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Brachytherapy and You

Brachytherapy and You

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The following information is based on the general experiences of many prostate cancer patients. Your experience may be different. If you have any questions about what prostate cancer treatment services are covered by your health insurance, please contact your health care provider or health insurance provider. This education material was made possible by a Grant from the California Department of Justice, Antitrust Law Section, from litigation settlement funds to benefit Californians diagnosed with cancer or their families.

What Will I Learn By Reading This?

You and your doctor may be talking about using brachytherapy (bray-key-thair-apee) as a treatment for your prostate cancer. It is important for you to learn about brachytherapy so that you will know what to expect and how best to take care of yourself before, during, and after treatment. In this booklet, you will learn about the following:

  • What brachytherapy is
  • How you get ready for brachytherapy
  • What to expect when you have brachytherapy
  • Possible side effects (unwanted changes in your body) of brachytherapy
  • Safety measures you need to follow after brachytherapy
  • How you can take care of yourself before, during, and after treatment

It is important to think about how you will work these things into your everyday life if you and your doctor decide that brachytherapy if the best treatment for you.

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What Is Brachytherapy?

Brachytherapy is a type of radiation treatment that works from inside your body to kill your prostate cancer cells. Brachytherapy is also called internal radiation therapy or seed implantation. Brachytherapy is used to treat prostate cancer in its early stages when it has not moved out of your prostate gland.

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How Does Brachytherapy Work?

When you get brachytherapy, small seeds or pellets are placed in your prostate during an operation. The seeds or pellets that are placed in your prostate are smaller than a grain of rice and are made out of a radioactive (ray-de-oh-ak-tiv) material. The seeds give a strong dose (or amount) of radiation to your prostate cancer. This radiation kills your prostate cancer cells. The radiation may also damage some of your healthy cells that are near your prostate. This causes side effects (or unwanted changes in your body) that will be talked about later in this booklet.

Size of seeds placed in your prostate

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What Do I Need To Do To Get Ready for Brachytherapy?

About one month before you have the seeds put in your body, your radiation oncologist (a doctor who specializes in the treatment of people with cancer) will make a treatment-planning meeting appointment. During this meeting, a special procedure called a Trans Rectal Ultrasound (TRUS) will be used by your radiation oncologist to make detailed pictures of your prostate and cancer. This ultrasound will be like the ultrasound you had for your prostate biopsy. During the ultrasound, a finger-like probe is placed in your rectum and pictures are taken of your prostate. Ultrasound uses sound waves to make a picture of your prostate gland. The ultrasound pictures give your radiation oncologist information about the size of your prostate, its shape, and the size of your prostate cancer.

Trans Rectal Ultrasound

From the ultrasound pictures, your radiation oncologist will decide how many seeds you need and exactly where to put them. They will also help your doctor choose the best type of seed implant to treat your prostate cancer. Your radiation oncologist may choose a low dose-rate (LDR) or high dose-rate (HDR). Low dose-rate seed implants stay in your body. High dose-rate implants are placed in and around your prostate cancer for only a few minutes. The seed implants are then taken out. The type of seed implant you have and how long it stays in your body will depend on the dose (or amount) of radiation you need to have the most effective treatment. About a month after the planning meeting, you will come back to have the seeds put in.

If the ultrasound picture shows that your prostate is too large, you may be given hormone therapy for a couple of months before the seeds are implanted. The hormone therapy will shrink your prostate cancer (See IMPACT brochure, “Hormone Therapy and You,” for more information). Hormone therapy is a prostate cancer treatment, which lowers the amount of the male hormone, testosterone, in your body. Testosterone has been found to help your prostate cancer cells grow. Your radiation oncologist will check the size of your prostate a couple of months after you have taken hormone therapy to see if your prostate has gotten smaller. This will help your radiation oncologist to decide the best way to put the seeds in your prostate.

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Getting Ready for Brachytherapy

  • What tests has your doctor told you that you need to have before your seed implant?
  • When are your appointments for these tests? List the day(s) and time(s) of your appointments.
  • Where do you need to go to have these tests? List the places where you need to go for your tests.
  • What transportation plans will you make to get to these places? If you need help, speak with your doctor or health care team.

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How Are Seeds Put in My Body?

