Advantages

• Treatment takes just one or two days.
• Recovery is quick so you can return to your normal activities soon after treatment.
• The radiation is inside the prostate gland and does not travel far, so there may be less damage to the urethra, bladder and back passage (rectum).
• It is suitable for men who have bowel problems such as inflammatory bowel disease.

Disadvantages

• It can cause side effects such as urinary and erection problems.
• It requires one or two anaesthetics depending on the method used

You will have a planning session to measure the size and position of your prostate to work out how many radioactive seeds you need. This is also a final check that the treatment is suitable for you. You will probably have a general anaesthetic so that you are asleep during the procedure, or you may have a spinal or epidural anaesthetic, so that you are awake but cannot feel anything.

You may have the radioactive seeds implanted on the same day as the planning session (one-stage method) or you may have them implanted two to four weeks' later (two-stage method). You will have a general anaesthetic or you may have a spinal or epidural anaesthetic.

You will have a CT or MRI scan four to six weeks after seed implantation, or sometimes sooner, to check the position of the seeds. You will have regular follow-up appointments after this to monitor your PSA level and any side effects. If your treatment has been successful, your PSA level should drop, although it may start to rise again because your prostate will still produce some PSA. Some men may experience a rise and fall in PSA at around one to two years after treatment.

You can read more about what treatment involves in our Permanent seed brachytherapy fact sheet.

You may not have any side effects for several days until the radiation from the seeds begins to take effect. Side effects are generally at their worst a few weeks after treatment, when the radiation dose is strongest, but should then improve over the following months as the seeds lose their radiation.

The most common side effects are:

• Blood-stained urine or discoloured semen for a few days or weeks.
• Bruising and pain in the area between your testicles and back passage which can spread to your inner thighs and penis. This will disappear in a week or two.
• Discomfort when you pass urine and needing to pass urine more often, especially at night.
• Problems passing urine, erection problems, bowel problems and tiredness.

There is no way of telling which of these you may get or how bad they will be.

Some men who have had brachytherapy and external beam radiotherapy together find that they have worse side effects. If you already had urinary, erection or bowel problems before treatment, these may be worse after treatment.

You can read more about side effects in our Permanent seed brachytherapy fact sheet.

• Which type of permanent seed brachytherapy will I have? The one-stage or two-stage procedure?
• Will I have external beam radiotherapy as well as brachytherapy?
• What are the chances of side effects such as urinary problems, erection problems and bowel problems with this treatment?
• How will I know if the treatment has worked?
• What should my PSA level be after treatment and how often will you measure it?
  If my PSA continues to rise, what other treatments are available?

You can find a list of references used to produce this page in our online fact sheet.