Prostate cancer is the second most common cancer in men and, fortunately, is also one of the most treatable. 

“I would say over the age of 70, probably 50% of men have some evidence of prostate cancer,” says Donald Finnerty, M.D., a urologist. “The trick is to find those cancers that are going to cause problems.” 

Radiation therapy to treat cancer

To shrink cancerous tumors, physicians often use radiation therapy, which can be delivered through a machine outside the body or through radioactive pellets implanted near the tumor site, which is called brachytherapy.

“Brachytherapy is the ability to employ the source of radiation close to the affected organ,” Dr. Finnerty explains. “It is a focal source of radiation.”

Brachytherapy can be used to treat many different types of cancers, including prostate and breast cancer.

Physicians often use iodine-125, which comes in radioactive pellets. These pellets are permanently placed in the body and emit radiation over a five-year period. 

“They are placed directly in the prostate gland so the duration and spectrum of radiation is localized,” he says. “The theory is to apply high-dose radiation over a long period of time to the tumor. It’s an attempt to spare the surrounding tissue, the bladder and the rectum.”

As the pellets remain in the body, the dosage of radiation declines and, after approximately five years, they become inactive. 

The procedure

Urologists work with radiation oncologists to administer brachytherapy to prostate cancer patients. The urologist inserts hollow needs into the prostate, then the radiation oncologist implants the radioactive seeds through those needles. The seeds are often threaded so the oncologist can control exactly where they are placed. 

“[Radiation oncologists] do a lot of pre-surgical planning because they want to know exactly how big the gland is and what it looks like – the anatomy – so they can plan how many seeds and where to put them,” Dr. Finnerty says. 

Brachytherapy has numerous physical and quality-of-life benefits. 

It is effective at curing prostate cancer, is a one-hour outpatient procedure and requires minimal post-operative downtime. The procedure also spares surrounding tissue, such as the sphincter and nerves. 

“Potency and impotence often are not issues,” Dr. Finnerty adds. “And it works.” 

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