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Prostate Cancer: Interstitial Brachytherapy

Radiation therapy is 1 way to kill cancer cells. Radiation can be given from outside or from inside the body. Interstitial brachytherapy for prostate cancer means the radiation is put right into the prostate. The benefit of this kind of treatment is that the radiation is limited to a small area. It does not affect your whole body.

Men with prostate cancer that's growing faster and likely to spread to other parts of their body may get external and internal radiation.

How it works

This therapy can be done in 2 ways:

Permanent or low dose brachytherapy. For this, sources of radiation are put inside the prostate. Tiny metal seeds are most often used. They're about the size of a grain of rice. The seeds are left in place for the rest of your life. But over time, the radiation goes away.

High-dose or temporary radiation. To do this, radiation is put into the prostate for a short time (about 5 to 15 minutes) and then taken back out. This is usually done 3 times over 2 days.

Cross section of a prostate showing radioactive seeds for interstitial brachytherapy.
Radioactive 'seeds' are implanted throughout the prostate.

Possible risks and complications

All procedures have risks. Most risks from this procedure are related to organs that are near the prostate and might be affected by the radiation. Risks include:

  • Bowel problems

  • Blood in the urine or semen for a short time after treatment

  • Bleeding or inflammation of the bladder or rectum

  • Burning when urinating

  • Erectile dysfunction

  • Loss of bladder or bowel control (incontinence)

  • Movement of seeds out of prostate

  • Needing to urinate often

  • Pain, bruising, or swelling where the needles were put in

  • Urinary obstruction (can't pass urine because of blockage)

Before treatment

You may be given hormone therapy to shrink the prostate. An ultrasound, CT scan, or an MRI is then used to map the size and shape of the prostate. This helps the healthcare provider know where to put the seeds or catheters and how many you may need.

During treatment

You are given anesthesia to keep you from having pain during the procedure. You will have 1 of these 2 treatments:

  • Permanent seeds. Permanent seeds are known as low dose rate (LDR) brachytherapy. LDR can be done during an outpatient visit. This means you can go home the same day. The healthcare provider uses a needle to put tiny radioactive seeds into the prostate gland. The needle is guided using a transrectal ultrasound. About 100 seeds are used. It depends on the size of the prostate.

  • Temporary radiation. Temporary radiation releases 1 high dose of radiation (HDR) with each treatment. The healthcare provider puts small, soft tubes (catheters) into the prostate gland. The catheters are hooked up to a machine. The machine sends a strong radioactive sources into the catheters (and into prostate) for several minutes at a time and then takes it out. This is done a few times. The catheters are removed after the last treatment. You may need to stay in the hospital for 1 to 2 days during this treatment. 

After treatment

Soon after treatment, you can go back to your normal activities. Your healthcare team will help you to manage any side effects.

With permanent seeds, you may need to limit your contact with young children and pregnant women for a few months. You may also need to take other precautions.

Talk with your healthcare team so you know what to expect this treatment is like and what you may need to do after treatment.

Online Medical Reviewer: Kimberly Stump-Sutliff RN MSN AOCNS
Online Medical Reviewer: Lu Cunningham RN BSN
Online Medical Reviewer: Richard LoCicero MD
Date Last Reviewed: 12/1/2019
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