Your radiation oncologist will use long, thin needles to put the seeds into your prostate gland through your perineum (the skin between your anus and scrotum). The radiation oncologist will use a TRUS (Trans Rectal Ultrasound) to guide where the seeds are placed. This will be done during an operation in the hospital after you have been given anesthesia. Anesthesia is a medicine that will keep you from feeling any pain during the operation.

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What Should I Do Before I Go to the Hospital?

Your radiation oncologist will talk to you about the steps you need to follow to get ready for your seed implant operation. The following will give you an idea of some of the things you may need to do before you go to the hospital.

Speak to your doctor or health care team about any medicines or herbs you are taking. Your doctor will tell you which medicines you should stop taking or keep taking before your surgery. For example: if you are taking ibuprofen (medicines like Motrin) or aspirin, you may need to stop taking this medicine about 10 days before your seed implant. Make a list of your medicines, how much you take (the dose or amount), and how often you take them. If you want, you can bring all of the medicines that you take to a doctor’s appointment so your doctor can see what you are taking. Make sure to tell your doctor about any medicines you are taking, even over-the counter medicines (medicines you buy without a prescription) such as aspirin, vitamins, or herbs before your surgery. Make sure to tell your doctor about any allergies you have to medicines.

You should make sure that you carefully clean your genital area (the part of you body that includes your penis, scrotum, perineum, and anus) with an antibacterial soap one time each day for two to three days before you go to the hospital. This will help lower your chance of getting an infection.

Make sure you know how to get in touch with your doctor or health care team in case you have any questions or if you have any emergency before or after your seed implant.

The day before your surgery, you may eat breakfast. When you have lunch and dinner you may only have clear liquids. A clear liquid is anything that you can see through like apple juice, 7-Up, broth, or water. Jell-O® is also a clear liquid.

The day before your seed implant in the afternoon you will need to take a laxative. Your doctor will tell you what kind of laxative to take. You can buy this laxative at a local drug store. A laxative is a medicine you take that will help empty out your bowels.

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Do not eat or drink anything after midnight the night before your seed implant. If you have medicines that you need to take, you can take them with small sips of water.

Your doctor’s office will tell you what time to be at the hospital. Before you go to the hospital in the morning, you will need to take an enema. Your doctor’s office will tell you what kind of enema to use. You can by the enema at your local drug store. An enema is a simple way to clean out your bowel. A small container of fluid is squeezed into your bowels through your anus. Follow the directions that come with the enema. If you have any questions about how to use the enema, speak with your doctor or health care team. The diet, laxative, and enema are important because your bowel must be clean before you get your seed implant.

This makes it much easier for your doctor to see your prostate. Double check with your doctor about what time you need to take the laxative and the enema. You will want to plan for a family member or friend to help you for two to three days when you go home. Your doctor will make sure you are ready to leave the hospital after your seed implant. You should feel well and be able to start doing normal activities in about three days. You should be able to return to work three to five days after your seed implant. If you are working, you should speak with your supervisor about taking time off work for your seed implant. You may also need to get a doctor’s note before you can return to work. Remember to speak with your doctor or health care team about this.

Planning Before You Have Your Seed Implant

  • What foods are you going to eat before your surgery?
  • When do you need to take your laxative and enema?
  • Who is going to help you when you get home from the hospital? Write down their name(s) and phone numbers:
  • What medications are you taking?
  • Do you have any allergies that you need to tell your doctor about?
  • When do you need to wash your genital area? What will you use?

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What Will Happen the Day I Have My Low Dose-Rate Seed Implant

When You Get To The Hospital

  1. When you get to the hospital, a member of the hospital staff will greet you and take care of any paperwork that was not done ahead of time. Make sure that you have your health insurance card and picture identification such as a driver’s license with you. You should also bring the name and contact information for your family member or friend who will help you get home from the hospital in case you need to call them. You should dress in loose, comfortable clothes like sweat pants. You may also want to bring the names and phone numbers of your doctor and health care team with you.
  2. The staff will show your family member or friend where to wait during your seed implant.
  3. Ask about anything that you do not understand or that worries you.

Getting Ready To Go To The Hospital

  • What transportation plans will you make to get to the hospital? If you need help, speak with your doctor or health care team.
  • What type of identification do you need to bring with you to hospital?

