Seed Implantation Questions and Answers What kind of physician typically performs the procedure and in what kind of setting? Non-surgical seed implantation is usually performed in an out-patient hospital setting by a team of physicians consisting of a urologist, radiation oncologist, and a radiation physicist. What is the difference between the Iodine and Palladium seeds? Radioactive palladium produces radiation more rapidly than iodine. Palladium seeds have been used in prostate cancer for about five years, while iodine seeds have been used for prostate cancer for about 20 years. So far, the cure rates with palladium and iodine appear to be about the same. Are there any side effects from non-surgical implantation? Complication rates with radioactive seed implants are less than those of radical prostatectomy or external beam radiation. After a radioactive seed implant, only five percent of patients who have not had prior surgery will become incontinent, and about 15 percent of the men treated under the age of 70 will become impotent. Some men experience mild discomfort in the groin area for two to three days, which is managed very effectively with mild analgesics. Some blood may be seen in the urine and sperm for a few days after the procedure. This is normal and stops after two to three days. What are the advantages of non-surgical seed implantation over other treatment options? Non-surgical seed implantation is associated with lower rates of impotence and incontinence compared to traditional treatments, such as radical prostatectomy and external beam radiation. Non-surgical seed implantation is a one-time, low-impact procedure. Patients can return to normal activity (including work) within one to three days, with little or no pain. Surgical patients remain in the hospital for 7 - 10 days and require weeks of recovery at home. External beam radiation patients must visit a radiation treatment center almost daily over a seven to eight week period. Non-surgical seed implantation can be performed on an out-patient basis. The cost of a radical prostatectomy ranges from $18,000 - $20,000, while seed implantation cost approximately $9,000 - $12,000. What kind of patient is best suited for non-surgical seed implantation? Non-surgical seed implantation is an alternative for men who have early-stage prostate cancer (cancer that has not spread outside the prostate gland. Seed implantation is also an attractive option for men whose poor health precludes radical prostatectomy. Does the radiation from seed implants pose any danger to organs or tissue surrounding the prostate or to the sexual partner? Since seeds are non-surgically implanted with pinpoint accuracy, they pose no risk to surrounding organs or tissue. This results in low complication rates with seed implants. Seeds represent no risk to a partner; however, patients should abstain from sexual activity for two weeks after the procedure. Are patients radioactive after the seed implantation? No. Although the seeds are radioactive, patients are not. Since the radioactivity is very low and the placement is so precise, virtually all the radioactivity is absorbed into the prostate. Special precautions should be taken when a patient is in contact with small childern and pregnant women in the first two months after treatment. How effective are seed implants compared to conventional therapies? According to six-year results, patients treated with Iodine-125 Seeds showed a 95 percent cancer-free success rate, with lower complication rates compared with radical prostatectomy and external beam radiation. Radiation Therapy What is radiation therapy? In radiation therapy, high energy x-rays or rays from radioactive substances, are aimed at a tumor causing damage to cancer cells, which subsequently die because they cannot divide. Some non-cancerous cells near the tumor also may be damaged, but the healthy cells will repair themselves. Radiation is a special kind of energy carried by waves or a stream of particles. It can come from special machines or from radioactive substances. When used at high levels, radiation can be used to treat cancer and other illnesses. Special equipment is used to aim the radiation at tumors or areas of the body where there is disease. The use of high-energy rays or particles to treat disease is called radiation therapy. It can also be called radiotherapy, X-ray therapy, cobalt therapy, electron beam therapy, or irradiation. How does radiation therapy work? High levels of radiation can kill cells or keep them from growing and dividing. Radiation therapy is a useful tool for treating cancer because cancer cells are growing and dividing more rapidly than many of the normal cells around them. In addition, most normal cells appear to recover more fully from radiation effects than cancer cells. Physicians carefully limit the intensity of radiation treatments and the amount of normal tissue being treated so that the cancer will be harmed more than the normal tissue. How long does the treatment take? Radiation therapy is usually given 5 days a week