The Process of these Interventions
The Process of these Interventions
The Process of these Interventions
The procedure for permanent (with seeds) and temporary brachytherapy varies depending on the treatment.
During brachytherapy (permanent seed implant)
Your medical team will explain the exact procedure planned for you. Feel free to ask them any questions.
- An antibiotic will be given to you via infusion before the procedure.
- The procedure lasts from 1 hour to 1 hour 30 minutes.
- It is mostly done under local anesthesia. The lower part of your body is “frozen,” but you are not asleep. However, some patients may need to be asleep. Once you are anesthetized, a urinary catheter is placed.
- To visualize the prostate well and properly implant the radioactive seeds, an ultrasound probe is used. It is a small tube inserted through the rectum that provides clear images of the prostate, urethra, and rectum, acquiring images on the computer. The goal is to optimize irradiation to treat the tumor while sparing neighboring healthy organs.
- Ultrasound guides the insertion of needles for introducing the radioactive sources. These needles, containing the seeds, allow them to be inserted into the prostate. The needles are inserted through the perineum (the area between the testicles and the anus). The seeds (between 40 and 60) are placed with very high precision.
- No incisions are made. When the needles are removed, the skin closes immediately, similar to a blood draw.
- At the end of the implantation, you are taken to the recovery room.
- Usually, the urinary catheter is removed before you leave the hospital. If not, it is typically done the next day at a local community health center (CLSC). Normally, you leave the hospital in the evening.
During high-dose rate brachytherapy (temporary)
Your medical team will explain the exact procedure planned for you. Feel free to ask them any questions.
- The procedure lasts about 2 hours.
- The procedure is performed by an experienced radiation oncologist.
- This treatment is administered while you are “asleep” (general anesthesia or epidural). This ensures you feel no pain during the treatment, and you remain still, which is crucial. A sedative may be offered before anesthesia.
- A urinary catheter is inserted. It is a tube that goes through the penis and allows you to urinate.
- The doctor inserts small empty plastic tubes (12 to 18 catheters or more) into the skin, between the scrotum and the anus. These tubes are then inserted deeper into the body, up to the prostate, using a probe. At this stage, no radioactive source is added. The procedure takes about 45 minutes.
- The medical team ensures that these tubes are well placed and conducts a computer simulation to ensure complete treatment of the prostate and all targeted tissues. Such simulation’s main advantage is dose optimization. This method aims to administer homogeneous treatment to the prostate and reduce effects on normal structures (such as the urethra, rectum, and bladder).
- The tubes are connected to a treatment device. This device sends a radioactive source (Iridium 192) through the tubes. The treatment lasts 20 to 30 minutes.
- Then, the tubes are removed, and you are taken to the recovery room.
- Usually, the urinary catheter is removed before you leave the hospital. If not, it is typically done the next day at a local community health center (CLSC). Normally, you leave the hospital in the evening.
Your return home and instructions to follow are similar to those described for external beam radiotherapy.
Additional Information - Treatment options
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External radiation or Brachytherapy?
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Sources and references
Last medical and editorial review: April 2024. See our web page validation committee and our collaborators by clicking here.
Discover our animated video!
Symptoms, risk and screening
Are you over 50 years old, or have you been having urinary problems for some time now? This video is for you! Several diseases can affect your prostate, and it’s important to detect them early. Let’s take a closer look.
Anatomy
What is the prostate
The prostate is a gland:
- Located between the bladder and the penis, just in front of the rectum;
- Formed of 2 lobes which surround the urethra, a canal that runs through the center of the prostate, from the bladder to the penis, letting urine and sperm flow out of the body;
- The size of a walnut, which grows larger in size in your forties;
- That has a soft, spongy texture to the touch like a small, ripe plum.
The prostate is made of:
- Gland cells that secrete liquids for ejaculation;
- Muscle cells that participate in the evacuation of your sperm during ejaculation;
- Fiber cells that maintain the structure of the gland.
Around the prostate, we find:
- The seminal vesicles, glands that produce sperm and that are located on either side of the prostate;
- The vas deferens, the tube that carries sperm from the testicle to the seminal vesicles;
- The nerve bundles that control your bladder and erectile function and that are located on either side of your prostate.