Before Your Low Dose-Rate Seed Implant

  1. A hospital staff member will get you ready for your operation by bringing you to a room where you will change into a hospital gown. At this time, you will be asked to remove your glasses, any jewelry you are wearing, and your dentures, if you wear them. Any personal items you brought with you to the hospital, like your clothes and your money, will be taken from you at this time. The hospital staff will place these items in a safe place until your seed implant is finished and you are moved into a regular hospital room. Once you are in a regular hospital room, they will return your personal items to you.
  2. An anesthesiologist will talk to you. An anesthesiologist is the doctor who gives you medicine so you do not feel anything during your seed implant and carefully watches you during the seed implant. The anesthesiologist may give you a regional (also known as an epidural) or general anesthesia. You may have already seen the anesthesiologist at your planning meeting and decided on what kind of anesthesia to have. Regional anesthesia is medicine that numbs your body from the waist down so that you do not feel the seed implant. If you get regional anesthesia, you will be awake during your seed implant. General anesthesia is when you are given medicine to make you sleep during your seed implant. If you have general anesthesia, a small tube will be put in your throat to help you breathe after you go to sleep. Your doctor will recommend the best anesthesia for you. You will not feel anything during your seed implant with either type of anesthesia.
  3. Ask the anesthesiologist about anything that you do not understand or that worries you.

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During Your Low Dose-Rate Seed Implant

  1. After you are given anesthesia, your doctor will use the TRUS to see where the seeds are to be placed.
  2. Once your doctor can clearly see your prostate, needles that hold the radioactive seeds are placed in your prostate through your perineum (the area between your anus and the base of your scrotum). The seeds are passed through these needles and into your prostate. Your doctor will follow the plan that was made for you.
  3. After the seeds are put in your prostate gland, the needles are taken out and x-rays will be taken to make sure that the seeds are in the right place in your prostate. Your seed implant will take about two to three hours.

Brachytherapy Seeds in your prostate

After Your Low Dose-Rate Seed Implant

  1. After your seed implant is over you will go to the recovery room. If you had general anesthesia, you will stay there until you are totally awake. This may take a few hours. If you had regional anesthesia, you will stay there until you can feel from your waist down. The recovery room nurses will watch you very closely until you wake up.
  2. After you leave the recovery room, you will move to the outpatient day unit, where you will stay until your doctor says you are ready to go home.

What You Will See When Your Low Dose-Rate Seed Implant is Over

  1. When you wake up, you will find a tube coming out of your penis. This tube is called a catheter. The catheter is connected to a plastic drainage bag. The catheter drains urine from your bladder into the bag. Your catheter will be taken out before you go home from the hospital.
  2. You will have a plastic tube going into a vein in your arm. It is connected to a plastic bag of liquid. This is your I.V. (also known as intravenous (in-tra-vee-nuhs)). The I.V. gives you any fluids you need. You may also be given medicine in your I.V. Your I.V. will be taken out when you can drink and eat without problems.
  3. You will go home the same day you have your seed implant.

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What Will Happen the Day I Have My High Dose-Rate Seed Implant

When You Get To The Hospital

  1. When you get to the hospital, a member of the hospital staff will greet you and take care of any paperwork that was not done ahead of time. Make sure you have your health insurance card and picture identification such as a driver’s license with you. You should also bring the name and contact information for your family member or friend who will help you get home from the hospital in case you need to call them. You should dress in loose, comfortable clothes like sweat pants. You may also want to bring the names and phone numbers of your doctor and health care team with you.
  2. The staff will show your family member or friend where to wait during your seed implant.
  3. Ask about anything that you do not understand or that worries you.

Getting Ready To Go To The Hospital

  • What transportation plans will you make to get to the hospital? If you need help, speak with your doctor or health care team.
  • What type of identification do you need to bring with you to hospital?

