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Clinical Overview
Prostate radiation seed brachytherapy is perceived to be a low toxicity, relatively easy procedure for curing prostate cancer.
One of our patients was recently implanted on a Thursday morning and played nine holes of golf two mornings later on the Saturday. Another brachytherapy patient of ours, whose colleagues had undergone major surgery for the same disease, asked us why anyone would prefer the prostatectomy operation
Side effects: That is not to say that there are no side effects from the brachytherapy procedure. Almost all our patients have some urinary side effects, usually urinary frequency or discomfort, which may take a few months to settle. A slow urinary stream is also common in the first period after the implant. Up to 10% of patients require temporary catheterisation after the procedure but we have not had anyone requiring a permanent catheter after brachytherapy. Although rectal complications are a small risk after brachytherapy, we have not encountered serious problems so far and believe the risk is indeed small. Other toxicity risks include anaesthetic related risks (although the plane of anaesthesia used for the procedure is relatively light) and infection; these are deemed to be small and prophylactic antibiotics are used for a week after the implant. We believe that approximately two thirds of patients retain sexual potency at the ‘status quo ante’ level.
Results: The Princess Grace Hospital brachytherapy results are demonstrated in fig 1 and are entirely comparable with other major centres. The ten years Seattle data with the same technique that we utilise demonstrate results comparable with surgical prostatectomy.
