High-dose Rate (HDR) Brachytherapy - High-dose Rate (HDR) Brachytherapy

High-dose rate brachytherapy (HDR or Temporary brachytherapy) is a newer form of brachytherapy involving seeds that are placed temporarily in the prostate gland. These seeds stay in place for less than an hour and contain higher intensity radioactive material than traditional prostate seed implants.

Using sophisticated computer and radiologic techniques, the patient is fitted with a template that holds tiny tubes, also called catheters, in place. The catheters are placed within the prostate and pelvis, with a length of the catheter remaining outside the body for connection to the high dose radiation machine. The fitting of the template and catheters is done in the operating room, followed by an overnight stay in hospital. The catheters and the template remain in place for one to two days during each treatment. A series of radiation treatments, usually three, are given the day after the fitting of the template. A computer-controlled device pushes highly radioactive seeds into the tubes one by one and controls the length of time each seed remains in place, thus controlling the radiation dose in different areas of the prostate. A higher dose can be targeted at the tumor, with a lower dose given in the areas near the urinary tract and rectum. The tubes are then removed and no radioactive material is left in the prostate gland. The patient returns in two weeks and the same treatment is repeated. The treatment is relatively pain-free.

Criteria necessary for a patient to be considered for HDR brachytherapy:

Most prostate cancer patients are candidates for HDR brachytherapy, if so desired.