Before Your High Dose-Rate Seed Implant

  1. A hospital staff member will get you ready for your operation by bringing you to a room where you will change into a hospital gown. At this time, you will be asked to remove your glasses, any jewelry you are wearing, and your dentures, if you wear them. Any personal items you brought with you to the hospital, like your clothes and your money, will be taken from you at this time. The hospital staff will place these items in a safe place until your surgery is finished and you are move into a regular hospital room. Once you are in a regular hospital room, they will return your personal items to you.
  2. An anesthesiologist will talk to you. An anesthesiologist is the doctor who gives you medicine so you do not feel anything during the surgery and carefully watches you during the operation. The anesthesiologist may give you a regional (also known as an epidural) or general anesthesia. You may have already seen the anesthesiologist at your planning meeting and decided on what kind of anesthesia to have. Regional anesthesia is medicine that numbs your body from the waist down so that you do not feel the operation. If you get regional anesthesia, you will be awake during your surgery. General anesthesia is when you are given medicine to make you sleep during your operation. If you have general anesthesia, a small tube will be put in your throat to help you breathe after you go to sleep. Your doctor will recommend the best anesthesia for you. You will not feel anything during your surgery with either type of anesthesia.
  3. Ask the anesthesiologist about anything that you do not understand or that worries you.

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Getting Your High Dose-Rate Seed Implant
There are three steps to getting a high dose-rate seed implant:

A. Getting Ready For Treatment

  1. After you are given anesthesia, your doctor will use the TRUS to see where the seed is to be placed. HDR seed implant uses a single radioactive seed, which is sometimes called an iridium wire.
  2. Once your doctor can clearly see your prostate, very tiny, soft, and flexible plastic catheters are placed in your prostate gland through your perineum (the area between your anus and the base of your scrotum). Your doctor will use these catheters to place the iridium wire in your prostate.
  3. Your doctor will then check to make sure that the catheters were placed in the right places. This process will take about 45 to 60 minutes. The catheters will stay in place until your treatment is over.
  4. When your doctor is finished, you will be taken to a recovery room where you stay until you wake up. You will stay in the recovery room for about two hours. In the recovery room you will rest on a special mattress that will keep you comfortable and keep you from moving the catheters.

B. Planning Your Treatment

  1. After you have recovered from the first part of your treatment, you will be taken for a CT scan (also known as a CAT scan). At this time, you will be given contrast. Contrast helps your doctor to see the exact placement of the catheters in your prostate.
  2. The CT scan will help your radiation oncologist and health care team plan the dose (or amount) of radiation you need from the iridium wire and how long the iridium wire will stay in each catheter.

C. Getting Your Treatment

  1. When your treatment plan is ready, you will be taken to a special treatment room. The catheters in your prostate will be connected to a special machine that places the iridium wire in your prostate.
  2. In the treatment room, the radiation therapist will use a computer to place the iridium wire in your prostate gland. The radiation therapist will not be in the room with you, but you will be watched through a window or by video camera. You will also be able to speak with the radiation therapist with an intercom (a way to talk between two rooms).
  3. Each treatment will last 10 to 15 minutes. You will not see, hear, or smell the radiation, but you will hear the machine as it puts the iridium wire in your catheters and then takes the iridium wire out.
  4. You will get from two to four high dose-rate treatments during your stay in the hospital. After each treatment, you will rest in a hospital room.
  5. You will not be radioactive when you are in your hospital room or when you go home.

During Your High Dose-Rate Seed Implant

  1. Picture of a PCAYou will be in the hospital for 24 to 36 hours. You will not be able to get out of bed when you are in the hospital.
  2. You will have a catheter. This is a tube put in your bladder through your penis. The catheter is connected to a plastic drainage bag. The catheter drains urine from your bladder into the bag. Your catheter will be taken out before you go home from the hospital.
  3. You will have a plastic tube going into a vein in your arm. It is connected to a plastic bag of liquid. This is your I.V. The I.V. gives you any fluids you need. You may also be given medicine in your I.V.
  4. You will also have a use of patient-controlled analgesia (an-l-jee-zee-uh) (PCA). The PCA is a machine connected to your I.V. that lets you control the dose (or amount) of pain medicine you need for your pain. Most men getting high dose-rate seed implants find the PCA very helpful in controlling any pain they have during their treatment.
  5. You will be able to eat during your treatment. You will be fed foods that are low in fiber and given a medicine that will make you constipated.When you are constipated, your bowel movements are not regular and you pass less stool. The medicine will keep you from having to get out of the bed to use the bathroom.
  6. After your last treatment, the catheters are taken out. You will go home a few hours after the catheters are taken out.

