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Mayo Clinic urologists and radiation oncologists have been performing permanent prostate brachytherapy since the early 1990s. More than 1,700 patients have received permanent prostate brachytherapy to date at Mayo Clinic.
In permanent prostate brachytherapy, physicians implant between 60 and 120 rice-sized radioactive seeds into the prostate under the guidance of ultrasound and X-ray. The seeds contain an isotope that emits radiation, which kills cancer cells. The seeds are placed during a procedure in which patients are placed under general anesthesia for two hours or less. The seeds are left in place to give off low doses of radiation for weeks or months.
In patients for whom the treatment was appropriate, the outcomes at 12 to 15 years following the procedure are excellent, with a substantial majority of patients remaining cancer-free. According to a number of studies, 90 percent of men who were appropriate candidates for radiation seed therapy remained free from prostate cancer for at least five years. Several long-term studies involving 10+ years of patient follow-up have demonstrated cancer control in more than 85 percent of men treated with permanent prostate brachytherapy. Seed implants generally produce side effects that are similar to external beam radiation, but they may seem more significant due to the temporary need to urinate frequently.
Patients who choose permanent prostate brachytherapy experience a concentrated dose of radiation placed directly in the tumor. Brachytherapy is a convenient outpatient procedure that is minimally invasive and allows patients to resume most normal physical activities after one to two days. Continued refinement in brachytherapy technique has improved outcomes while limiting rates of urinary, bowel and sexual dysfunction.
Nationally, more than 30,000 men have brachytherapy each year, and it has become a major treatment modality for early-stage prostate cancer. The American Cancer Society and other health organizations recognize it as an effective treatment, and the procedure is reimbursable by all major insurance providers including Medicare.
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Simple and inexpensive pretreatment testing can help identify patients who are vulnerable to urinary complications from brachytherapy treatment for prostate cancer. Read the article from the July 2004 Checkup.
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