Saturday, March 16, 2013

Prostate Cancer - Seed Implants

As I mentioned in my last prostate cancer update blog posting, after my "volume" procedure earlier this week, I qualified for radioactive seed implants.

That comes as a great relief to me because I don't have to go through hormone therapy to reduce the size of my prostate glad to qualify for seed implant.  While I was at the cancer center I talked to one man who just finished four months of hormone therapy and was in pretty bad shape.  I heard my doctor informing another patient that his prostate did not reduce in size after his hormone therapy.  So of course I was very apprehensive, so much so that I decided not to go through hormone therapy is that was the only option left to me.  Thankfully, I didn't have to make that decision.

My doctor's office called me and informed me that my seed implant procedure will take place May 2nd.  That is good timing because it permits me to attend next week's Bloggerpalooza.  

Bill and I can still take our annual spring vacation trip South to his hometown of Toccoa, Georgia and I can visit my roots in western North Carolina and my brother in Greenville, South Carolina.  Bill and I have been taking these trips for the past three years and look forward to them very much.

The following (for those of you interested) is what will happen to me during my seed implant medical procedure on May 2nd:

What Happens During The Procedure?

The entire procedure takes approximately 90 minutes. Most patients go home the same day.
A radiation oncologist and urologist perform the procedure. Both physicians are actively involved in all aspects of the implantation, from the planning to the post-operative care. During the procedure, the urologist provides ultrasound guidance and the radiation oncologist places the radioactive seeds.
The procedure is performed as follows:
  • After general or spinal anesthesia, the legs are elevated and padded very carefully.
  • The ultrasound probe is inserted into the rectum and is used to take pictures of the prostate. The probe remains in place throughout the procedure.
  • The radioactive seeds are loaded into the designated number of needles.
  • In a specific order, each needle is inserted through the skin in the perineum (the area between the base of the scrotum and the anus) and into the prostate using continuous ultrasound guidance. Once accurate needle placement is confirmed, the seeds in that needle are released. This process is continued until all of the radioactive seeds have been implanted. No surgical incision or cutting is necessary. For HDR, once the needle placements are confirmed, they are filled with a radioactive material. After a period of minutes both the needles and the radioactive material are removed.
  • The urologist inserts a tube with a camera called a cystoscope through the penis and into the bladder. If he or she detects any loose radioactive seeds within the urethra or bladder, they are removed.
  • If some blood is in the urine, the urologist may place a catheter into the bladder for a short period of time to ensure proper drainage. All patients are instructed how to drain urine from the bladder, if necessary.

What Are The Results?

Although it is a relatively newer treatment, results show that, in patients with similar types of prostate cancer, brachytherapy alone or in combination with external beam radiation therapy appears as effective as a radical prostatectomy and regular external radiation in 10-year follow-up studies.

What Are The Side Effects?

Urinary symptoms are the most common. These include frequent urination and a need to get to the bathroom quickly. Some men have a burning with urination and, in a few cases, an inability to empty the bladder completely.
These symptoms can usually be managed with medicine, and they improve over time. Temporary self-catheterization may be necessary to help drain the bladder
Urinary incontinence is rare in general. The risk may be somewhat increased in patients who have undergone a previous surgical procedure to remove a part of the prostate called a TURP (transurethral resection of the prostate). A doctor can minimize this risk by doing a careful prostate ultrasound before the procedure to determine how much prostate tissue is still present to implant the seeds.
Rectal bleeding occurs in less than 1% of patients. Diarrhea is rare.
The impotence rate at five years after the procedure is about 25% using brachytherapy alone. If hormone therapy is added, the impotence rate rises to 50%.

Special Considerations

Close, prolonged contact (such as sitting them in your lap) with young children and pregnant women should be limited for the first two months after the procedure.


Anonymous said...

Oh, please hold me in your lap right after the "procedure"! I have always wanted to GLOW IN THE DARK!

You do know that I am bringing a special item for you to the Spo-a-thon, right?

Peace <3

Ron said...


My only concern during this seed implant procedure is the catheterization. I don't have a good feeling about that. We will see.


Anonymous said...

I gotcha, Ron. I do not ever want anyone implanting a catheter up my thing! But I hear "they" do use KY!

Ron said...


I was offered the chance once before to have that instrument with a camera stuck up my penis and I decline. Looks like there is no getting out of it this time. Very invasive, I don't like it. At least I'll be knocked out when they put it on. Not when they take it out I understand.


David Jeffreys said...

Self-catheterization??? I cannot begin to imagine that!


Geo. said...

I had no trouble 7 years ago with a catheter being removed after recovering from open-heart surgery, Ron, but I was only in my mid 50s. I asked a close friend, who is 75, what he went through and he said,"I wish they'd told me to bring a towel for the ride home." He's ok now, 2 weeks later, but I hope your experience is closer to mine than his. Best of luck.

Ur-spo said...

back when I gardened (oh I miss that!) I would recite a small incantation as I put the seed into the soil. It starts with "A seed is a promise". I hope yours is no less fruitful.

anne marie in philly said...

(clenching her nether regions tight)

at least they will sedate you before they take full advantage of you. :-O

Ron said...

Anne Marie,

Every orifice I have will be poked, invaded, photographed and displayed by the time I'm done with this latest procedure. Thank God I will be sedated. Wake me up when it's over.


Ron said...

Dr. Spo,

I hope so too. No complications so I can get back with my life. I'm looking forward to at least six months without a doctor's visit. That would be a treat after this past year.


Ron said...


Ain't going to happen. I'll be out in space when I'm catheterized. Unfortunately, I'll be awake when they take it out. OUCH!


Ron said...


I have a lot of trepidation with this whole procedure. I'm hoping that I have minimal side effects. It seems that everyone has a different outcome. I do have a towel in the car, just in case. I hope I don't have to use it.


nitewrit said...


Gee,Ron,you won't be able to dawdle all those grand kids that call you going,"Grandpa, it's me, your favorite grandson...send money" upon your knee.

And no more lap dances at the Pink Pussycat gentlemen's Club for a while. How will you get along?

Maybe you can give your IPhone to a nurse and ask her to take pictures. Hmmm, wonder if you can get prints from that bladder-cam?

Lar (with my legs firmly crossed.)

Ron said...


Lots of invasive procedures in store for me. I think every orifice except my ears have been poke, probed, and explored this past year. Whoops! I forgot, they haven't put a medical instrument up my nostrils. That's probably next.


Amanda said...

I know, it all sounds terribly invasive, painful... but if it cures the cancer and you can live for another 25 years, have peace of mind, then it is worth it.

Ron said...

Absolutely right Nadege. That's why I'm going through this. While I am concerned with the many possible side effects of this procedure (none of the procedures are without side effects), I'm opting for more than the ten years of life that I was told that I could have if I did nothing and let the cancer grow. I'm hoping this time next year I have a successful story to tell. Thanks again for your always positive words of encouragement.