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What Can I Expect When I Get Home from The Hospital?

If you had general anesthesia, you may feel sick to your stomach for a few hours after your operation. You may also have a sore throat from the tube that was used during anesthesia for your seed implant. You will probably feel better if you eat something light such as soup and crackers or plain rice for supper. Make sure to drink three to four glasses of water during the day. This will help give your body the fluids it needs to heal after your operation. You should start to feel better by the next day.

You may have some bruising or mild soreness in your perineum (the area between your anus and the base of your scrotum). This area should not be very painful. Your scrotum may also look bruised and swollen which is caused by the needles used to place the seeds in your prostate. Your doctor will tell you what medication you can take to help get rid of the soreness. If you are sore, take the medication when the pain starts so that you can control it. If the soreness and swelling does not get better in two to three days or gets worse, call your doctor or health care team. You can put ice packs on your scrotum for the first 48 hours after your operation to help keep the swelling down. Use the ice packs for no more than 20 minutes at a time. Make sure to put a small dishtowel or piece of cloth around your ice pack before putting it on your scrotum. Ice cubes in small plastic bags make good ice packs. A bag of frozen peas also makes a good ice pack. Do not use the ice pack on your scrotum for more than 20 minutes at a time.

You may find that you have some trouble urinating (peeing) and that your urine stream is weak. You may also see a little blood in you urine. This is caused by irritation of your urethra (the tube the carries urine from your bladder out through your penis) by the radiation. This is all normal for a few weeks after your seed implant. Your doctor may give you some medicine such as Hytrin, Flomax, Uroxatral, Detrol, Ditropan, or Pyridium to help you urinate. It is important to take this medicine as the doctor tells you to. If you have any questions about being able to urinate (pee) or the medicine, call your doctor or health care team.

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When Should I Call My Doctor?

You should call your doctor right away if you:

  • Have increasing pain around perineum (the area between your anus and the base of your scrotum) that your pain medication does not take away. There should be only a small amount of pain in your perineum after your seed implant, and it should get better each day.
  • Have increasing swelling in your scrotum. There should be only a small amount of swelling after your seed implant, and it should get better each day.
  • Start to have a temperature or fever more than 101°F.
  • Are not able to urinate (pee).
  • Have any questions or concerns about how you are healing. If you have any of these signs talk to your doctor or health care team. There are medicines and treatments that can help you feel better. It is important that you talk to your doctor or health care team about any side effects you may have during or after your treatment. Your health care team can help treat these problems.

Planning For Going Home.

  • What are you going to do about food when you get home from the hospital?
  • What are you going to use for an ice pack to help with any soreness or swelling you might have?
  • Who is going to help you when you get home from the hospital? List their name and contact information:
  • How do you get in touch with your doctor or health care team if you need help?

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Are There Side Effects With Brachytherapy?

Yes, there can be side effects or unwanted changes in your body when you have brachytherapy. Side effects are different from person to person. Some people have no or very mild side effects. Some have bothersome side effects that may last for only a short period of time. Other men may have side effects that last for a longer period of time or forever. Some side effects occur within days or weeks of your treatment and others may not happen for six or more months after your treatment. The good news is that there are ways to deal with most of the side effects.

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What Side Effects May I Have After My Seed Implant?

There are several side effects that you may have after your seed implant. They are urinary problems, bowel problems, erectile dysfunction or impotence (difficulty in getting or keeping an erection of the penis), and fatigue (or tiredness).

The urinary problems you may have are:

  • Burning Feeling When You Urinate (Pee) You may find that you have a burning feeling when you urinate (pee). This is called urethritis (yur-i-thrI-tis). This is very common in men who have had a seed implant and can happen 20 to 60 days after your seed implant. This burning feeling can be very uncomfortable and may last up to two months. This feeling should go away with time. There are medicines you can take to make you feel more comfortable. Talk to your doctor or health care team if you have a problem like this.
  • Difficulty Urinating (Peeing) You may find that you have a hard time urinating (peeing). This is common after brachytherapy. You may have a hard time getting your urine to start or stop. You may also have mild pain when you urinate (pee). Also, you may not completely empty your bladder when you urinate (pee). This is called retention (re-ten-shun). Talk to your doctor or health care team if you have a problem like this. Your doctor may give you medicine to help you urinate more easily.

