Treatment Process
What should I expect during treatment? How long will it take? Patients are bound to have many questions. We have anticipated and answered the most frequently asked questions about the treatment process. We also provide procedure overviews that you can download and use with patients.
Prostate brachytherapy process
Treatment planning
The radiation oncologist prescribes the type and number of the seeds required to treat the cancer. The prostate gland is measured with an ultrasound study. The images of prostate, taken in small increments, are downloaded to a computer. A medical physicist generates a plan for seed placement based on the shape and volume of the prostate gland.
Treatment delivery
Throughout the procedure, the patient is positioned on the operating table with his legs up in stirrups. A needle template is placed against the perineum, the area between the scrotum and anus.
Guided by the template, Prospera seeds are inserted using long, thin SurTRAK needles. There are multiple methods of inserting the seeds. Loose seeds or strands of seeds may be used, depending on which is best according to the individual treatment plan. Typically 80 to 150 seeds are implanted, based on the size of prostate.
Ultrasound imaging ensures that the seeds are properly placed. The seeds are then implanted and the empty needles withdrawn. After all the seeds have been implanted, a CT scan or fluoroscope imaging may be used to verify proper seed placement.
The procedure takes 45 minutes to an hour, followed by several hours for recovery and observation.
The seeds are extremely small and minimize discomfort. The radiation does not pose a threat to others. Over time the radiation decays, allowing the seeds to remain in place even after treatment has ceased.
After treatment. Patients may be advised by their physician to be careful of strenuous activity, heavy lifting, and applying pressure to the area for six weeks after the procedure. After that, they may resume normal activities.
ClearPath APBI process
Preparation. At the time of lumpectomy, the surgeon inserts the ClearPath applicator into the surgical cavity. The applicator has multiple catheters that expand to the shape of the cavity. With the applicator in place the patient will be able to sleep comfortably and participate in most normal activities.
Treatment plan. The radiation oncologist prescribes the radiation dose required to treat the tumor bed. Then the radiation oncology team generates a plan for delivering the prescribed dose based on the volume, shape, and location of the surgical cavity. They use their familiar 3D treatment planning systems to conform the radiation dose to avoid nearby critical structures, such as skin, ribs, heart, and lungs. The dose can be distributed differentially by varying the source dwell-time within each of the ClearPath catheters. The distance from the radiation source to the tissue is always optimized regardless of the size and shape of the surgical cavity.
Treatment delivery. At the time of treatment, a radioactive source is threaded into the catheters of the ClearPath applicator. The treatment plan determines how long the seed remains in each catheter. Patients typically receive two treatments a day for five days. Then the ClearPath applicator is removed.
After treatment. Typically, patients can resume their normal activities immediately following treatment.
