Radiation therapy for prostate cancer: internal radiation therapy

Internal radiation therapy for prostate cancer is also called brachytherapy.

There are two main approaches

The first involves permanent placement of about 40 to 100 "seeds" that give off low levels of radiation for up to several months. These radioactive seeds are about the size of a grain of rice, and are implanted into the prostate while a man is under anesthesia in the operating room. Small, thin needles are inserted through the skin (between the scrotum and anus) to place the seeds into the prostate.

Like external radiation, the first step involves several tests that guide the placement of the seeds, such as transrectal ultrasound, CT scans, or MRIs.

Since the seeds give off low levels of radiation, the doctor may advise your loved one to keep his distance from pregnant women or small children for a period of time. He may also be advised to wear a condom during sex. There is also a rare chance that the seeds may travel in his body, but this doesn't appear to be a serious problem. Talk to the doctor about any concerns you may have.

Temporary internal radiation

A newer approach is called temporary or high dose rate brachytherapy. Needles are inserted into the area between the scrotum and anus. Inside these needles are soft catheters that are left in place (the needles are removed). The radioactive substance is placed into the catheters, usually for up to 15 minutes; then it is removed.

A man typically receives 3 of these treatments over several days. The catheters are then removed. A man’s urine may look reddish brown in color for several days, and he may also have some soreness.

Both of these approaches may be combined with external beam radiation.

Potential side effects

Just like external radiation therapy for prostate cancer, internal radiation therapy can cause urinary problems and impotence. A man’s age—and whether he previously had any urinary or erectile problems—are also a factor.

Bowel problems can occur, but they are usually temporary. According to the American Cancer Society, frequent urination is a more common long-term side effect than severe urinary incontinence.

Updated 10/09

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