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Brachytherapy: Prostate Seed Implants Treatment

With the decade of research behind it, brachytherapy has become the most common treatment utilized by Dr. Gregory Echt. He has already utilized the therapy on over 4,000 patients, helping to spearhead the procedure’s evolution as the fastest growing method of treating prostate cancer in America.

As part of the conventional brachytherapy, CAT scans are required about a month after the initial treatment. The images produced by the scan help show the precise location of each seed. With this information, the distribution of radiation is determined, and an oncologist will review each result. For IMRT external therapies, the treatment field is run on a test basis to ensure that the treatment will match the intended pattern. For any high dose treatments, independent checks are performed to confirm the source positions of the seeds, as well as dwell times.

While brachytherapy is a fit for a significant number of prostate cancer patients, there are a few requirements, especially if a patient wants only brachytherapy, known as a monotherapeutic approach.

  • The prostate itself (and not just the cancerous tumor) cannot be enlarged to a high degree. Enlarged prostates commonly occur as men age.
  • Dependent on a patient’s case, a PSA test result of less than ten must be present. For more information on this or other prostate cancer tests, click here.
  • Also, dependent on the specific case of the patient, there must be a Gleason score of lower than 7. Click here for more information on the Grading and Staging of Prostate Cancer.In cases where the disease has already spread outside the prostate, it is likely that external beam radiation will also be utilized.

Advantages of Prostate Seed Implants Treatment

  • The process is not extremely time-consuming and is not incredibly invasive. The implantation only takes about an hour. The patient is able to return home immediately afterwards, with the assistance of an acquaintance. Within a couple of days, most patients have returned to their regular daily lives.
  • Dr. Echt’s prostate cancer clinic has fifteen years of data behind them, and the data has repeatedly shown that brachytherapy is highly effective, with a high success rate. Many medical studies have shown that the seed implantation process has a higher success rate than surgical treatment.
  • With the usage of a mild anesthetic, most patients report the procedure as painless.
  • Since there is no major surgery involved, the recovery time is notably faster and bears fewer possible complications.
  • Some of the side effects for many prostate cancer treatments are erectile dysfunction or urinary issues. The American Cancer Society reports that brachytherapy has the smallest odds of some form of sexual problems over any alternative, making it preferable for many patients.

Disadvantages of Prostate Seed Implants Treatment

  • While the procedure has a very low rate of ongoing urinary problems, in the immediate aftermath of the procedure, many men feel the urgent need to urinate. This side effect can come in conjunction with an increased frequency of urination or a weak urine stream. All of these issues are temporary. About 5% of men experience an inability to urinate that requires medical attention, but it is still a temporary issue.
  • After implantation, the patient’s PSA levels may drop. This drop can last several years. The medical team will need to monitor PSA levels closely, and this makes the test a poor indicator of prostate cancer or other conditions.
  • While it has the lowest rate of sexual dysfunction, about 20 to 30% of men do experience some kind of erectile dysfunction, particularly in older patients. The usage of drugs, such as Viagra, has been very successful in combating this side effect.

How Does Prostate Seed Implants Treatment Work?

As one of the fastest-growing prostate cancer treatments in the country, brachytherapy usage is becoming widespread because it is highly effective while being only minimally invasive for the patient, both during the procedure and in the following days. The procedure itself is fairly simple to understand.

Initially, a patient is given a mild, local anesthetic. After this, most patients report the procedure as painless. Once the anesthetic has taken effect, the “seeds” are injected directly into the prostate, into the area between the scrotum and the anus. The seeds are only about the size of a grain of rice, which means that doctors use ultrasound imaging and computers to help guide the placement of the seeds. The images taken by the ultrasound are analyzed by the computer, which then renders a three-dimensional image which showcases the specific placement of the seeds. Using this image, doctors ensure that the seeds are placed in a way to make sure the entire gland gets exposed to radiation. Since there are normally several affected areas, this allows the prostate cancer treatment to be the most effective.

There is no need to remove the seeds. Instead, they stay in a location and slowly disintegrate over the ensuing weeks or even months.

During the process of disintegration, the seeds shed low levels of radiation. The level is enough to harm and hinder cancer cells in the region while minimally impacting surrounding healthy tissue. Eventually, the seeds completely disintegrate, leaving absolutely no radioactive material behind.

The entire implantation takes only about an hour, and the patient is allowed to return home immediately afterwards, although a friend or family member does have to drive them home. Within a few days, the patient can return to a normal routine with almost no restrictions, although there are some precautions required around any pregnant women or newborns since they are more sensitive to radiation.