|
Insertion Radioactive Transplant
What is
Insertion Radioactive Transplant?
Brachytherapy is a radiation therapy that can be
used as a prostate cancer treatment. Sometimes
referred to as interstitial radiation therapy,
seed therapy, or seed treatment, prostate
brachytherapy is capable of delivering high and
concentrated doses of radiation to the prostate
gland.
Back to Top
Effects
of Insertion Radioactive Transplant
Radiation is used in the treatment of prostate
cancer because exposure to damages the DNA of
cells.
Back to Top
Candidates for Insertion Radioactive Transplant
Ideal
candidates for this procedure are those who are
diagnosed with prostate cancer.
Back to Top
Your Consultation
Before
the procedure patients usually start antibiotics
to help prevent an infection and undergo
mechanical bowel preparation. Not eating
anything after midnight or taking enemas or
laxatives are all examples of bowel preparation.
Fecal matter could interfere with the treatment.
Before beginning, an anesthesiologist puts a
patient under general or spinal anesthesia that
numbs him from the waist down. Patients who
remain awake should not laugh, cough, or talk
because these activities could upset the
precision of the treatment.
Back to Top
The
Insertion Radioactive Transplant Procedure
Patients who pursue temporary brachytherapy as
their prostate cancer treatment will undergo a
planning stage. A radiation oncologist, an
urologist, and a physics team will carefully
plan the minimally invasive surgery to ensure
the seed is put in the correct location. The
radiation oncologist and the physics team design
a map for the flexible plastic catheters. The
oncologist uses the transrectal ultraound (TRUS)
to take pictures of the prostate and surrounding
organs every five millimeters. After imaging,
which takes about 15 minutes, the oncologist
writes a prescription for the amount of
radiation needed, then gives the prescription
and images to the physics team. The physics team
arranges a pattern for the small and flexible
catheters that will be inserted into the
prostate gland.
During the minimally invasive surgery, only one
iridium-194 seed is used. The seed is inserted
through the catheters one at a time. Because
they are flexible plastic instead of rigid
steel, the catheters can be guided to wherever
the medical team plans for them to go. An
urologist can maneuver around an enlarged
prostate gland or an interfering pubic arch.
Patients therefore do not need to undergo
neoadjuvant hormone therapy.
Back to Top
Recovery
Most patients move around freely as soon as the
catheters are removed and the anesthesia wears
off. Doctors will prescribe antibiotics and
possibly an alpha-blocker, which relaxes the
neck of the bladder and decreases the severity
of urinary side effects. Patients may also take
over-the-counter medications to alleviate
soreness in the perineum. Some patients will use
ice packs the next day or two to reduce
swelling.
Back to Top
Risks
Temporary brachytherapy leaves no radioactive
seeds inside the body, therefore, there is no
risk for seed migration. Some researchers are
also finding that high dose rate brachytherapy
has a lower incidence of cold and hot spots. A
cold spot occurs when an area is not adequately
irradiated, while a hot spot occurs when an area
is over-irradiated. Cold spots may lead to
prostate cancer recurrence while hot spots may
lead to damage of the rectum or bladder.
Back to Top
Frequently Asked Questions
Q:
What is Brachytherapy?
A:
Brachytherapy, sometimes referred to as implants
or intracavitary radiation is a radiation
treatment method capable of delivering higher
dose than external beam radiation can deliver.
Brachytherapy involves insertion of sealed
radioactive sources either directly into the
patient's tumor (known as the interstitial
method) or into a body cavity close to the tumor
(the intracavitary method). Radiation
oncologists use either interstitial catheters or
intracavitary containers to place the
radioactive material.
Q:
What are the treatments available?
A:
Prostate Cancer may be treated with IMRT or one
of two types of brachytherapy- Permanant Seed
Implants (PSI) and Temporary High Dose Rate
Implants. Prostate seed implantation, in which
tiny radioactive "seeds" of iodine-125 are
implanted into the prostate. Ultrasound imagery,
computed tomography and advanced computerized
implant dosimetry enable placement of
radioactive seeds with a high degree of
accuracy. Once a patient is approved for seed
implant by the brachytherapy team, a set of
ultrasound images of the prostate is obtained
with a rectal probe. These images are used to
plan the distribution of radioactive seeds in
the prostate. The radiation oncologist, a
medical physicist and a dosimetrist determine
the optimal seed distribution to deliver an
appropriate dose to the cancer in the prostate
while minimizing radiation exposure for the
urethra, rectum, bladder and other critical
structures. The procedure itself is relatively
painless.
Q: What is
permanent low dose radiation (LDR)?
A:
LDR brachytherapy
is uses iodine-125 and palladium-103 stored in
titanium cases usually referred to as
brachytherapy seeds. As the name permanent
brachytherapy suggest, the seeds are permanently
left inside the prostate gland. Over the course
of their radioactive lives, the seeds will
continuously emit low levels of radiation.
Q:
What is temporary high dose radiation (HDR)?
A:
HDR brachytherapy uses a single radioactive seed
made of iridium-194 which is sometimes referred
to as an iridium wire. Soft flexible plastic
catheters are inserted through the perineum and
into the prostate gland. HDR brachytherapy
entails an overnight stay in the hospital during
which a patient undergoes two or three
treatments with the wire through each catheter.
Q:
What happens during the procedure?
A:
A hospital stay for temporary brachytherapy
lasts 24 to 36 hours because a patient receives
two or three treatments. He is placed in the
lithotomy position, meaning his feet are put
into stirrups and his legs are lifted to 90
degrees. This position gives the doctor a clear
view of the perineum, which is cleaned and then
possibly shaved according to the practice of the
center. The doctor inserts an ultrasound probe
into the rectum and attaches it to a stabilizing
device which holds the tool for the duration of
the treatment.
Back to Top
The following list of Urology procedures are
performed at Beverly Hills Medical Group -
please click the links to find out more:
|
