Prostate Brachytherapy

Brachytherapy involves the insertion of tiny radioactive seeds, each about the size of a sesame seed, directly into the prostate gland. The seeds are LDR (Low Dose Rate) and contain a radioactive isotope called Palladium-103.

Once implanted in the prostate, the seeds emit a continuous low radiation dose over several weeks, targeting cancer cells while minimizing damage to healthy tissue. Eventually, the seeds stop delivering radiation. They remain in the prostate for life.

LDR Prostate Brachytherapy is an established treatment option with long-term cancer control reported in several studies. When done with intraoperative real-time adaptive planning, LDR Brachytherapy can deliver millimeter-level precision to sculpt the radiation dose to your specific anatomy and "dose-escalate" to areas of concern while minimizing radiation to surrounding healthy tissues.

Brachytherapy for prostate cancer is a one-time outpatient procedure. The procedure typically takes between 30 and 60 minutes.

The vast majority of men return to their normal lives the day after the procedure with minimal to no pain or discomfort.

Compared to many other conventional treatments for prostate cancer, modern, intraoperatively planned LDR brachytherapy has lower rates of sexual, urinary, and gastrointestinal side effects.

The precision of real-time planning allows us to maximize radiation dose to cancer while sparing the urethra, rectum, and neurovascular bundles responsible for erectile function.

Brachytherapy is ideal for men with early-stage prostate cancer that is less likely to spread beyond the prostate. It may also be combined with other treatments for men with intermediate or high-risk prostate cancers or those who have a greater chance of their cancer spreading beyond the prostate.

Final recommendations depend on your:

• PSA level and trajectory
• Biopsy results (Gleason score, number of positive cores)
• Imaging (MRI to assess extracapsular extension)
• Prostate size (ideal range 20-60 grams)
• Urinary symptoms (IPSS score)
• Overall health and treatment preferences

The prostate is a gland in the male reproductive system, about the size of a walnut. It is located below the bladder in front of the rectum, and surrounding the urethra.

Prostate cancer is the most commonly diagnosed cancer in men in the United States. One in eight men will be diagnosed with prostate cancer in their lifetime, but the earlier it is detected, the more options for treatment and the higher the chance of survival.

Palladium-103 has a short half-life (17 days), meaning radiation dose decreases rapidly. After 1 year, seeds are essentially inert.

Precautions (first 2 months):

• Avoid prolonged close contact with pregnant women or young children (maintain 6-foot distance for extended periods).
• No restrictions on daily activities, work, or casual interactions.
• Use condom during intercourse (rare seed passage, but precautionary).
• Carry wallet card with implant information for airport security or medical procedures.

Evidence: Decades of published data support LDR brachytherapy as an effective, well-tolerated treatment for localized prostate cancer. Intraoperative real-time planning further improves outcomes by optimizing seed placement during the procedure.

In collaboration with Western Radiation Oncology, Advanced Urology provides a team of skilled physicians specializing in urology and radiation oncology for prostate cancer patients. The team is committed to offering the latest and most advanced treatment options. Their patient-centered approach means treatment is tailored to each patient's individual needs.

John Shumway, M.D.

Director of Advanced Prostate Cancer Therapeutics

Dr. Shumway is a skilled radiation oncologist who specializes in brachytherapy for prostate cancer. He is the lead radiation oncologist at one of the busiest brachytherapy programs on the West Coast (El Camino Hospital) and leads the advanced prostate cancer division of Western Radiation Oncology, focusing on treatments such as Pluvicto. Dr. Shumway routinely travels across the country to perform prostate brachytherapy.

• vs. Radical Prostatectomy: Brachytherapy is outpatient, no incisions, lower rates of incontinence/ED. Surgery offers definitive pathology and immediate cancer removal.
• vs. External Beam Radiation (EBRT): Brachytherapy is one-time procedure (vs. 20-40 daily treatments). Both effective; brachytherapy may have fewer bowel side effects.
• vs. Active Surveillance: Brachytherapy treats cancer definitively while preserving function. Active surveillance monitors without treatment.
• vs. Focal Therapies (HIFU, Cryo, Laser): Brachytherapy treats whole gland but with precision dose sculpting. Focal therapies treat lesion only but require ongoing surveillance.

If your provider has determined you are a good candidate for Brachytherapy for Prostate Cancer Treatment, you will receive a call from our care coordination partners at Western Radiation Oncology (a California-based company) with more information.

Please Note: The call will come from 650-960-7397.

Western Radiation Oncology provides patient education videos, FAQs, and comprehensive information about the brachytherapy process.

If you've been diagnosed with localized prostate cancer and want a highly effective treatment with minimal disruption to your life, brachytherapy may be an excellent option. Our prostate cancer team will review your case and coordinate with Western Radiation Oncology to create a personalized treatment plan.