Seed implants therapy, also known as brachytherapy, is a radiation procedure used for prostate cancer treatment. This involves directly placing radioactive seeds into the organ or gland containing the tumor that minimizes the spread of radiation to the surrounding organs. Brachytherapy can be a standalone treatment or alongside procedures like racial prostatetectomy, external beam radiation (EBRT) and cryotherapy.

Radioactive seed implants as a treatment for prostate cancer goes back as early as 1911. It was able to contain the cancer within the affected gland, however due the crude imaging and insertion methods, the inaccurate placement of the radioactive seeds gave rise to several complications. Modern developments such as CT scans and transrectal ultrasound (TRUS) now allow better imaging and have improved the success rate for seeds implants therapy.

Seed implants therapy is divided into two types: permanent with low dose rate (LDR), and a newer technique called temporary or High Dose Rate (HDR). With the permanent method, a radioactive seed such as palladium-103 or iodine-125 is implanted into the prostate gland. The number of seeds ranges from 40 to 100, depending on the tumor and the patient. HDR or temporary involves hollow needles with radioactive material like iridium-192 being placed into the prostate gland for five to 15 minutes and then removed. This procedure will be repeated twice or thrice over the next few days.

This minimally invasive procedure approximately takes an hour and a half, and most patients are discharged the same day. Patients that have cancer localized in the prostate and do not have a very aggressive tumors are eligible candidates for this procedure. Other factors include proper identification of the tumor’s stage, the patient’s age, obesity concerns and the patient’s overall health.

Side effects for seed implants therapy in the first few weeks include urinary symptoms such as painful urination and red discoloration in the urine. Some complications — but much rare side effects — are diarrhea, rectal bleeding and painful bowel movements. Medications are prescribed to help manage these side effects, as they usually subside as time progresses.

Post operation monitoring include Prostate-Specific Antigen or PSA tests taken every three months, for the next 12 to 18 months, then biopsies at 18 and 60 months. Studies show that seed implants therapy alone or alongside EBRT on prostate cancer patients can be as effective as more invasive procedures like radical prostatectomy. Although this is still a fairly new treatment, seed implants therapy for prostate cancer has shown a significant success rate and most patients are even able to maintain quality of life.