Temporary brachytherapy for prostate cancer:
Temporary brachytherapy is when your doctor places radioactive pellets into your prostate gland. These pellets release radiation to kill nearby cancer cells and are removed after the treatment. Once they’re removed, you are no longer radioactive.
The testicles
The testicles are two small, oval-shaped organs located below the penis, enclosed in a skin pouch called the scrotum.
Image of the testicles (cruk)
Starting from puberty, the testicles begin producing sperm. Inside the testicle, small tubes come together to form the epididymis, a single tube that becomes wider as it exits the testicle. This wider tube is known as the spermatic cord.
The spermatic cord leads to a short passage called the ejaculatory duct, which opens into the urethra, the tube that carries urine and semen out of the body through the penis.
Testosterone:
The testicles produce the hormone testosterone, which is responsible for developing male characteristics such as:- A deeper voice
- Facial hair growth
- Increased muscle mass
- The ability to achieve an erection
- Male sexual drive (libido)
Where does testicular cancer start:
The testicles consist of various cell types, and the kind of cancer you have depends on the specific cell where it begins. Most testicular cancers arise from germ cells, which are responsible for producing sperm. Doctors classify germ cell cancers into two main types:- Seminoma
- Non-seminoma
Temporary brachytherapy for prostate cancer:
Temporary brachytherapy is when your doctor places radioactive pellets into your prostate gland. These pellets release radiation to kill nearby cancer cells and are removed after the treatment. Once they’re removed, you are no longer radioactive.
In brachytherapy, the radioactive source is placed very close to the cancer, so it receives a high dose of radiation, while nearby tissues receive much lower doses.
This type of brachytherapy is also known as high dose rate (HDR) brachytherapy.
Depending on your condition, you might have another type called permanent seed brachytherapy.
When you have high dose rate brachytherapy:
You might receive temporary brachytherapy for prostate cancer that:
– is confined within the prostate gland (localized prostate cancer).
– has extended into the surrounding tissues of the prostate gland (locally advanced prostate cancer).
Your doctor might suggest temporary brachytherapy alongside external radiotherapy if you have localized or locally advanced prostate cancer categorized as CPG 3, 4, or 5.
Additionally, your doctor might propose hormone therapy before radiotherapy to shrink the prostate cancer, facilitating precise placement of the pellets.
Before treatment:
You will meet with your treatment team to discuss your treatment plan and sign a consent form indicating your agreement. It’s beneficial to prepare questions in advance to ensure you understand the process and feel more assured about what lies ahead.
The anesthetist administers the anesthetic and monitors your condition throughout the treatment to ensure you are ready for it.
The nurse specialist assesses your overall health, weight, blood pressure, pulse, and temperature. They may also perform an ECG to check your heart.
It’s important to inform the treatment team about any medications you are taking. If you are on blood thinners, you may need to stop them up to 2 weeks before starting radiotherapy.
You may be prescribed tamsulosin to aid in urination, and your doctor might recommend antibiotics for a specific duration.
Treatment:
Your doctor inserts a catheter through your penis to locate the urethra within the prostate gland using ultrasound and to drain urine during the procedure.
An ultrasound probe is placed into your rectum to visualize your prostate clearly on a screen. Using needles, your doctor inserts approximately 15 to 20 small tubes into your prostate through the perineum (the skin area between the scrotum and anus).
Image (cruk)
After inserting the tubes, the doctor removes the ultrasound probe. Following this, you will be transferred to the recovery room to awaken from the anesthesia. Subsequently, you’ll proceed to your planning scan appointment.
After the scan:
After returning to the ward for approximately 2 hours, the radiotherapy team calculates the precise amount of radiotherapy required for your treatment.
During this period, it’s important to remain as motionless as possible to ensure the stability of the tubes within the prostate. Support pads may be placed under your legs and bottom for added comfort. If you experience any discomfort or pain, inform your doctor or nurse promptly so they can provide pain relief and ensure your comfort.
Additionally, you may undergo another CT scan to aid in the planning and accuracy of your treatment.
Having treatment:
You will proceed to the treatment room where the radiographers will connect the brachytherapy machine to the tubes in your prostate. Once set up, the radiographers will step out of the room but will monitor you closely via a CCTV screen nearby. You can communicate with them if you require anything.
During this phase, which typically lasts between 15 to 40 minutes, it is crucial to remain perfectly still. The computer-controlled radiotherapy machine will deliver small radioactive metal pellets through the tubes, precisely administering the required dose of radiotherapy.
Once the treatment session concludes, the radioactive pellets are safely returned to the machine. Your radiographers will then carefully remove the tubes. This process may cause some discomfort, but painkillers and gas and air can be provided if necessary.
Let me know if there’s anything else you’d like to explore or understand better!
After treatment:
After the procedure, you return to your ward with a catheter still in place to drain urine. Typically, the nurse removes it within a few hours or by the following day.
You will usually spend the night in the hospital and can expect to go home the next day. If there are any difficulties with urination, your stay may be extended for observation.
Side effects of temporary brachytherapy:
Temporary brachytherapy can lead to various side effects, which can vary from person to person. Not everyone experiences all of them.
1. Pain and Swelling: You might notice swelling and bruising around the area where the needles were inserted. Painkillers and warm baths can help alleviate discomfort.
2. Urine Issues: Burning sensation during urination and spotting of blood might occur initially. You may also experience increased frequency or difficulty in urination. Drinking plenty of water and reducing bladder irritants like fizzy drinks and caffeine can be helpful.
3. Fatigue: Feeling tired is common in the first few days after treatment, especially as you recover from the anesthesia. Rest as needed to regain energy.
4. Blood in Semen: It’s normal to see blood in semen for a few weeks post-treatment. Initially, ejaculation might be painful, but this typically improves over time. You may also notice a decrease in semen volume due to radiotherapy.
5. Bowel Issues: Inflammation of the bowel can cause constipation, loose stools, or diarrhea for several weeks. Inform your healthcare provider if these symptoms arise, as medications can be prescribed to manage them.
6. Long-Term Effects: Some effects may persist for months or years, such as urine leakage and difficulties with erections.
Remember, it’s crucial to communicate any concerns or symptoms to your doctor or nurse for appropriate management and support.
You are not radioactive:
After treatment, all radioactive materials are completely removed, ensuring it’s safe for you to be around others, including pregnant women and children, when you return home.
Follow Up:
About six weeks after your treatment, you’ll have a follow-up outpatient appointment scheduled. If you proceed with external radiotherapy, it typically begins within two to four weeks after completing HDR treatment. During this period, you’ll also undergo regular blood tests to monitor your PSA levels in your bloodstream.
Daignosis
If you have any symptoms, your first step is usually to visit your GP. They will discuss your symptoms with you and conduct an examination. Based on their findings,
Treatment options
A team of healthcare professionals (multidisciplinary team) will determine your treatment plan. Most people undergo surgery to remove the affected