Oncologist Questions Prostate Cancer

Using radiation with prostate cancer

My uncle has been diagnosed with prostate cancer. He is 75 and his PSA is 7.2. One of the treatment options he was given is radation therapy. He said something about "seeds". What are these? How is that radiation treatment?

13 Answers

There are radioactive Iodine or Paladium seeds being implanted into the prostate gland in the operation room. They release radiation into the prostate tissue over a few months, sufficient to kill the cancer cells.
Radiation therapy includes external beam radiation and internal radiation. The external radiation therapy is to have radiation beams made by a machine. When we turn the machine on, the machine will deliver the beam and will radiate the site we want it to deliver radiation to. Patients receiving this kind of radiation will not be radioactive. The internal radiation is to have many little radioactive seeds implanted in the patient's prostate. The seeds will irradiate the patient's probate internally until the radioactivity is gone. So, patients with those seeds inside will be radioactive for sometimes. No kids should be arround them.
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Radioactive seeds are OK for treatment of prostate cancer, but I much prefer IGRT [Image Guided Radiation Rx.] since your Doctor can control the dose so much more accurately. I haven't used seeds for 15 years. Old Doc Shaw
Permanent seed therapy is either with Iodine or Palladium seed implanted into the prostate. Once introduced, they cannot be removed manually. Seed therapy is one form of radiation therapy for early stage disease. Most people use external beam and seed therapy together. High dose therapy is one strong iridium seed soldered to a wire and introduced into the prostate. In my view, the planning is better. However, both are invasive procedures. Today, we use non-invasive external beam radiation shaped precisely to envelop the prostate and surrounding tissue.
Radioactive seeds are metallic tube like devices which are placed into the prostate under ultrasound guidance which attempt to treat the prostate cancer locally.

Dr Cox
Seeds may be one of the options. Not every center can do this technique. Not every patient fits the best suited for this procedure. Call and ask about this and other options.
Thank you and we wish you and your uncle luck with his cancer. Seeds are a form of brachytherapy when tiny radioactive metallic pellets are inserted and left in the prostate. They're implanted for life. Your uncle's urologist is the best to answer whether or not your uncle is a 'seed' candidate, but here's a little quick information from a web search: http://www.webmd.com/prostate-cancer/radioactive-seed-implants#1

All the best.
The term for this treatment is "brachytherapy." The "seeds" are radioactive and deliver radiation to the cancer when they are left in place. It is appropriate for certain kinds of prostate cancer.
Before I go into what the "seed" treatment is, you should know there are many factors that determine what treatment is the best for your uncle, or if he needs treatment at all. For my answer, I am going to assume: 1. he is in good health (does not have uncontrolled diabetes, heart disease, etc.); 2. he had more than 3 cores on his prostate biopsy show he had cancer; 3. the Gleason score was 6 or 7 (a scale that determines how aggressive prostate cancer is); and his PSA didn't jump from a lower number (say 3-5ish) to 7.2 in under a year.
In this context he has three options available for him: 1. Active surveillance - they will follow his PSA roughly every 6 months to make sure he remains at low risk of it causing him problems, and then treating him when/if the time comes. 2. Surgery with radical prostatectomy. 3. Radiation therapy.
Within the realm of radiation therapy there are two basic types. The most common type is "External Beam". This is where the patient lays on a table and radiation is delivered by a machine that moves around him to deliver radiation. The radiation is very much like an X-ray in that the patient does not see or feel anything during the treatment. The catch here is that for prostate cancer, external beam radiation is delivered daily, Monday thru Friday, for about 9 weeks. The other type, the kind you are talking about, is called "Brachytherapy". This is where there is an actual source of radiation placed inside the patient to deliver the treatment. You can kind of think of brachytherapy as treatment "from the inside out" versus "from the outside in" as would be the case in external beam treatments. The "seeds" you mention are actual pieces of radioactive material that are placed in the prostate to treat the cancer. This is typically done in the operating room under anesthesia and the Radiation Oncologist puts many needles into the prostate and drops the radioactive "seeds" into place. Once the seeds are in place, they give off their radiation around a very small area over a period of time and eventually decay to where they no longer give off any meaningful radiation. These seeds are permanent and left in the prostate. Here the treatment (at least from your uncle's involvement) is really only one day, rather than the roughly 9 weeks of external beam.
Each of the radiation treatment options has it's own set of side effects that is beyond the scope of this reply, but it is important to talk to the Radiation Oncologist about the pros and cons of the two treatments.
Your question is really for a Therapeutic Radiation Oncologist, which I am not (I am a Diagnostic Radiologist who has specialized in breast cancer diagnosis). That said, radioactive seed implants, surgically placed within the prostate, do emit radiation to treat the localized prostate cancer. Best regards to your uncle.
I am a radiologist, not a radiation Oncologist, but I can answer your question. The seeds are themselves radioactive and are implanted directly into the prostate gland. That way, the tumor in the gland receives the therapy and radiation exposure to the rest of the pelvis( which can lead to problems later) is reduced.

"Seeds" refers to radioactive pellets that are inserted into the prostate,
and deliver radiation from the inside out. Radiation, whether from seeds,
or delivered by the more common method, from outside in, is very effective.
The five year relative survival for your father should be around 99%.
Thank you for allowing me to participate in your father's care.Per your inquiry, your father is a 75 year old male who has been diagnosed with prostate cancer, after presenting with a PSA of 7.2.However, in order to offer specific treatment recommendations, I would need to know the results from your father's biopsy. The biopsy results will inform me of the Gleason Score, which is essentially the 'grade' of the prostate cancer.The Gleason score and the PSA are the main factors that determine treatment recommendations, and would therefore guide your father's treatment decisions.The seeds that you mentioned are radioactive (iodine -125) seeds that are implanted in the prostate, by a procedure known as brachytherapy. These seeds are implanted to kill cancer cells. The implantation requires an outpatient surgical procedure during which your father would be under anesthesia, so that he does not experience any pain throughout the procedure.An expert radiation oncologist implants the radioactive seeds under the guidance of ultrasound imaging to ensure that the seeds are placed accurately.The procedure described is usually completed in approximately 1.5 hours (90 minutes).Should your father decide to proceed with radiative seed implantation, his Radiation Oncologist would provide him with detailed instructions about how to prepare for the procedure, what to expect after the procedure, as well as follow-up care.Best Regards,Sophia Edwards-Bennett MD PHD(Dr. EB)