Brachytherapy – what is it?

For some types of prostate cancer, for example early stage or localised cancer, brachytherapy is often the treatment of choice. Brachytherapy is a special kind of radiotherapy in which the cancer is treated with radiation from a source placed very close to the cancer. This involves inserting tiny radiation sources (‘seeds’) directly into the prostate. These seeds then continuously release radiation into the cancer. Brachytherapy is also known as internal radiotherapy.
For some types of prostate cancer, for example early stage or localised cancer, brachytherapy is often the treatment of choice. Brachytherapy is a special kind of radiotherapy in which the cancer is treated with radiation from a source placed very close to the cancer. This involves inserting tiny radiation sources (‘seeds’) directly into the prostate. These seeds then continuously release radiation into the cancer. Brachytherapy is also known as internal radiotherapy.

Prostate brachytherapy – what is the difference between HDR and LDR brachytherapy?

The main difference between HDR and LDR brachytherapy is the radiation dose. LDR stands for low dose rate, HDR for high dose rate. Low-dose LDR prostate brachytherapy is primarily used for smaller, less aggressive cancers. The seeds, which contain weakly radioactive iodine-125, remain in place in the prostate and release radiation into the cancer over a prolonged period.
When treating prostate cancer which is, for example, already at a more advanced stage, experienced urologists – in consultation with a radiotherapist – will generally prefer HDR brachytherapy. This involves treating the prostate cancer with a high dose of radiation for a short period of time. This type of treatment is often carried out in combination with percutaneous (external) radiotherapy. In addition to the difference in dose rate, HDR brachytherapy uses iridium-192 as the radiation source rather than iodine. The radiation source is introduced into the prostate under computer guidance using special hollow needles.

Brachytherapy of the prostate is generally only considered if the cancer is confined to the prostate, i.e. there are no secondary cancers (metastases).

What are the advantages of brachytherapy?

As an internal radiotherapy procedure, brachytherapy offers a number of advantages over external radiotherapy and extensive surgical procedures:

• better efficacy due to more precise irradiation of the cancer
• shorter treatment times (1–2 days) and fewer hospital stays
• faster recovery (2–5 days)
• minimally invasive therapy
• fewer side effects (no urinary incontinence, less sexual dysfunction)

What are the side effects of prostate brachytherapy?

Prostate brachytherapy generally has very few side effects. There may be temporary problems emptying the bladder, but these will usually be treated prophylactically with drugs. Brachytherapy does not usually affect sexual potency, but where it does this can be treated with medication.
The most important component of treatment for prostate disease is ongoing follow-up by a urologist – something that applies just as much to brachytherapy. Your urologist will advise you accordingly and will organise regular urology and radiotherapy follow-up.

Brachytherapy at Urologische Klinik Munich-Planegg is performed by urologists Dr. Ramin Djamali-Leonhard and Dr. Friedemann Meisse, who head the clinic’s brachytherapy department.

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You can find more information on brachytherapy in our flyer:
LDR-Brachytherapie: Schonende Alternativtherapie beim Prostatakarzinom - Die permanente Seed-Implantation

Also visit our institute's brachytherapy page at:
www.prostatakrebs-brachytherapie.de