A distinguishing characteristic of Valley’s cancer program is the availability and quality of radiation seed implant therapy. Valley has attracted patients from around the world as a result of its unique prostate implant program.
Many physicians from around the country and throughout the world have come to Valley to learn brachytherapy from Valley Radiation Oncologist Michael Wesson, M.D. Dr. Wesson has conducted grand rounds at St. Vincent’s Hospital in New York City, sharing expertise in prostate implant techniques with attending physicians and residents-in-training from the hospital's Department of Urology.
Information for Valley Patients
Once a diagnosis of prostate cancer is made, you may need further testing to determine whether or not you are a candidate for a radioactive seed implant. If this treatment is recommended, you will have a consultation with a urologist and a radiation oncologist. The urologist and radiation oncologist will outline the best treatment options for you based upon the findings of your tests.
Based upon the stage, grade and size of your prostate cancer,* and upon your PSA level, a customized plan of treatment will be made for you. This can include hormonal suppression therapy, external radiation and seed implantation – alone or in combination. Your physician(s) will discuss these options with you.
Frequently Asked Questions About Seed Implant Therapy
What type of radiation will I need?
The size of the prostate, the extent of the tumor and your PSA level determines how much and what type of radiation you need.
What is a volume study?
A volume study is a special ultrasound procedure that will show your prostate's anatomy in three dimensions. This will be submitted to the Radiation Oncology Department so your specific seed placement can be planned according to the results of the volume study. The size of the prostate is determined by a volume study. Your urologist and/or radiation oncologist will fully discuss this with you.
How do I prepare for a volume study?
You will be given written instructions at your urologist's or radiation oncologist's office prior to the procedure.
What type of preparation is required prior to seed implantation?
Start a soft diet three days prior to the procedure. The day before, cut down to full liquids. At bedtime the night before the procedure, you will need to take two ounces of milk of magnesia. Do not eat or drink after midnight the night before the procedure. Take an enema at home the morning of the procedure.
What about sexual activity?
You should abstain for two weeks after the implantation. No abstinence is required before. You may notice blood in your semen for several weeks after the procedure.
Will this procedure affect my sexual potency?
There is a risk of impotence associated with this procedure depending upon your specific treatment plan. Your urologist and radiation oncologist will discuss this with you.
Will I be radioactive?
Radioactive seeds have a very low energy level, and the radiation does not travel very far. Almost all of the radiation is contained within the prostate itself. Very small amounts of radiation, however, can reach other people either from a seed being passed in the urine or as radiation escapes from the prostate. A person will receive very little radiation during short periods of close/direct contact. The longer a person is in close contact, the more radiation they will receive. Because of this, a few precautions should be taken:
Children should not be allowed to sit on your lap for a period of time following the implant. (Your radiation oncologist will give you specific guidelines.) A short hug or kiss will not pose a problem, however. At a distance of several feet, there is no limit to the length of time you may spend together.
Pregnant women, or those who think they may be, can safely be in close contact with you for a limited period of time.
You may sleep in the same bed as your partner, provided she is not pregnant.
Your semen may be discolored. This is normal and a result of bleeding that may have occurred during the implant. You should refrain from sexual intercourse for two weeks following the implant, after which a condom should be used for the first three ejaculations within a 14-day period (whether intercourse-related or not). After 14 days, it will not be necessary to use a condom.
Will this procedure cause urinary incontinence?
Incontinence occurs in less than 1 percent of patients.
How is the procedure performed?
The procedure takes place in the operating room and lasts about an hour. An ultrasound probe is inserted into the rectum to give doctors a video image of the prostate and other organs. Using a needle, the seeds are inserted through the perineum (the skin under the scrotum) and into the prostate. The seeds are directed at cancerous tissue while having a minimal effect on surrounding healthy tissue.
What will happen the day of the procedure?
You will be admitted to the Same-Day Surgery suite on the morning of the procedure. A nurse will prepare and medicate you for the operating room. An anesthesiologist will visit you in the Same-Day Surgery area or in the operating room, to discuss the type of anesthesia you will receive. Once in the operating room anesthesia will be given and you will be positioned on the table for the procedure. Following the procedure, you will be brought to the recovery room for approximately one hour. Then you will return to the Same-Day Surgery suite. You must have someone available to drive you home.
Will I go home with a catheter?
In most cases no. A catheter will be placed into your bladder at the time of the procedure and is usually removed after surgery. Occasionally, patients are sent home with a catheter, which is removed at a later time. If that happens, you will be given instructions on what to do.
May I resume my normal diet after surgery?
Yes. You will be given a light meal when you return to the Same-Day Surgery area and you may resume your normal diet after discharge from Same-Day Surgery.
When will I go home?
In most cases, the same day. However, the decision will depend upon your overall health status. You may be given a prescription for antibiotics and for pain relievers, if needed, at that time.
When can I go back to work and resume normal activity?
In most cases, within several days. Your urologist and/or radiation oncologist will discuss this with you.
Are there any complications I should be alerted to?
You should notify your urologist immediately if you:
are unable to urinate
have a high temperature
experience nausea or vomiting
experience severe pain or burning when urinating
have excessive blood in your stool or urine (you may see light pink blood or some clots in your urine – this is expected)
Care After the Procedure
After the seed implant, you will be followed periodically by both your urologist and radiation oncologist. The first follow-up visits to your urologist and radiation oncologist will be scheduled one to two weeks following your surgery.
If you have further questions or concerns, please call your urologist's office or the Radiation Oncology Department at The Luckow Pavilion.