The bowel problems you may have are:

  • Mucous in your bowel movements You may find that you have more mucous in your bowel movements. Mucous is formed when your bowels are irritated. The body makes mucous to protect the inside of your bowels. You may have mucous in your bowel movements for six to nine months after your seed implant.
  • Soreness in your rectal area You may also have soreness in your rectal area. This usually goes away by itself. If you are very sore, let you doctor or health care team know. There are medicines and things that you can do to be more comfortable.
  • Being unable to tell whether you need to urinate (pee) or have a bowel movement For the first few months, when you feel like you need to use the bathroom, you may not be able to tell if it is to urinate (pee) or have a bowel movement. This feeling usually goes away. You may want to sit on the toilet when you go to the bathroom if you have this feeling. It is normal to feel this way the first few months after having the seeds put in your prostate.

To keep your bowel movements soft, eat high fiber foods and fruits (like whole grains, such as bran muffins and cereals, wheat germ, and whole wheat bread, fresh fruits and vegetables, and prunes or prune juice) and drink at least eight glasses of water each day.

The erectile dysfunction (or impotence) problem you may have is:

  • Fewer erections Over time, you may notice that you are not having as many erections (when your penis is hard enough to have sex) as you used to. This is because the radiation from the seeds can harm the nerves near your prostate that help you have erections. This may or may not get better over time and happens to about half of the men who have brachytherapy. Talk to your doctor or health care team if you have a problem like this.

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Another problem you may have is:

  • Fatigue or Tiredness You may feel more tired than usual during these first few months after your seed implant. You may feel tired all the time or you may get tired more easily when you do daily activities. This is a common side effect of brachytherapy treatment. There are things you can do to help deal with this side effect.
    • Remember to get plenty of rest. Plan for rest periods during the day.
    • Keep a regular sleep schedule. Go to bed the same time each night, even if you don’t feel sleepy. If you never watched latenight TV before, don’t start now. Don’t sleep or nap after supper. Don’t “sleep in” more or longer than you used to.
    • Drink plenty of fluids. Try to drink at least eight 8-ounce glasses of water each day.
    • Eat a healthier diet. A healthy diet helps you keep up your strength, prevents body tissues from breaking down, and rebuilds tissues that the cancer treatment may have harmed.
    • Stay away from drinks with caffeine in them before you rest.

If you have trouble figuring out how to make changes to deal with your tiredness, you may want to talk with your doctor or health care team. If you have any side effects or problems right after or months after your seed implant talk to your doctor or health care team. They can help you find ways to manage them.

Managing Your Side Effects

  • What foods will you eat to keep your bowel movements soft?
  • What will you do if you are feeling more tired than usual?
  • Who can you speak to if you need help dealing with your side effects?
  • What things do you need to talk about with your doctor and health care team?

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Will I Be Radioactive?

If you had a high dose-rate seed implant, you will not be radioactive and you do not need to follow any special safety measures when you go home. These safety measures are only for men who get low dose-rate brachytherapy. With low doserate brachytherapy the radioactive seeds are left in your prostate gland.

Many men who get brachytherapy are worried about the radiation from the seeds that are put in their body. If you had a low dose-rate seed implant, the seeds in your body do give off radiation. But, by the time it reaches the outside of your body, the radiation dose (or amount) is so small that you are not a danger to most other people. The seeds are sealed so that the radioactive material stays in the seed and does not leak out. Your doctor will talk to you about the safety measures you need to follow after your seed implant.

There are some safety measures that you should follow after your implant. For about six months after your treatment, you should avoid long hugs with pregnant women or young children. Young children should not sit on your lap for about six months after your implant. You should avoid letting young family pets sit in your lap for long periods. This is not a problem if the animal is older. You may want to talk to the any pregnant women or children you know before you have your seed implant so they know about the safety measures ahead of time.

If you want to spend more than ten minutes talking to a pregnant woman, she should sit or stand at least three feet (the length of a yardstick) away from you. This will keep her and her unborn baby safe from even the small amount of radiation given off by your seed implant. You should not be worried about visiting, or being visited by your family or friends. Four to six months after your seed implant, the radiation level will have fallen so low that it is barely there.

