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 (iodine-125 or palladium-103 are often used) 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.

According to the American Cancer Society, this type of radiation for prostate cancer may not be as effective in men with large prostate glands due to the fact that seeds cannot be placed everywhere they are needed. Some men with large prostate glands may undergo hormone therapy to shrink the gland before receiving this treatment.

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

This type of radiation therapy for prostate cancer is called temporary or high dose rate (HDR) 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 (either iridium-92 or cesium-137) is placed into the catheters, usually for 5 to 15 minutes; then it is removed.

According to the American Cancer Society, the advantage of this approach is that most of the radiation is delivered within the prostate gland, which is designed to avoid harming the nerves, urethra, bladder, rectum, and other nearby tissues.

A man typically receives 3 of these treatments over several days. The catheters are then removed. A man’s urine may then 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 if there is a risk that the cancer has spread beyond the prostate gland.

Potential side effects

Just like external beam radiation for prostate cancer, internal radiation therapy for prostate cancer 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.

Always discuss everything you read on this web site with a qualified medical professional.

Updated 1/13

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References:

The American Cancer Society. Prostate Cancer. http://www.cancer.org. Accessed March 29, 2012.

US TOO International, Inc. Pathways for new prostate cancer patients. http://www.ustoo.com. Accessed September 1, 2008.