The technique is only suitable for patients who have a low risk cancer and a small prostate, as well as minimal urinary symptoms. The ideal patient is a man over 60 years of age who wishes to minimise the side effects of therapy. In the past 15 years I have performed more than 500 cases.
Once it has been established that a patient is potentially suitable for brachytherapy, a volume assessment is performed. This involves an ultrasound, which is achieved under a light anesthetic, and an examination of the bladder takes place at the same time. This template tells me the patient’s suitability for brachytherapy and also can be used to plan the accurate placement of seeds.
A computer plan of where the seeds are to be placed is then generated. There is usually a two to three week time lag from the volume assessment to the actual placement of seeds, which are sourced from America.
The patient is assessed by one of the radiation oncologists prior to the therapy. This procedure is performed in the Day Surgery Unit, which is conveniently located on level three at St Vincent's Clinic.
Advantages of SEEDS
The great advantages of low dose rate brachytherapy are its single-session and outpatient nature. The 10 year survival rate for low risk cancers is identical to surgery. Side effects are minimal, with incontinence and rectal damage rare. Impotence may occur in 50% of patients, but it is generally less severe than that occurring after surgery and responds well to Sildenafil.
Urinary frequency is common for the first one to 12 months and a very small minority has difficulty passing urine. Erectile dysfunction was previously believed to be less common with this technique than any other treatment for localised prostate cancer, however more recently this has not been the case. If erectile dysfunction does occur, it is always less severe than post-surgical erectile dysfunction.