Common Q&A

In this section you can find general answers to the questions that are most often asked by patients about brachytherapy and that have not already been covered in the other sections of this website. Please remember that every patient is different. Therefore, the answers to some of these questions may not apply to you. Contact us either via the website e-mail or if you prefer, by phone if you cannot find the answer to your question on this website. We look forward to talking to you and will treat anything you say to us about your treatment in strict confidence.

Some of the questions, particularly those that are specifically about your own treatment and symptoms can only be answered by our medical staff. We know that if patients are well informed and involved in making decisions about their treatment it can make a lasting and significant difference to how quickly and well they recover from treatment.

Receiving and understanding the right information during your visits to our Centre is vitally important to us. ‘Questions to ask: getting the most out of your appointment’ is a booklet developed by the Department of Health to help everyone get the best out of each appointment. Click here to go to the Department of Health leaflet

Common Q&A

Question:
Can the seeds come loose after implantation?

Answer:
This is technically possible, but it is very rare. Most of the seeds implanted are joined together by weaving them into a strand of absorbable material. This helps to keep them in the correct position inside the prostate gland. In the highly unlikely event that you pass a loose seed in your urine and can see it in the toilet bowl, the best course of action is to remove it with a pair of tweezers and place it in a sealed container. You should then contact your hospital who will provide advice for safe disposal.

Over the past 10 years we have never had a patient return a seed to us. Using the latest real-time technique the problem has been largely overcome.

Common Q&A

Question:
If I have brachytherapy do I become radioactive?

Answer:
No. Once you have had the seeds implanted you do not become radioactive yourself; it is only the seeds that are radioactive – not you! Most of the radiation is released into the prostate gland over the first 3 months and they continue to be biologically active for about 9 months in total. After that they are effectively inactive and they remain in the prostate as there is no need to remove them.

You will not be a hazard to your family and friends so there are no restrictions on being with them, although, as a precaution doctors recommend that you should avoid a long cuddle with a young child, or a pregnant woman, during the first 2 months after your implant procedure.

Common Q&A

Question:
What about my sex life after brachytherapy?

Answer:
Sexual intercourse should be avoided for the first 2 weeks after your procedure because there is a very slight risk that one of the seeds could come out in your semen when you ejaculate. You should use a condom for the first two or three times you have sex for this reason. If you are unsure about when you can stop using a condom, ask one of the team at the centre and they will advise you.

On the first few occasions you have sex, you may have some mild discomfort or irritation during, or immediately after intercourse. Your semen may also be discoloured due to the internal bleeding that may have occurred during the implant procedure.

Impotence (the inability to achieve a satisfactory erection) is a side effect of all prostate cancer treatments but it occurs less often following brachytherapy compared with surgery or external beam radiotherapy (EBRT), and usually responds well with treatment, for example, a PDE5 inhibitor such as Viagra®, Cialis® or Levitra®, which will be available on the NHS. Talk to us or your GP about obtaining a prescription. 

Common Q&A

Question:
If I have brachytherapy will I have to have any other procedures as well?

Answer:
This depends on your assessment in hospital and the extent of the cancer in your prostate gland. Sometimes brachytherapy is carried out with external beam radiotherapy (EBRT), and the consultant in charge of your treatment will advise on what will be the best treatment approach for you. For patients with a large-volume prostate, hormone treatment may be necessary to shrink the size of the prostate gland before brachytherapy can be done.

A further important consideration is that when you have had brachytherapy, you can still have surgical treatment at a later stage, in the very unlikely event that this is ever necessary (at our Centre 0.25% of patients or 4 patients out of 1,400 treated).

Common Q&A

Question:
If I have already had surgery on my prostate gland can I have brachytherapy?

Answer:
If you have had a radical prostatectomy and your prostate gland removed, brachytherapy cannot be done because there is no prostate gland tissue to accept the seed implants. If you have had less extensive surgery, i.e. transurethral prostate surgery (often abbreviated to TURP), brachytherapy may still be an option for you, and we will be able to advise you on this.

Common Q&A

Question:
If I have brachytherapy and my prostate cancer comes back, can I have further treatment?

Answer:
Yes. Following brachytherapy you will return to the hospital for an examination after 4–6 weeks, and then periodically as determined by your doctor (every 6 months or every year, for example). A rectal examination may be performed, PSA levels are checked and any side effects discussed. This follow up plan will be the same whether you have brachytherapy, radical prostatectomy or external beam radiotherapy (EBRT).

Some tests may be done to measure how fast your urine is flowing and to learn what amount is left in the bladder following urination to check how well your bladder is working. Repeat x-rays may be done at some of the follow-ups. A repeat prostate biopsy may also be done. If abnormal results are found during these follow-up visits then we will assess the best course of treatment and will discuss it with you.