Royal Prince Alfred Hospital Royal Prince Alfred Hospital
Radiation Oncology

Prostate Brachytherapy

Since 2003, The Royal Prince Alfred Hospital has been performing High Dose Rate [HDR] brachytherapy treatments for prostate cancer patients as one of its main treatment modalities.


Radiation Oncologists performing a Brachytherapy prostate implant 

Brachytherapy is a form of radiation treatment in which a radioactive source is placed directly into the target [the prostate gland]. This type of radiotherapy treatment can safely deliver a higher dose of radiation precisely to its target whilst minimizing dose to the surrounding normal tissue. It is normally given in conjunction with a course of external beam radiation treatment with the aim of curative treatment for some types of prostate cancer. When administered with external beam radiotherapy it is given in two parts, before and during the course of external beam radiotherapy with a gap of two weeks between implants.
What Will Happen to Me During My Brachytherapy Treatment?
If brachytherapy has been recommended by your radiation oncologist as part of your treatment. You will be booked to have your first implant before you start your external beam radiation therapy.
A staff member will contact you by phone let you know a date and time for your brachytherapy treatment.
The procedure involves the assistance of several members of our radiation therapy team. These include your radiation oncologist, an anaesthetic doctor, a registered nurse, two radiation therapists and a physicist.
On the day of your brachytherapy treatment expect to be in The Radiation Oncology Department from 7.30am to 4.00pm.
The day before your brachytherapy implant you will be required to drink a bowel cleaning preparation to clear your bowel. This ensures you have an empty rectum for the implant the following morning. Make sure you have been seen by one of our nurses at least one week before the implant. He or She will provide you with the brachytherapy preparation instructions [please click here].
Your brachytherapy treatment is performed in two stages in our operating theatre.
Insertion of Your Needles and Dose Optimization
This stage takes about one hour.

Under anaesthetic, you will be positioned on the operating table.

Your knees will be raised and held steady in stirrups.

Your perineal area is cleaned with an anti-septic solution.

A urinary catheter is inserted via the penis into the bladder.

An ultrasound probe is inserted into your [empty] rectum. Under ultrasound guidance, 18 to 20 hollow round ended  needles are inserted through the template and skin into your prostate.

The needles are held firmly in place by a plastic template which is sutured to your perineum [the skin between your scrotum and anus] until the treatment time.

After this, your legs are placed back down on the bed and you will be transferred to our CT scanner.

The CT scan is used to localize the needles, the prostate, and the rectum allowing us to plan the optimal dose distribution in 3 dimensions.

Your Brachytherapy Treatment
This stage takes about 40 minutes. The actual treatment will take approximately 20 minutes. Prior to the treatment delivery our brachytherapy team will perform quality assurance checks on your treatment plan and delivery. This will normally take another 20minutes.
Once the treatment had been planned the radiation therapists will check all the treatment information and take you into the brachytherapy treatment room.
The radiation therapists will then connect the needles to the machine that  contains the radioactive source.
Once connected the radiation therapists will leave the treatment room so that hey can switch on the treatment machine. The machine moves the radioactive source by remote control to the needles inside your prostate.
The radiation therapists will be watching you at all times using cameras and they can also hear you.
The treatment should not cause any discomfort.
After the treatment the hollow needles and the template are removed by your Radiation Oncologist.
The urinary catheter is kept in until the urine is less bloodstained and is removed prior to your leaving the department.
Side effects
Side effects will vary from patient to patient. They may include:
  • Small amount of bleeding [small clots in your urine]

  • Inflammation of the prostate

  • Diarrhoea, and

  • cystitis (burning while urinating). These should settle down within a week or so, but may flare up again when you start your external beam treatment.

  • Possible infection

 Should you have any concerns or trouble urinating, please contact your Radiation Oncologist