You are here: Information for patients
No. Once you have had the seeds implanted you don't become radioactive yourself; it's only the seeds that are radioactive — not you! You will not be hazard to your family and friends so there are no restrictions on being with them, other than avoiding a long cuddle with a young child, or a pregnant woman, during the first two months after your implant procedure.
Yes. Following brachytherapy you will return to the hospital for an examination after 4 — 6 weeks, and then yearly. A digital rectal exam is performed and PSA levels are checked and any side-effects discussed. Some tests may be done to measure the rate of urine flow and learn what amount is left in the bladder following urination to check the workings of the bladder. Repeat X-rays may be done at some of the follow-ups. A repeat prostate biopsy may be performed. If abnormal results are found during these follow-up visits then your doctor and nurse will assess the best course of treatment and will discuss it with you.
This depends on your assessment in hospital and the extent of the cancer in your prostate gland. Sometimes prostate brachytherapy is carried out with external beam radiation, and the consultant in charge of your treatment will advise on what will be the best treatment approach for you. For patients with a large-volume prostate, hormone treatment may be necessary to shrink the size of the prostate gland before prostate brachytherapy can be done. A further important consideration is that when you have had prostate brachytherapy you can still have surgical treatment at a later stage, if this is considered necessary by your consultant.
If you have had a radical prostatectomy and your prostate gland removed, brachytherapy cannot be done because there is no prostate gland tissue to accept the seed implants. If you have had less extensive surgery, i.e. transurethral prostate surgery (often abbreviated to TURP), prostate brachytherapy may still be a further option for you, and your consultant or another member of the hospital care team will advise you on this.
Most patients return to driving very quickly. Often patients feel able to drive home after discharge from the hospital, but you should check your motor insurance policy to ensure no restrictions apply after medical treatment. The majority of men are back at work within 3 — 5 days, although the delay may be a little longer if you have a strenuous job.
This is possible, but it is very rare. In the highly unlikely event that you pass a loose seed in your urine and can see it in the toilet bowl, the best course of action is to remove it with a pair of tweezers and place it in a sealed container. You should then contact your hospital who will provide advice for safe disposal.
After the implant procedure you will receive a course of antibiotics to prevent infection, and tablets to help you pass urine (these are called alpha-blockers). You should continue to take the full course of these medicines and follow the instructions that will be provided with them when you get home. You may also receive medication to soften your stools while you are in hospital, to make opening your bowels easier. If you are in pain immediately after the procedure you will be given medication to ease this as well.
You may experience some discomfort after several days when the radiation from the seeds starts to take effect in the lower urinary tract. You may also have mild discomfort as a result of the needle punctures. You can use a simple painkiller such as paracetamol at home to relieve these effects, but it's important to avoid aspirin. Aspirin thins the blood and this could make any bruising or bleeding you have worse. You may see some bruising near your scrotum or underneath it, and the discolouration may spread to your upper thighs. This will start to disappear after 1 — 2 weeks. You should be aware that your urine may be blood-stained for several days after the implant procedure. This may be alarming at first but it should clear up on its own. If blood continues to appear in your urine you contact the hospital.
Sexual intercourse should be avoided for the first two weeks after your procedure because there is a very slight risk that one of the seeds could come out in your ejaculation. You should use a condom for the first two or three times you have sex for this reason. If you are unsure about when you can stop using a condom, your consultant or a member of your care team at the hospital can advise you on this. On the first few occasions you have sex, you may have some mild discomfort or irritation during, or immediately after intercourse, and your semen may be discoloured due to the internal bleeding that may have occurred during the implant procedure. Erectile dysfunction (ED) - the inability to achieve a satisfactory erection — is a side-effect of all prostate cancer treatments. ED occurs less following brachytherapy compared with surgery or external beam radiation, and usually responds well to treatment.
After prostate brachytherapy you can expect some side-effects regarding your ability to pass urine. These urinary side-effects can take up to 3 — 6 weeks to develop, and the symptoms are usually mild-to-moderate in intensity. The effects can include discomfort during urination (called dysuria), an increased frequency ('need to go') and a poor urine stream (reduced volume). These symptoms tend to peak at about 3 — 4 months, but by 6 — 9 months are improving. One year after brachytherapy, about 90% of patients will have returned to normal with respect to their ability to pass urine. Incontinence (loss of control) after brachytherapy is very rare. Urine retention (a build-up of urine in the bladder that is difficult to release) is uncommon; it occurs in about 10 — 15% of patients after prostate brachytherapy, and some of these patients may require a catheter to help them pass urine. However, urinary side-effects are less frequent following brachytherapy than with surgical intervention and treatment with external beam radiation.
There are number of simple precautions you can take to make you feel more comfortable at home for the first few months after prostate brachytherapy. If you eat high-fibre foods and fruit regularly this will keep your bowel motions loose. You should drink 1½ to 2 litres of fluids each day to help to flush out your urinary system, although you should limit your fluids after 7 pm (especially coffee, tea and alcohol). This will help to reduce the amount of urine produced during the night and decrease the number of times you will have to get up to go to the toilet.