetic.

• The radiation oncologist uses needles to insert the seeds through the skin between the scrotum and anus (perineum). Ultrasound is used to guide the seeds into place.

• The procedure takes 1–2 hours and you can usually go home the same or next day.

• The seeds slowly release radiation into the area of the prostate to kill cancer cells.

• There are safety issues for patients and others.

• The seeds lose their radioactivity after about one year. They are not removed from the prostate.

• Also called high-dose-rate (HDR) brachytherapy.

• May be offered to people with a higher PSA level and a higher Gleason score or Grade Group. It is often given with a short course of external beam radiation therapy (EBRT).

• The radiation is delivered through hollow needles that are inserted into the prostate while you are under anaesthetic.

• The needle implants stay in place for several hours or, in some cases, overnight. You usually will have 1–3 brachytherapy treatments during this time.

• For each treatment, radioactive wires will be inserted into the needles to deliver a high dose of radiation to the prostate in a few minutes.

• There are no safety issues.

• In some cases, the implant procedure is repeated 1-2 weeks later.