Prostate Brachytherapy is a minimally invasive technique, where Radioactive Iodine 125 seeds are directly placed via needles through the perineum into the prostate, under ultrasound guidance and image-intensifier control.
This is a well-established, effective treatment for low-grade clinically localised prostate cancer with similar cancer control to radical prostatectomy in this group of patients. This treatment is not suitable for men who have significant bladder outflow obstruction (slow flow), or men with large prostates.
The benefits of Brachytherapy include:
- Directly placing the radioactive substance in the prostate with less “collateral damage” i.e. less toxicity to bowel and bladder than external beam radiation.
- Rapid convalescence and return to work generally within a few days
- The risk of erectile dysfunction is relatively low short-term (< 20% at 2 years < 50% at 5 years) and normally responds to medication
- Hospital stay generally one night
Although most men develop only minor urinary symptoms (frequency / urgency), occasionally these are very annoying for several months and occasionally patients may develop urinary retention. Serious rectal complications are exceedingly rare. Late scarring in the prostate or urethra (strictures) is an uncommon, but difficult complication to manage. Also late bleeding secondary to radiation prostatitis / cystitis can occur and can also be troublesome to manage.
The brachytherapy group in New Zealand with the largest experience is Brachytherapy Associates. Michael Mackey is a member of this group.