What You Need to Know About Internal Radiation for Prostate Cancer

Men with prostate cancer have several treatment options, one of which is radiation therapy. This type of treatment is common for prostate cancer because it effectively targets cancer cells while minimizing damage to the surrounding healthy cells of the prostate and other nearby organs. Radiation therapy can eliminate the need to surgically remove the prostate, which comes with more severe side effects for most men compared to radiation therapy.

There are two types of radiation therapy used to treat prostate cancer. The first type is external beam radiation therapy, which involves directing radiation from a machine outside the body toward the affected area. The second type is internal radiation therapy (commonly called brachytherapy), in which radioactive material is implanted in the prostate to deliver the radiotherapy. Some prostate cancer patients may receive both internal and external radiation therapy, especially if they have a higher risk of cancer spreading outside of the prostate.

Why Brachytherapy is Effective in Treating Prostate Cancer

Brachytherapy is most often performed instead of surgery for early-stage patients whose cancer is slow-growing. Some men may receive brachytherapy as their primary treatment. For men with more advanced prostate cancer, brachytherapy may be combined with other treatments.

Brachytherapy treatments include placing radiation in the prostate so that it can directly target cancer cells, minimizing the impact on nearby healthy tissues. This approach produces fewer side effects compared to other types of treatment, including surgery. However, if cancer has spread beyond the prostate, internal radiation therapy is less likely to be a part of the treatment plan.

Types of Brachytherapy for Prostate Cancer

Radiation oncologists use three types of brachytherapy to treat prostate cancer – two of them temporarily place radioactive material in the prostate and another with permanent placement.

High Dose-Rate (HDR) Brachytherapy

High dose-rate (HDR) brachytherapy delivers concentrated doses of radiation within a short time through radioactive pellets placed in catheters inserted temporarily in the body. The sessions can last between 10 and 20 minutes each and be scheduled twice daily for up to five days or once weekly for up to five weeks. The period in which the radioactive material remains in your body is called the “dwell time.” A longer dwell time delivers the maximum amount of radiation to the cancer cells without damaging other organs, such as the rectum, bladder, or urethra.

The radiation oncologist uses computed tomography (CT) scans and magnetic resonance imaging (MRI) to determine where to place the catheters and the radioactive pellets. After each session, the radioactive material is removed. The catheters may be left in until all of the treatment sessions are complete. HDR brachytherapy is generally an outpatient procedure.

Low Dose-Rate (LDR) Brachytherapy

Temporary LDR Prostate Brachytherapy

Low-dose brachytherapy uses a lower dose of radioactive material over a more extended period of time. Catheters are placed so that the radiation can be inserted and delivered into the prostate several times over several days. This type of brachytherapy may require you to remain in the hospital for the duration of treatments. The radiation oncologist will remove the radiation source and the device used to hold the radiation in place after you finish treatment.

Permanent Low-Dose Brachytherapy for Prostate Cancer

Permanent brachytherapy uses tiny radioactive “seeds” placed through a surgical procedure and left to break down over time. The seeds release low doses of radioactivity for weeks or months. This method minimizes damage to nearby healthy tissues.

Because the seeds can release radiation for several months, patients should be cautious about who they are near. Your oncologist may recommend staying at least 3 feet from pregnant women or children, especially in the first few weeks after the seeds are implanted.

You should also wear a condom during sexual activity, as pellets may dislodge and exit your body.

Because the radioactive seeds are tiny and do not release any more radiation after one year, your doctor will not remove them after treatment. You will not feel them, and they will not cause discomfort.

Is Brachytherapy Appropriate for Every Prostate Cancer Patient?

Brachytherapy is not recommended for all men who have prostate cancer. Internal radiation is typically not suggested for advanced-stage prostate cancer that has spread to the lymph nodes or other parts of the body. In addition, men who have undergone transurethral resection of the prostate (TURP) or have experienced other urinary problems may not be suitable candidates for brachytherapy. Patients with larger prostate glands may not benefit from internal radiation as it can be more difficult to access all of the locations where the seeds should be placed. It’s possible to reduce the size of the prostate using hormone therapy before administering internal radiation.

What to Expect After Prostate Cancer Treatment

Men undergoing brachytherapy should be aware of some side effects. Some of the most common include:

• Radiation proctitis (rectal irritation)

• Bowel urgency or diarrhea

• Rectal bleeding, blood in the stool, or blood in the urine

• Erectile dysfunction

• Difficulty starting urination

• Urinary burning or incontinence

In some cases, other complications may occur. One such complication is urethral stricture, which is a narrowing of the urethra, the tube that carries urine out of the body. Fistulas or ulcerate channels may also form in the rectum wall.

Is Erectile Dysfunction a Side Effect of Brachytherapy?

Though the risk is lower than with surgery, erectile dysfunction is a possible side effect of brachytherapy. For most men, this side effect goes away after treatments are complete, improving as time goes by. In the meantime, talk to the radiation oncologist about what you’re experiencing. They may be able to provide medication that can help until you’re feeling back to normal. Some men may need to continue using it after treatments are complete.

Prostate Cancer Treatment in South Chicago

If you are newly diagnosed with prostate cancer, it’s a good idea to talk with an oncologist before choosing surgery to remove your prostate. The prostate cancer specialists at Affiliated Oncologists are available to provide an assessment and recommend a treatment plan. Many men have time to make a decision since treatment does not always need to start right after a diagnosis.

Request a consultation at one of our cancer treatment centers throughout the South Chicago suburbs, including Mokena, Hazel Crest, Palos Heights, and Oak Lawn, Illinois.

Categories: Prostate Cancer