Prostate Cancer Treatment
PROSTATE CANCER SURGERY:
BRACHYTHERAPY (or RADIOACTIVE “SEEDS”)
WHAT IS IT?
Brachytherapy involves precision surgical placement in the prostate of multiple tiny radioactive “seeds”, about the size of a grain of rice. These seeds deliver targeted radiation to the tumor in the prostate gland itself. The seeds produce a very intense but short duration of radiation accurately delivered to the prostate gland.
The seed method reduces the amount of unwanted radiation damage on the healthy tissue of the colon, rectum, and bladder, which is an undesirable side effect of external beam radiation therapy (EBRT). The seeds most commonly use radioactive iodine, whose radiation slowly destroys the cancer over the approximately 60 days of radiation effect. Once the radiation has worn off (decayed) and disappears, the the inactive seeds remaining in the prostate.
Brachytherapy’s major advantage is a significantly lower risk of erectile dysfunction (“impotence”) and urinary incontinence (“leakage” or “dribbling”) than is commonly seen with radical surgery to remove the prostate gland. Brachytherapy is an effective alternative to the longer and more invasive radical surgery to remove the prostate gland (prostatectomy) that has been a common treatment for prostate cancer. The good news is that for localized prostate cancer, long term treatment outcomes and survival rates are about the same for brachytherapy and radical prostatectomy.
THE THREE PHASES OF BRACHYTHERAPY TREATMENT:
- Your initial consult will focus on a physical exam, detailed study of the prostate, and preparation of a three-dimensional model of the prostate using highly sophisticated computers. Specialists in radiation dosing then calculate the exact number of seeds that you require for the proper radiation dose for your type of tumor. They also determine placement of the seeds in the prostate to reduce unwanted radiation effects to the rectum, bladder, and colon that lie near the prostate.
- When the number of seeds and placement map coordinates for each seed have been determined, you are ready to have the actual implant procedure done. It takes about 35-60 minutes and is usually carried out with “twilight” sedation rather than general anesthesia. The surgeon uses slender, minimally invasive needles. You then rest in the recovery area for an hour or two, and are then able to go back to your hotel or home. Most men are able to go out to dinner that evening.
- Patients from overseas are checked by the Urologist about a week after surgery and are able to return home after the post-operative checkup. Then one month after surgery, the patient undergoes a CT scan to check the seed placement and the effect on tumor size.
ARE YOU A CANDIDATE?
During your consultation with the Prostate Cancer team, your physician will review your entire case, all of your imaging studies, pathology reports and other medical information and have a pre-surgery consultation with you to review all of the various treatment modalities, the pros/cons, risks/benefits, and outcomes data on each one. He will review your personal preferences and goals, and then you and your physician will decide the best treatment approach for you.
In general, the ideal candidates for Brachytherapy are men who:
- have large prostate glands and smaller tumors
- have lower grade, less aggressive tumors
- are younger and sexually active
- have medical risks making radical prostate surgery more risky to undergo, such as history of heart or lung disease, diabetes, history of blood clots, smokers, or those who have had adverse reactions to general anesthesia.
- have lives that demand sooner return to work than the weeks of recovery from radical prostate surgery.
WHAT BENEFITS CAN I EXPECT?
- There isn’t the long post-surgical recuperation or disruption of normal life activities that is needed after radical prostatectomy. Most men can go out to dinner the night of the procedure.
- Seed placement causes little discomfort, and usually only requires mild pain relievers.
- The seed procedure is minimally invasive surgery, low risk, and the data shows that this option has minimal complications.
- You can resume normal activities the next day.
- Long term, radioactive seed therapy has minimal to no adverse effect on sexual function compared with other modalities.
- Much lower risk of developing other complications such as urinary or bowel incontinence.
- Some difficulties, as temporary discomfort with urination, may occur in some patients and are short-lived.
WHAT ARE THE POSSIBLE RISKS?
Your risks of developing complications during surgery depends on several key factors: your general health before surgery, the skill of the surgeon and surgical team, the quality of the hospital facility. Any major surgery has potential general risks that we do our best to minimize by carefully evaluating all our patients with medical and surgical review and consultation before you ever leave home to do our best to be sure that:
- you meet the appropriate criteria for the procedure,
- you are medically stable to travel and undergo surgery,
- you are mentally prepared and feel comfortable with your surgeon,
- your surgeon has the right training and experience to meet your needs,
- the hospital has all the facilities and equipment to properly carry out the surgery recommended.
Med Expert Chile offers treatment options at JCI-accredited facilities with leading surgeons known for careful attention to reducing risks of infection and complications during surgeries. General risks of any major surgery can include, but not limited to, infection, excessive bleeding or blood clots, adverse reactions to anesthesia, inadvertent damage to other tissues surrounding the surgical site, or in very rare cases, disability or death.
Specific risks known to be possible for your particular procedure will be discussed ahead of time by your surgeon. We do everything possible to reduce these risks and help you feel comfortable and prepared to go forward with surgery.
WHAT DOES IT COST?
We do not sell “Off-the-shelf” surgeries at a fixed cost. We determine the right procedure for each person after our medical-surgical consultation to discuss your best options. A precise cost estimate can only be given after our Medical Director and Surgeons have completely evaluated your specific case and your medical needs and discussed all this with you.