Other side effects

Bowel problems
Occasionally, patients can experience troublesome bowel symptoms after brachytherapy, such as an increased need to open their bowels or diarrhoea. These symptoms tend to start 6 months after the seeds are implanted and usually get better on their own over time. The symptoms can often be managed by changing your diet slightly, by reducing the roughage (fruit and fibre intake) or taking a medicine that stops diarrhoea. Many of our patients have found that Normacol®, a fibre supplement, available without prescription from most chemists, is very effective in regulating bowel function, if required.

Fewer than 1 in 20 men (less than 5% of patients) may develop difficulties with bowel movements. But bowel symptoms may be more common if you have had additional external beam radiotherapy (EBRT) before the brachytherapy procedure.

Urinary incontinence and erectile dysfunction
The two most troublesome side effects associated with all the radical treatments for prostate cancer are urinary incontinence (loss of bladder control), and erectile dysfunction (impotence).

Other side effects

The likelihood of getting these side effects for each treatment has been recently compared in an article in the Lancet (Jani and Hellman 2003 Lancet 361 1045-1053); a table adapted from this paper is shown below. The more plusses (+) there are the greater is the likelihood of these side effects occurring.

At our Centre we have looked at the incidence of these side effects in patients we have treated. In our early studies we found that less than 1% of patients we treated suffered from incontinence. In another study looking at the first 400 patients we treated with brachytherapy between March 1999 and December 2003, we found that 60 patients (15%) experienced temporary urinary retention.

Other side effects

Many of these patients had also received additional hormone therapy or EBRT or both. Using our latest brachytherapy technique, less than 5% of patients now experience urinary retention at any stage.

As a world-leading centre in prostate brachytherapy we have an ongoing research programme to continually improve the brachytherapy technique. The results of our most recent improvements have recently been published showing that 85% of the patients we treated had retained sexual potency one year after the seeds were implanted and 83% retained sexual potency after two years. Sexual potency deteriorates naturally as you get older. We found that about 75% of the patients we treated with brachytherapy who were sexually potent one year after therapy were still sexually potent after 5 years. There results are similar to the effects expected from aging.

Hormone therapy may also affect your ability to achieve an erection. We have found that over the long term, potency rates are similar to those treated without hormone therapy. Being proactive in treating men experiencing difficulties with erections causes a quicker resolution of the problem and improves erectile function in the longer term. If you find you have erectile problems please feel free to discuss this during your follow up consultations.