It is safe to sleep in the same bed as your partner. It is safe for you and your partner to have sex three days after your seed implant. Most men find they can have sex one to two weeks after their seed implants. You can stay at home with your family, move around, travel or meet other people.

Safety Measures To Think About If You Had Low Dose-Rate Seed Implants

  • Will you come in contact with someone who is pregnant or thinking about becoming pregnant?
  • What young children may you see after your treatment?
  • What will you to them and/or their parents to explain the safety measures?
  • Will you be in contact with any young pets? What will you do to protect them?

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Are There Things I Should Remember About Having Seeds?

You should not lift anything heavy or do any hard activity for the first two days after your seed implant. After that, you can do anything that you usually do except for riding a bicycle or motorcycle. It is best not to ride any kind of bicycle including an exercise bicycle or motorcycle for four to six months after your seed implant. Riding a bicycle or motorcycle will put pressure on your genital area (the part of your body that includes your penis, scrotum, perineum, and anus) where you had your seed implant. If you had low dose rate seed implants, this pressure could cause the seeds in your body to move.

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Will I Be Able To Have Sex After My Seed Implant?

Yes, you will be able to have sex after your seed implant. Most men find that they can have intercourse (sex) one to two weeks after there seed implant. If you had low dose-rate seed implants, there is a small chance that a seed may come out when you have sex. You should wear a condom for the first two months after you have your seed implant. This way if a seed comes out, the condom will catch it.

You can flush the condom down the toilet with the seed in it. You may see that your semen (the fluid that comes out of your penis at climax of sex) is brown or black. This is normal and comes from a little bleeding that may have happened when the needles were put in. This may happen one time or many times.

You will find that as time goes on, the amount of semen will become less. You probably will not have enough sperm to father a child. However, there may be a chance of making your partner pregnant. You and your partner should continue whatever form of birth control you were using.

Men who have brachytherapy can have problems having an erection (the penis getting hard enough for sex). If this happens, you may want to talk to your doctor or health care team about things you can do to deal with this. If you could not get an erection (the penis getting hard enough for sex) before brachytherapy, this will not get better after brachytherapy.

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Will I Need To See My Doctor After My Seed Implant?

Yes, your doctor will check you often after your seed implant to make sure everything is ok. Your first appointment with your doctor will take place two to four weeks after your seed implant. During this visit you will have a test called a CT scan (also known as CAT scan). A CT Scan is a special kind of X-ray that takes pictures of your body from many different views at once. CT scans take more detailed pictures than ordinary X-rays. The pictures taken from a CT scan will help your doctor see how your seed implant is working. Ask your doctor or health care team for more information about a CT scan. After this visit, you will see your doctor every three months for three years. You will also have PSA tests during this time.

Helping Yourself After Your Seed Implant

  • When do you need to see your doctor or health care team?
  • How can you reach your doctor or health care team?
  • What can you do to help yourself if you are tired?
  • What things about your treatment do you want to talk about with your partner?

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What Have I Learned By Reading This?

You learned about:

  • Brachytherapy
  • How to get ready for this treatment
  • What you can expect to happen before, during and after your seed implant
  • Possible side effects of this treatment
  • Safety measures you need to take
  • What things you can do to take care of yourself

If you have any questions, please talk to your doctor or health care team. It is important that you understand what is going on with your treatment. This knowledge will help you take better care of yourself and feel more in control so that you can get the most from your treatment.

