All You Need To Know About 4D Brachytherapy

Brachytherapy has been used in the successful treatment of prostate cancer for over 25 years and is a proven, effective alternative to other treatments including watchful waiting, hormonal therapy, surgery or traditional radiotherapy.

Brachytherapy is a targeted form of radiotherapy used for treating localised prostate cancer. This means that it can be used to treat patients whose cancer has not spread outside the prostate itself. Prostate brachytherapy is sometimes referred to as low dose-rate (LDR) brachytherapy or seed implantation.

‘Brachy’ means close. In prostate brachytherapy, a radioactive seeds (each the size of a grain of rice) are permanently inserted directly into the prostate gland to target the dose of radiation as close to the cancer cells as possible. This means that the cancer cells can be killed whilst minimising damage to the surrounding healthy cells.

Whilst there are a number of techniques currently used to successfully perform brachytherapy, the most recent, efficient technique, is a one-stage real-time technique that is not only quicker, but also more effective: 4D Brachytherapy.

In 4D Brachytherapy, the seed requirement is calculated in advance of the implant. Surgeons use a two-minute scan to take five key measurements of a man’s prostate. These are fed into a computer programme to work out how many seeds are needed and where they should go. This means that stranded seeds can be pre-ordered and loaded prior to the procedure, resulting in a more efficient use of operating room time and fewer clinic visits for the patient.

Up to 120 seeds are then inserted into the prostate in an operation that takes between 30 and 40 minutes. As with all LDR brachytherapy, these seeds are not then removed, but the radiation gradually diminishes over a period of about 6 months. Why choose 4D Brachytherapy?

  • Whilst LDR brachytherapy is also very efficient (the procedure lasting just 2-3 hours), with 4D Brachytherapy, patients are often discharged on the same day and may be able to return to work within 48 hours.
  • As with traditional brachytherapy, the highly targeted treatment means that higher doses can be used than in traditional radiotherapy, and this also helps to ensure the bladder and surrounding areas are not damaged.
  • Therefore, incontinence – historically a common side effect of prostate cancer treatment – is also much rarer, with fewer than one in 100 patients suffering bladder problems afterwards and, unlike surgery, patients do not need to use a catheter.
  • With 4D Brachytherapy, some 83% of men remain potent, more than both surgery and conventional brachytherapy
  • Perhaps most importantly, 4D brachytherapy is available on the NHS.

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