Internal Radiation Therapy is a procedure that delivers a very high dose of radiation to tissue in the immediately affected area and minimizes the damage to healthy tissue like the rectum and the bladder. This is accomplished by inserting dozens of tiny seeds that are radioactive directly into the prostate gland. The therapy depends on ultrasound or CT that guides placement of very thin needles through the skin of the perineum.
The needles deliver the tiny seeds (made up of radioactive palladium or iodine) directly into the prostate using a pre-determined, customized pattern created by extremely sophisticated computer programming. This high tech process allows the needles and seeds to directly conform to the size and shape of each prostate. This procedure is normally completed in just an hour or two. It is done under a local anesthesia and the patient goes home the same day.
Radiation is emitted from the seeds for up to several weeks. Once insertion is complete, the seeds remain in place causing no harm whatsoever.
Some physicians use a different approach. They will use a more powerful radioactive seed and implement over several days. These are temporary implants. This procedure requires hospitalization and may be combined with low doses of external beam radiation.
Long term results are not yet in on this procedure primarily due to the fact that internal radiation therapy is still a recent process and is limited to just a few patients. However, after 5 years more than 90% of patients treated still remain cancer free.
The procedure is not recommended for large, advanced tumors or for men who were previously treated with transurethral resection of the prostate (TURP) or Benign Prostatic Hyperplasia (BPH). These men are at a higher risk for urinary problems. When a man has small, well-differentiated tumors it is an option that has fewer side effects as well as being less invasive. It is less costly than external radiation or surgery and requires a shorter hospital stay.
Discomfort experienced post-implant is usually controlled by oral painkillers and a man can expect a few weeks of incontinence. Long term problems like prostatitis (inflammation of the prostate gland) are infrequent and usually not severe in nature. Only 15% of men under the age of 70 experience sexual impotence and 30 to 35% of men over the age of 70.