Brachytherapy for Prostate Cancer

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What is Brachytherapy?
“Brachytherapy” comes from a Greek root meaning “from a short distance.” It is the practice of treating cancer by placing a radioactive source(s) directly into the cancer tissue. Multiple catheters are placed within the prostate and a single radioactive source moves sequentially in and out of each catheter treating the area at risk from the inside out.

There are two versions of brachytherapy available:

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1.Permanent Seed Implants
2.Temporary Implant

Gamma West Cancer Services offers both low does rate (LDR) permanent seed brachytherapy and high dose rate (HDR) temporary brachytherapy. We perform over 500 of these implants per year making us one of the biggest brachytherapy clinics in the United States. HDR is less familiar to many urologists (and patients) than permanent seeds, but in therapy centers that offer both technologies, HDR tends to be used more frequently. Gamma West is renowned for its success in treating prostate, breast and other cancers using brachytherapy. This is a highly specialized field where experience is critical. Gamma West physicians have successfully performed thousands of these procedures.

Prostate Cancer Facts

  • Prostate cancer is the most common cancer, excluding skin cancer, and the second leading cause of cancer-related death in men in the United States
  • Many prostate cancers are slow growing and have a fairly benign course. Some prostate cancers are very aggressive
  • About 200,000 cases per year are diagnosed in the United States
  • Almost one third of all cancers diagnosed in men are of prostate origin
  • Lifetime risk is one in six
  • Prostate cancer is more common in men than breast cancer is in women

Screening for Prostate Cancer

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  • Prostate-Specific Antigen (PSA) blood test
  • A very useful screening test to diagnose prostate cancer in earlier stages
  • Patients should discuss annual PSA screening with their physician after age 50, or earlier if they have a family history of prostate cancer
  • Tissue Biopsy
  • Biopsies are performed when a PSA test or a medical examination suggest a higher risk of prostate cancer

Most Common Therapy Options
Surgery
Radical Prostatectomy – total removal of the prostate – is likely curative BUT ONLY if the cancer is organ confined
Surgery alone is an inadequate therapy for prostate cancers that extend into the extraprostatic tissues, seminal vesicle or regional lymph nodes

Radiation Therapy

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External Beam Radiation Therapy
Treatment is delivered from outside the body using a high energy x-ray machine. The patient undergoes daily radiation therapy for about two months
Careful therapy planning and delivery is needed to limit the dose to the immediately adjacent rectum and bladder

Brachytherapy
The most conformal way to deliver radiation to the prostate – conformal radiation treatments deliver a higher dose of radiation to the cancer while the dose to the surrounding tissues is minimized

Why HDR Brachytherapy?
HDR Brachytherapy allows the physician to more precisely control the dose delivery within the prostate gland, and the doctor is able to more accurately limit the dose to the surrounding normal tissue. The patient is not radioactive after therapy with HDR brachytherapy.

What to Expect

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A Gamma West Radiation Oncologist performs a comprehensive consultation in relation to the patient’s specific cancer diagnosis. On the day of the procedure, catheters are placed and two treatments are given – the first following the catheter placement and the second approximately 5 hours later on the same day. After the second treatment the catheters are removed and the patient is discharged from the clinic. Patients treated with brachytherapy alone will return for two more implant procedures separated by two week intervals. Higher risk patients are treated with external beam radiation for 5 weeks followed by two outpatient brachytherapy implants scheduled two weeks apart.

Benefits of HDR Brachytherapy
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The HDR radioactive source is thousands of times more active than a permanent seed. HDR implants treat a wider area around the prostate than seeds, including the seminal vesicles and much of the peri-prostatic fat, so the “safety margin” of the therapy is greater. HDR brachytherapy delivers a very high radiation dose in a very short period of time which is especially important for those tumors that we feel may be faster growing. Urinary side effects are relatively short and no radiation precautions need to be followed because HDR is a temporary implant.

Making an Informed Treatment Decision
There are many sources that will be helpful in increasing your understanding of prostate cancer and the various therapy options. In addition to the several associations and government organizations focused on prostate cancer research and education, helpful materials can also be found at your closest Gamma West clinic. Additionally, it will be important for you to meet and discuss your diagnosis and treatment options with medical professionals dedicated to effectively treating, and in many cases, curing prostate cancer. These medical professionals include radiation oncologists and surgeons. Speaking with other prostate cancer survivors can also provide a great deal of hope and support, along with practical information on what to expect. Gamma West can help you connect with other men who have utilized HDR brachytherapy as their curative therapy for prostate cancer. Watch or read testimonials of some of our patients.