A full 14.29% or 1 out of every 7 men will be diagnosed with prostate cancer in his lifetime. One out of every three men who die from cancer had been diagnosed with prostate cancer. While prostate surgery, or prostatectomy, has proven effective in healing the cancer, there’s a 10% chance of urinary incontinence and a 50% chance of sexual dysfunction after the procedure.
Cancer is normally treated with radiation, through a beam of radiation directed at the affected areas to kill cancer cells. Brachytherapy, to put it simply, does the radiation treatment from the inside out. It can also be called “internal radiation.” Small sources of radiation, called “seeds,” are placed in or near the affected area, for more targeted radiation treatment.
The Prostate Cancer Foundation of Chicago did a study over 11 years, from 1997 to 2008. They studied over 9,000 patients with prostate cancer. Of the patients, 67.5% were considered low risk, 29.36% were considered medium-risk or intermediate, and 1.01% were considered high-risk patients.
All of the patients were treated with brachytherapy, wherein an ultrasound probe located the affected area and radiation seeds were injected into the prostate. Of the patients, those considered low-risk had a 95% 5-year survival rate. Medium-risk patients had an 89% 5-year survival rate, and high-risk patients had a 71% 5-year survival rate.
To survive 1 to 3 years is considered healthy. Overall, prostatectomy 5-year survival rates range from 55% to 71%. While it is possible for lower-risk patients to survive up to 5 years without brachytherapy, only 29% of high-risk prostate cancer patients survive 5 years. Comparatively, brachytherapy for prostate cancer has excellent survival raters.
Brachytherapy simply means, literally, short-distance treatment. It is one of the earliest forms of radiation treatment for cancer, developed when radiation treatment was still new. The 1950s and 1960s saw the development of new forms of technology for brachytherapy, and it became an established practice in 1970. Like any other radiation treatment, it has certain long term side effects.
In brachytherapy, a small radiation source, or seed, is placed near the tumour or cancer cells themselves. This way, it is more targeted and more precise than a radiation beam attacking cancer cells from the outside. It also damages much less cells in the process. It can be given in low doses for a prolonged time, or in high doses for short bursts of time.
One of the most common side effects of brachytherapy for prostate cancer is radiation proctitis, or bowel problems. There may be rectal pain or diarrhea, but only sometimes for the long-term. Every now and then, there is some pain or discomfort with urinating for a few weeks. This also goes away soon.
Certain long-term side effects may include erectile dysfunction or impotence, which is what 40% to 70% of patients feel after therapy, especially if they are over 65, have other related health conditions, and are on additional hormone therapy. There may also be proctitis, or inflammation of the rectum, that can be treated by anti-inflammatory steroids.
Other long-term side effects include lymphoedema, which is sometimes caused by radiation treatment and manifests in leg swelling or in swelling of the scrotum. Another is cancer of the bladder or lower bowel because of the radiation, but only 5 to 6% of patients get this. Radiotherapy also has the risk of damaging or weakening bones, which can be cured with drugs or therapy.
Because there is no surgery, there are no surgery-related risks or complications. The lack of an external beam also minimizes tissue damage from radiation. However, there will always be risks with this kind of treatment. Regular check-ups with the doctor after therapy can quickly catch and treat any other concerns.