One of the treatments for early prostate cancer is the use of radiotherapy. This can be delivered externally, which is known as External Beam Radiotherapy and generally takes 6 weeks and can be associated with quite a few side effects. 

A more efficient alternative is the use of radioactive seeds implanted in the prostate known as Brachytherapy. The seeds are made of titanium and contain radioactive iodine. These seeds gradually lose their radioactivity over a period of time and can be placed in such a way as to create much higher doses of radiation to selected areas of the prostate with minimal effects on the tissues surrounding the prostate.  This therefore reduces the risk of side effects.

Brachytherapy is best offered to men who have a PSA test under 15 and preferably under 10 who have intermediate grade cancer (Gleasonís Grade 3) or less. Brachytherapy involves two steps, the first being the volume study during which the prostate is scanned and electronic images taken. These are then down loaded into a computer program to plan the precise placement of the individual seeds. The second step takes place approximately 4 weeks later when the implant is carried out. Ultrasound scanning is used to accurately place the seeds which are inserted via needles through the perineum (the area behind the testicles and in front of the anus).

This is a minimally invasive procedure with an overnight hospital stay. Men are fit to go home the following day with no restrictions on activities. The main problem associated with brachytherapy is that the radiation causes the prostate to swell temporarily causing symptoms of poor flow, getting up at night, hesitation and in some cases complete (temporary) urinary blockage. Approximately 30% of men will have mild bowel disturbance after the procedure and about 15% of men will develop impotence which fortunately responds well to the use of various medical treatments. The cure rates for brachytherapy are similar to those for surgery but with the advantage of minimal side effects. The major drawback for brachytherapy is its cost which is in the order of $20,000 - $26,000 although this is covered by insurance companies. Brachytherapy is not available through the public hospital system.