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Key Words

  • Allergy: when your body is reacts to something in a bad way to something that is normally harmless such as medicines, certain foods, plants or animals.
  • Anesthesia: the medicine the doctor gives you to help you sleep or numbs your body so that you don’t feel pain when you have an operation.
  • Anesthesiologist: a doctor who gives you anesthesia and carefully watches you during an operation.
  • Anus : the opening of the rectum through which solid waste leaves the body
  • Bladder: the organ in your body that holds your urine until you urinate (pee).
  • Bowel: your intestines.
  • Brachytherapy (also known as seed implantation or internal radiation
  • therapy): a type of radiation treatment that works from inside your body to kill prostate cancer cells.
  • CAT scan (also known as a CT scan): a special kind of X-ray machine that takes pictures of your body from many different views at one time.
  • Catheter: the rubber tube placed in your body to drain urine from your bladder out through your penis.
  • Clear liquids: foods and beverages made from liquids that you can see through. This type of diet is easily digested and leaves no remains in your intestines. Constipation : when your bowel movements become less regular than normal and your stool is hard, dry, and difficult to pass.
  • Contrast: A medicine that you take orally or by IV that helps your prostate cancer show up better during a CT Scan.
  • CT scan (also known as a CAT scan): a special kind of X-ray machine that takes pictures of your body from many different views at one time.
  • Dose: amount of medicine.
  • Ejaculate (also known as semen): The fluid that comes out of your penis at the climax of sex.
  • Enema : an easy way to clean out your bowel by squeezing a small container of fluid into your bowels through your anus.
  • Epidural: medicine that numbs your body from the waist down so that you do not feel an operation.
  • Erectile dysfunction (also known as impotence): difficulty in getting or keeping an erection of the penis.
  • Erection: when your penis is hard enough to have intercourse (sex).
  • Fatigue: mental or physical tiredness.
  • Fiber: The parts of grains, fruits, and vegetables that are not digested by the body. Fiber helps the intestines take in water, which increases the amount of the stool and causes it to move more quickly through the colon.
  • General anesthesia: medicine, which makes you sleep during the operation.
  • Genital area: the area of your body that includes your penis, scrotum, perineum, and anus.
  • High dose-rate (HDR): a type of brachytherapy or seed implant that gives a large amount of radiation to your prostate cancer but does not stay in your body.
  • Hormone therapy: a prostate cancer treatment that lowers the amount of testosterone in your body.
  • I.V. (also known as intravenous (in-tra-vee-nuhs)) : medications that are given to you through a needle in your vein.
  • Impotence (also known as erectile dysfunction): difficulty in getting or keeping an erection of the penis.
  • Intercom : a machine that allows you to talk between two rooms.
  • Intercourse: the act of having sex.
  • Internal radiation therapy: radiation given from inside your body to treat prostate cancer.
  • Intravenous (in-tra-vee-nuhs) (also known as I.V.) : medications that are given to you through a needle in your vein.
  • Iridium wire: a high dose-rate seed implant.
  • Laxative: a medicine that helps empty your bowels.
  • Low dose-rate (LDR): a type of brachytherapy or seed implant that gives a small amount of radiation to your prostate cancer and stays in your body.
  • Mucous: a material made by your body to protect the inside of your bowels when they are irritated by the radiation.
  • Over-the-counter : medicines you buy without a prescription from your doctor.
  • Perineum: the area of the body between the scrotum and the anus.
  • Radiation oncologist: a doctor who specialized in the treatment of people with cancer.
  • Radioactive: a material that gives of high or low energy rays, such as x-rays.
  • Rectum: the final part of the intestines that ends at the anus.
  • Regional anesthesia (also known as an epidural): medicine that numbs your body from the waist down so that you do not feel an operation.
  • Retention: when you are unable to completely empty your bladder when you urinate (pee).
  • Scrotum: the muscular sac, which contains your testicles (balls).
  • Seed implantation (also known as brachytherapy or internal radiation
  • therapy): a type of radiation treatment that works from inside your body to kill prostate cancer cells.
  • Semen (also known as ejaculate): The fluid that comes out of your penis at the climax of sex.
  • Side effects: unwanted changes that may occur in your body after prostate cancer treatment.
  • Stool: the fecal matter that comes out at each movement of your bowels.
  • Testosterone: a male hormone called testosterone makes you grow hair on your face and body and have a man’s body shape and controls your desire for sex.
  • Tiredness : mental or physical fatigue.
  • Trans Rectal Ultrasound (TRUS): A finger-like probe that is placed in your rectum that uses sound waves to make pictures of your prostate.
  • Tumor : abnormal tissue growth.
  • Ultrasound: the use of sound waves to make a picture of an organ in your body.
  • Urethra: the tube inside your body, which carries urine from your bladder out through your penis.
  • Urethritis (yur-i-thrI-tis): a burning feeling when you urinate (pee).
  • Urinary : the parts of your body, which make and get rid of urine.
  • Urinate: to pee
  • X-ray: an imaging test that uses radiation to take a picture of the inside of your body.
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