Structure
Three main zones of the prostate
Peripheral zone
- The peripheral zone is the largest area of the prostate. It can easily be felt by the doctor during a digital rectal exam (DRE).
- Most prostate cancers start in the peripheral zone.
Transition zone
- This is the area located in the middle of the prostate, between the peripheral and central areas. It surrounds your urethra that runs through the prostate.
- With age, the transitional area increases in size until it becomes the largest portion of your prostate. This is called benign prostatic hyperplasia (BPH) or enlarged prostate.
Central zone
- It is the part of the prostate that is farthest from the rectum. This is why prostate tumors located in this area can not be felt by the doctor during a digital rectal examination.
- If the doctor is in doubt, the following information will help decide if additional investigation is necessary:
- Your PSA level
- Your age and family history
- Your ethnic origin
Fonction
In short
Your fertility and natural fertilization
- It produces … a prostatic fluid rich in enzymes, proteins and minerals that nourishes and protects your spermatozoa.
- It makes … a protein (APS) that is used to liquefy your sperm to facilitate the mobility of your spermatozoa.
- It allows … ejaculation by contracting.
- It promotes … fertility through its enzymes facilitating the penetration of sperm through the cervix.
- It is not related to the mechanism of erection. Therefore, the origin of erectile dysfunction lies elsewhere.
Additional details
Exocrine Function
The prostate is made up of thousands of tiny fluid-producing glands. Specifically, the prostate is an exocrine gland. Exocrine glands are so-called because they secrete through ducts to the outside of the body (or into a cavity that communicates with the outside). Sweat glands are another example of an exocrine gland.
The fluid that the prostate gland produces forms part of semen, the fluid that carries sperm during orgasm. This fluid, produced in the prostate, is stored with sperm in the seminal vesicles. When the male climaxes, muscular contractions cause the prostate to secrete this fluid into the urethra, where it is expelled from the body through the penis.
Urine Flow
The prostate wraps itself around the urethra as it passes from the bladder to the penis. Prostatic changes can affect urine flow. Increasing the size of the prostate or muscle tone may impede the flow of urine due to the close anatomical relationship between the urethra and the prostate.
Prostate Specific Antigen (PSA)
The prostate also produces a protein called prostate-specific antigen (PSA). PSA is released with the ejaculatory fluid and can also be traced in the bloodstream. The testing of PSA levels in the blood is used to detect prostate cancer. The level of PSA in the blood is usually measured in nanograms of PSA per milliliter of blood (ng/mL).
A raised PSA level
Usually, a PSA rate of less than 4 nanograms per milliliter of blood is normal, but age should also be taken into consideration as PSA levels gradually increase with age. A rise in PSA concentration may indicate the presence of:
- An enlarged prostate (benign prostatic hyperplasia)
- An inflammation or infection of the prostate (prostatitis)
- A prostate cancer
Your doctor will have you undergo other tests to determine the exact cause of the increase in your PSA.
We are here for you
You have questions or concerns? Don’t hesitate. Contact us at 1-855-899-2873 to discuss with one of our nurses specialized in uro-oncology. They are there to listen, support and answer your questions, and those of your family or your loved ones. It’s simple and free, like all of our other services.
Also take the time to visit each of our pages on this website, as well as our YouTube channel, in order to get familiar with the disease, our expert lectures, our section on available resources, the support that is offered to you, our events and ways to get involved to advance the cause..
Staying Informed
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The medical content and editorial team at PROCURE
Our team is composed of urologists, and nurses certified in uro-oncology with a deep knowledge of prostate cancer and other diseases related to the genitourinary system. Meet our staff by clicking here.
Sources and references
- Prostate Cancer – Understand the disease and its treatments; Fred Saad, MD, FRCSC and Michael McCormack, MD, FRCSC, 4th et 5th editions
- Canadian Cancer Society
- Prostate Cancer Foundation-PCF.org
- National Cancer Institute-USA
- American Cancer Society
- Memorial Sloan Kettering Cancer Center
- Prostate Cancer UK
Last medical and editorial review: September 2023
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