for 6 or 7 weeks. When radiation is used for palliative therapy, the course of treatment lasts for 2 to 3 weeks. This schedule helps protect healthy body tissues by spreading out the total dose of radiation. Weekend rest breaks allow normal cells to recover. The total dose of radiation and the number of treatments needed will depend on the size and location of the cancer, the type of tumor, the general health of the patient, and any other treatments the patient is receiving. What are the benefits of radiation therapy? Radiation therapy is an effective way to treat many kinds of cancer in almost any part of the body. One-half of all cancer patients are treated with radiation, and the number of cancer patients who have been cured is increasing every day. For many patients, radiation is the only form of treatment necessary. Physicians can use radiation prior to surgery to shrink a tumor. Following surgery, radiation therapy may be utilized to stop the growth of any cancer cells that remain. In some cases doctors use radiation in conjunction with anticancer drugs to destroy the cancer, instead of surgery. Even when curing the cancer is not possible, radiation therapy can still provide relief. Many patients find the quality of their lives improved when radiation therapy is used to shrink tumors and reduce pressure, bleeding, pain, or other symptoms of cancer. This is called palliative therapy. What are the side effects of radiation therapy? External radiation therapy does not cause your body to become radioactive. There is no need to avoid being with other people because of your treatment. Hugging, kissing, or having sexual relations with others poses no risk to them of radiation exposure. Side effects of radiation therapy are most often related to the area that is being treated. The radiation oncologist and nurse will tell you about the side effects to watch for and how to deal with them. You should contact them if you have any unusual symptoms during treatment such as coughing, perspiring, fever, or unusual pain. Most side effects that occur during radiation therapy, although unpleasant, are not serious and can be controlled with medication or diet. These side effects usually diminish within a few weeks after treatment ends. However, some side effects may last longer. Many patients have no side effects whatsoever. Throughout each patient's treatment, the radiation oncologist will regularly check on the effects of the treatment. The physician may order tests to confirm that the radiation is causing as little damage to normal cells as possible. An example of the type of test would be a routine blood test to check the levels of white blood cells and platelets, which may be lower than normal during treatment Are the side effects the same for everyone? The side effects of radiation treatment vary from patient to patient. A patient may experience no side effects or only a few mild ones through a course of treatment. Some individuals have more serious difficulties with side effects. The side effects depend mostly on the treatment dose and the area treated. A patient's general health also can affect how the body reacts to radiation therapy and whether they experience side effects. Before beginning treatment, a patient should ask the physician and nurse about side effects, how long they might last, and how serious they might be. The most common side effects are fatigue, skin changes, and loss of appetite and can result from radiation to any treatment site. Other side effects are related to treatment of specific areas. For example, temporary hair loss may be a side effect of radiation treatment to the head. Fortunately, most side effects will diminish in time. In the meantime, there are ways to reduce the discomfort they cause. If a patient has a side effect that is particularly severe, the doctor may prescribe a break in treatments or change the kind of treatment. Every patient should tell their doctor, nurse, or radiation therapist about any side effects they experience. Are there risks involved with radiation therapy? As with many other treatments for disease, there are risks for patients who are receiving radiation therapy. The radiation used to damage or destroy cancer cells also can damage normal cells. When this happens, the patient experiences side effects which are monitored by the radiation oncologist. The risk of side effects is usually outweighed by the benefits of killing cancer cells. Is radiation treatment painful? Although radiation therapy is not painful, it can cause unwanted side effects. The person may be more tired than usual. The skin where radiation is aimed may feel like it has been sunburned and will need to be protected from the sun. Is the patient radioactive? The patient receiving radiation therapy is not radioactive during or after radiation therapy. None of the treatments will hurt other individuals. If a patient has a radioactive implant in place, visitors will not be allowed to get too close to the patient until the implant is removed, and visiting time may be limited or restricted.