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Brachytherapy is a type of radiation therapy. High dose rate (HDR) brachytherapy delivers radiation through a temporary seed placement inside the prostate area under general anesthesia. You will be asleep and remain comfortable. This procedure is done in the Radiation Oncology Department. You will get instructions on where to check in on the day of the procedure.
Before coming in for the therapy:
You will meet with a radiation nurse. They will ask you questions about your medical history. Your current medicines must be reviewed (name, dose, etc.).
You will need lab work and an ECG.
You will be asked about any prior issues with anesthesia.
The radiation nurse may call you with more instructions.
Patients who get anesthesia are not allowed to drive for 24 hours. On the day of your procedure, you need a ride home. It can be a friend or family member. Someone (age 16 or older) needs to stay with you for 24 hours.
The Brachytherapy Treatment
Compression leggings gently massage your lower legs. This helps the blood flow.
Once asleep, your legs will be put up into leg rests. Your skin at the insertion site will be cleaned with a special soap. A small tube will be put into your bladder to collect urine. This tube is removed before you go home.
The radiation doctor places the treatment catheters into the prostate. Placement is checked by the CT scanner. You will be asleep the entire time.
After the CT images are done, the radiation treatment is planned. Computer software is used to plan the treatment. The plan is done and approved by the radiation doctor and the physicist.
A tiny radioactive seed is used to deliver the radiation. It is about the size of a pencil lead. It is attached to a wire and kept inside a lead-lined storage box.
During the treatment the seed moves out of the storage box and into the therapy catheters. It stays there for your prescribed dose. It takes about 15-30 minutes.
After the radiation dose has been given, the seed goes back into the storage box. It does not remain in your body and there is no radiation in your body. The treatment part of the procedure is over. The catheters are removed. Your legs are lowered back onto the table. You then start to wake up. You are moved to the recovery room and watched for about an hour. When you are more awake, you are moved to the discharge unit. Total recovery time is 2-3 hours.
You are not radioactive after the procedure and you pose no danger to others.
You will have something to drink once you are fully awake. Family members or friends can visit. You will then get ready to go home. The radiation doctor will talk to you and answer any questions. You may remember bits and pieces of the procedure or you may not remember anything.
After the Procedure
No drinking alcohol for 24 hours.
No driving for 24 hours.
Do not use any dangerous equipment or make major decisions for 24 hours.
Avoid hot tubs, pools or outdoor water sources for about 1 week. This is to prevent infections. Showers and sponge bathing are ok.
Avoid activities like biking, horseback riding, motorcycling, etc. for 2 weeks.
It is OK to return to most types of work. We can provide work notes if needed.
Avoid sex for at least 4 weeks. You will notice blood or dried blood in the semen. This is normal and will clear up over time.
Pain after this procedure is mild. You may use Tylenol (acetaminophen) or ibuprofen as directed. Sit on a pillow if you have pain. You need to let this area heal. Listen to your body. If something causes you pain, don’t do it. If you are still having pain, please call.
We will prescribe an antibiotic that you will need to take for a few days. You start taking the antibiotic the evening you go home.
You will have a follow-up visit 3 months after the procedure. We will do lab work to get a PSA at that time.
Who to Call
If you have any questions or concerns, please call us at 608-263-8500.