Profile: 70-year-old male with a history of diabetes
Diagnosis: Early-stage prostate cancer
Treatment Decision: After meeting with the RPCI prostate team about his options, the patient chose high dose rate (HDR) brachytherapy over surgery because of his age and pre–existing medical condition.
What is it?
HDR brachytherapy is a type of internal radiation therapy that involves the temporary placement of a high–energy radioactive source directly in or around a cancerous tumor.
Advantages:
- Simple procedure (usually takes about 1 hour)
- Minimally invasive (requires no incisions or sutures)
- Quick recovery time
- Unlike low dose rate brachytherapy (which involves extended placement with hospitalization or permanent placement of the radioactivity), HDR is an outpatient procedure
- Lower cost as hospitalization is not needed
- Can be performed under spinal or general anesthesia
- Each treatment session takes only a few minutes
- Radiation dose can be meticulously tailored to the size and shape of the tumor, reducing exposure of normal tissues and injury to bladder, urethra and rectum
- Radiation dose is more accurately and uniformly delivered to the target area
- Unlike permanent implants, radioactive source is removed after treatment so there is no radiation exposure to others
How it Works:
After giving spinal or general anesthesia, the doctor places, thin, flexible needles through the skin and into the prostate. Ultrasound is used to guide the placement of the needles into the correct position. A small, high–intensity radiation source on the end of a thin cable is placed using a state–of–the–art, automated, remote after–loading device. It moves up and down each needle and rests for a calculated period of time at various positions within each needle. After the correct dose of radiation has been administered, the source Is removed.
Treatment Time:
The overall treatment time can vary, but is usually only several minutes, during which time the patient does not experience any discomfort. This patient received three treatments given over a 24–hour period separated by approximately 6 hours between each treatment.
Possible Side Effects:
Usually mild and short–term (urinary irritation, urgency and frequency for 1–2 weeks after procedure)
Recovery:
After completion of each treatment, the patient was taken to the recovery area for observation for any potential side effects that could occur in the early post–treatment phase.
Follow–up:
Patient received detailed discharge and follow–up instructions. Follow–up appointments generally involve alternating visitations with the treating urologist and radiation oncologist.
Prognosis:
Treatment was well tolerated by the patient with rapid recovery (patient resumed normal activities within two days). Minimal side effects were reported. Long–term prognosis is excellent.
