Brachytherapy

What is brachytherapy?

Brachytherapy literally means ‘short therapy’. There are two types of prostate brachytherapy: low dose-rate (LDR) and high dose-rate (HDR). (The term ‘dose-rate’ refers to the type of radiation source used and not to the actual radiation dose delivered.) Low dose-rate is most commonly used.

Who is suitable for brachytherapy?

This treatment is only suitable for organ-confined prostate cancer, for those whose prostates are not over-enlarged, and for those who have few, or mild urinary symptoms. Typically men with low or intermediate risk prostate cancer are treated with a LDR seed implant alone. Such patients would normally have a PSA below 15, a Gleason score of 6 or 7, and a cancer stage of T2b or less. Where there is a possibility of spread, or for higher risk disease, a short course of radiotherapy and/or hormone treatment is sometimes offered. HDR brachytherapy is normally given with a short external beam radiotherapy course and is ideally suited to men with a high risk cancer which has spread to the seminal vesicles (i.e. stage T3b).

You can read about the different types of Brachytherapy in their individual sections (see Menu, left).

How will I know whether the treatment has been successful?

As with any radiotherapy treatment, the potential success of brachytherapy will not be known until about 36 months after the treatment has finished, when the PSA will have reached its lowest level. If there is a steady rise of more than 2.0ng/mL above this low point in a six-month period, your consultant should be advised.