Radiation therapy, namely prostate brachytherapy, is used to treat prostate cancer. Setting up radioactive sources inside the prostate gland allows radiation to kill cancer cells while inflicting less harm on healthy tissue around it. Therefore, cancer receives the majority of the radiation, whereas surrounding healthy tissue only receives a small amount. Because early-stage prostate cancer is less prone to spreading beyond the prostate gland, brachytherapy may be considered a potential treatment option. Brachytherapy can be utilized in conjunction with other treatments, such as external beam radiation therapy (EBRT) or hormone therapy, particularly for larger prostate tumors or those that pose a greater risk of metastasizing beyond the prostate. However, prostate brachytherapy is not employed for treating advanced prostate cancer that has already spread.

Types:

The method of performing prostate brachytherapy differs depending on the following categories:

• High-dose rate (HDR) brachytherapy:
  HDR brachytherapy involves placing radioactive sources in the prostate gland and delivering a single high dose of radiation directly to the prostate for a few minutes.
• Low-dose rate (LDR) brachytherapy:
  LDR prostate brachytherapy involves implanting radioactive seeds permanently inside the prostate gland, where they gradually release radiation over several months.

Procedure:

• Low dose rate (LDR) brachytherapy

LDR prostate brachytherapy involves the permanent implantation of radioactive sources into the prostate gland. This approach is also referred to as "seed implants" in the context of brachytherapy. The procedure is carried out with the patient under anesthesia, using a wand-like tool that is inserted into the rectum to capture ultrasound images of the prostate. The images help guide the placement of numerous small radioactive implants, similar in size to grains of rice, inside the prostate gland via a long needle. The needle is passed through the perineum, which is the area between the scrotum and anus, to reach the prostate. These seed implants will emit radiation for a few months and remain permanently in the body. After the procedure, the patient will spend some time in a recovery area before being discharged to go home. Although the low levels of radiation in the seeds are typically not harmful to others, precautions are taken to avoid close contact with children and pregnant women for a brief period. The doctor may also recommend using a condom during sexual activity.

• High dose rate (HDR) brachytherapy

HDR prostate brachytherapy involves the temporary insertion of radioactive sources into the body for a brief period of time. During HDR brachytherapy, the single radiation source of Iridium moves to specified positions within the catheters and delivers radiation. Thereafter, the catheters (plastic tubes) are removed, and the patient goes home. The patient is not carrying any radioactivity; hence, there is no need to maintain distance from family members.

Recovery:

After prostate brachytherapy, there is some pain and swelling in the perineum. Placing an ice pack over the area and taking pain medication prescribed by the doctor may help relieve pain and swelling. Normal activities may be resumed when comfortable. the doctor may give  instructions for recovery, such as avoiding vigorous exercise and heavy lifting

Risks:

Prostate brachytherapy may cause side effects, including:

• Difficulty in urination
• Frequently feeling an urgency to urinate
• Pain or discomfort when urinating
• Needing to urinate at night
• Blood in the urine

Serious side effects from prostate brachytherapy are possible but quite rare. They include:

• The side effects of prostate brachytherapy may include difficulty in passing urine for 48-72 hours and occasional blood in urine for 48 hours. Long-term side effects of brachytherapy may include stricture or tightening in the urinary passage. However, with computerized inverse planning and HDR brachytherapy, the dose to the urethra is reduced, significantly lowering the incidence of stricture. Similarly, late second primary cancer, previously a side effect of LDR brachytherapy due to the permanent radioactive seeds, is effectively avoided with HDR brachytherapy.

Conclusion:

Prostate cancer treatment has a high success rate, especially when healthcare experts detect the illness in its early stages. Brachytherapy is a type of radiation therapy that targets the cancer's site. There are two forms of brachytherapy: high-dose rate (HDR) and low-dose rate (LDR). In both circumstances, the technique is minimally invasive and has a high chance of success. For more information on how healthcare professionals use brachytherapy to treat prostate cancer, talk to your doctor and make an informed choice.