Prostate Cancer Treatments – High-Dose Rate Brachytherapy
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High-Dose Rate (HDR) brachytherapy is an innovative form of internal radiation therapy for the treatment of prostate cancer.
Because the prostate gland is located close to the bladder and rectum, it is important for radiation treatment to be tightly focused on the prostate to avoid serious side effects. HDR brachytherapy offers a fast, precise way to give radiation treatment for some prostate cancer patients. The radiation is deposited inside a tumor, delivering a maximum dose while minimizing exposure to the surrounding healthy tissue.
Some brachytherapy techniques use permanent seeds implanted in the prostate to deliver radiation therapy. These seeds remain in the prostate indefinitely, and can cause problems because the seeds move both during and between treatments.
HDR brachytherapy, on the other hand, uses laser-thin, hollow catheters to deliver a precise, three-dimensional dose of radiation. The catheters are temporarily inserted in and around the prostate using image-guidance (usually ultrasound, CT scan, or MRI), before each treatment.
First, the CTCA radiation team checks the position of the catheters with millimeter precision. Next, a series of radioactive pellets are inserted into each catheter. Computer guidance controls (1) how far the pellet goes into the catheter to precisely target the location of tumors, and (2) how long the pellet stays in the catheter to release its radiation dose.
With a few well-placed catheters, HDR brachytherapy can provide a very precise treatment for prostate cancer that takes only a few minutes. After a series of treatments, the catheters are removed. There are no radioactive seeds left in the body, as is the case with other types of brachytherapy.
Each HDR brachytherapy treatment takes about 15-20 minutes. Because there is no incision and no surgical wound to heal, recovery from the procedure is generally rapid.
Some of the potential benefits of HDR brachytherapy include the following:
- For prostate cancer, the entire treatment takes 1 1/2 days instead of 5 to 7 weeks.
- Radiation beams are precisely targeted inside the prostate, controlling the location and intensity, and offering excellent precision and maximum dose concentration.
- Radiation exposure to healthy tissues and organs is minimized or eliminated, reducing side effects like incontinence and erectile dysfunction.
HDR brachytherapy is applicable to virtually all stages of localized prostate cancer. It may be given alone, or it may be used in combination with external beam radiation therapy (EBRT) or hormone therapy. In many cases, brachytherapy is a promising alternative to surgical removal of the prostate.
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