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Brachytherapy (implantation of the prostate) with permanent seeds is considered a standard treatment option for men with early stage, low risk prostate cancer. There is now published 15-year follow-up data (Seattle Prostate Institute) indicating excellent outcomes comparable to that of surgery and external beam radiation.
At the London Regional Cancer Program (LRCP), this procedure is done with Iodine-125 seeds as an outpatient elective procedure. It is offered to selected men with the following criteria: Clinical stage T1c, T2a or T2b (AJCC 2002 Staging). (Those with a prior TURP or stages T1a or T1b are NOT suitable); Gleason score less than or equal to 6; PSA10; Prostate volume less than or equal to 50cc.
Other factors determine whether you are suitable for the procedure including the number of extent of the cancer on prostate biopsy, your urinary function and overall health.
In London, permanent seed implant is typically performed under a general anesthetic as a day surgery procedure using 2D-ultrasound guidance with most men receiving their implant in the morning with discharge home by the early afternoon.
In collaboration with Dr. Aaron Fenster at the Robarts Research Institute we are developing new techniques for 3D-ultrasound robotic assisted prostate brachytherapy that promises to provide more flexibility and accuracy in delivering this treatment for men with early stage prostate cancer.
X-ray of the pelvis following a prostate implant demonstrating the pelvic bones and hips and the clustering of the brachytherapy seeds in the prostate.