Brachytherapy Streamlines Prostate Cancer Care – It Cuts Back Treatment Time Without Diminishing Results

Called brachytherapy, this type of radiation treatment offers a simpler, easier option for some prostate cancer patients, without compromising on effectiveness, says NYU Langone radiation oncologist, Dr. Michael Zelefsky.

“… during a five- or 10-minute span we can give super focused radiation actually within the prostate and direct it to the tumor,” he says. “And what this does as well is treat lesser the normal tissue because we’re treating from within and not from externally from without and not infrequently for more aggressive tumors.”

What is brachytherapy?

Brachytherapy is a specialized radiation treatment where doctors place radioactive “seeds” or sources close to, or inside, the tumor. They use special machines to make tiny adjustments during treatment, based on how the prostate moves.

This enables your doctor to target cancer cells with precision while leaving the surrounding healthy tissue undamaged.

The technique is very effective, because it delivers a concentrated dose directly to the affected area, thereby improving treatment results but with fewer side effects. It can be especially beneficial for patients who have small, localized cancers.

Patients often experience quicker and smoother recovery times with brachytherapy compared to traditional radiation therapy.

“Brachytherapy really means the internal placement of radiation is directly within the tumor,” Dr. Zelefsky explains. “This emphasizes the precision and targeted approach in treating tumors from within, aligning well with an introduction to this radiation therapy method.”

Related: If You Feel Something, Say Something — Men Ignore Symptoms Too Often

How does brachytherapy work?

Brachytherapy is usually done as an outpatient procedure, meaning you don’t have to stay in the hospital overnight. You can go home the same day.

It’s quick. The actual treatment usually takes only a few minutes but the entire procedure may take several hours.

Brachytherapy involves 5 steps, Dr. Zelefsky says:

• Preparation: To help find the exact placement of the radioactive sources, your doctor will conduct detailed imaging studies such as MRI or CT scans, beforehand to map the exact location and size of the tumor.
• Placement: During the procedure, radioactive “seeds” or sources will be carefully placed directly into or near the tumor. This can be done through needles, catheters, or custom-made applicators, depending on the location and type of tumor.
• Delivery: Once in place, the sources give off radiation over a set period, targeting the tumor while avoiding surrounding healthy tissue. The duration of radiation exposure can vary from minutes in high-dose-rate (HDR) brachytherapy to days or weeks in low-dose-rate (LDR) brachytherapy.
• Removal: In LDR brachytherapy, the radioactive seeds will be left in place to decay naturally over time. In HDR brachytherapy, the sources will be removed after each treatment session.
• Care: After the procedure, you will need follow-up care to manage any side effects and to monitor the treatment’s effectiveness.

What are the pros and cons of brachytherapy?

Like any cancer treatment, brachytherapy has some upsides and some downsides, Dr. Zelefsky points out.

Pros:

• Limits exposure to healthy tissues.
• Often requires fewer sessions compared to other treatments
• Fewer side effects
• Can be done same day as an outpatient procedure

Cons: 

• Not suitable for cancer that has spread significantly beyond the initial tumor
• Some patients experience urinary, bowel, or sexual dysfunction
• Not all treatment centers offer brachytherapy
• In some cases, radioactive seeds are left in the body permanently, which might cause concern for some patients.

“It’s important to consider not just the effectiveness of the treatment, but also how it affects their quality of life,” Dr. Zelefsky says.

Related: How To Get Comfortable Talking About Symptoms & Side Effects

How is brachytherapy used with other treatments?

Combining Brachytherapy with external radiation offers a powerful way to treat advanced prostate cancer.

“And that combination has also been shown, even for more aggressive tumors, to be a very effective approach in eradicating disease,” Dr. Zelefsky says.

This dual strategy takes advantage of brachytherapy’s precise way of delivering high-dose radiation directly to the tumor and the broader reach of external beam radiation therapy (EBRT) to target cancer cells in the surrounding area. It’s been shown to increase the overall effectiveness of the treatment by attacking the cancer while at the same time, limiting damage to surrounding healthy tissues.

It’s like hitting the cancer from the inside and the outside, making sure it’s tackled from every angle, especially for more complex and advanced cases.

Who is a good candidate for brachytherapy?

“Brachytherapy is best suited for those patients with somewhat smaller prostates and those patients who don’t have preexisting urinary related symptoms,” Dr. Zelefsky says.

Treatment works best when the cancer is confined to the prostate, making it an ideal option for early-stage prostate cancer patients.

An ideal candidate for this kind of treatment has tumors that are localized and have not metastasized, meaning they have not spread to distant parts of the body.

It’s probably not the best option for a patient who has severe urinary blockage symptoms, as the procedure can exacerbate these conditions. It’s also less suitable for anyone with a very large prostate unless there are pre-treatment options to reduce prostate size.

Related: King Charles, 75, Reveals Upcoming ‘Corrective Procedure’ To Treat Enlarged Prostate

Questions for your doctor

When considering brachytherapy, it’s important to discuss all of your options with your doctor. Some questions you might ask:

• Is Brachytherapy right for me?
• What side effects can I expect?
• How does it compare with other treatments?
• What does the recovery process involve?
• Will my insurance cover the costs?

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