No. Having done 1300 cases I am really qualified for this question. The patient has the seeds placed under anesthesia...Its the needles that would have been painful. Once the seeds are placed the needles are removed and the patient is awakened. The seeds that remain are not felt. The catheter can be removed also but most leave it for 24 to 72 hours and that can have minor discomfort.
Not terribly. The seed procedure is done under anesthesia so the patient is not awake and doesn't feel the actual insertion of the seeds. Following the procedure the patient usually has a catheter in the bladder for up to a few days that can be uncomfortable. Usually there is urgency and frequency in urinating for several weeks with rare pain.
Seeds. No, after the initial implantation one cannot tell they are there.
Radiation seeds. There is usually no sensation caused by the seeds once they are implanted. The radiation they give off however, can cause some temporary burning sensation on urination.
Should be! The seed implant tends to increase lower urinary tract symptoms, especially in the first three months. It's best to have few symptoms to start. There is no pain after the procedure in most. My patients tell me they rarely use pain medicine that I provide.
No. Usually not, they can cause irritation of urethra for a short period of time that can be discomforting.
Various types. There are different grades of prostate cancer making some cancers more or less aggressive than others. Staging of the cancer is also important. If a man has advanced cancer and is treated with radioactive seeds alone, the likelihood of failure is so high that it is not an good option. We try to tailor treatment to each patient to maximize the long-term cure with the lowest side effects possible.
It depends on risk. Brachytherapy with radioactive seeds or with high dose rate (hdr) brachytherapy can be used for low, intermediate, and high risk patients. Most people believe that seeds or hdr is most appropriate for low risk patients and that intermediate and high risk patients should be treated with a combination of brachytherapy and external beam radiation.
Majority should. There are many different specialist and interests as well as options in prostate cancer therapy. The lowest cost, equal effectiveness, one day treatment, lowest complications with incontinence and impotence leads to seeds or brachytherapy. Too many turf wars and people just making more money doing other things leads the patient to get conflicting advice.
Size; other diseases. Almost anyone with a gland size of 50 grams can have seeds placed to adequately deliver dose. Some larger glands are too big to cover (some can be shrunk with hormones). Prosca factors make it riskier in some, and some cannot stop blod thinners, have ulcerative colitis, or other medical relative contra-indicatons.
Not for everyone. Well planned and executed seed implants are highly effective for prostate cancer. But not all patients are candidates due to size of gland, extent of disease, and other factors. Also, if your urologist is part owner of a radiation facility, then financial incentives are against using seeds, and more patients are treated at the radiation facility.
Why should it be? The 1st question in prostate cancer medicine is, should it be treated at all? If yes, then consensus is that all treatments are equal with respect to benefit. Variation occurs in toxicity based upon age, amount of pc, aggressiveness of pc, and the need to combine therapies. Suggest 2 opinions from different fields (medical oncology or urology or radiation) be obtained before deciding.
Rare. Very rare.
0.2%-8.8% in 1 study. The absolute answer of the chance of a fistula is, it depends. Having additional therapy such as external beam radiotherapy increases the risk as well as if the brachytherapy was used as a "salvage" treatment for residual cancer. Refer to the article below from the university of virginia: http://www. Ncbi. Nlm. Nih. Gov/pubmed/11066049 other complications: strictures, ed, proctitis, cystitis.
Very rarely. This is a complication, not a side effect and occurs in less than 1% of implants in most retrospective analyses. These fistulas are usually prostate to rectum and can cause leakage of urine through the rectum as well as chronic infection and pain. Like any procedure, prostate brachytherapy is safe and effective in the hands of an experienced radiation oncologist.
Can radioactive seed implants for prostate cancer cause complications like a vesiculorectal fistula?
Yes. It is possible, but fortunately it is extremely uncommon.
Yes. Having done 1300 seed cases I have never seen this complication. The skill of the doctor is therefore critical. If the seeds end up in the wrong place between the bladder and rectum a hole can develop and the above complication can happen. I am so good at knowing where the needles, seeds and rectum is I will never expect this in my patient. But it is listed in the consent form.
RECTOURETHRAL. This is one of the most feared, and thankfully rare complications of radiation therapy, external or with seeds. It can occur also in response to treatments for radiation proctitis, when attempts are made to cautering bleeding vessels in the rectum near the prostate. This condition is to be distinguished from a fistula from colon to urinary bladder which is much easier to fix., .
Not if done well. The beauty of a good implant is tht the seeds are "in and around" the prostae capsule, so the dose to the rectum is generally within tolerance. The problem comes when the seeds are maldistributed leading to excess dose to the rectal wall. I've never had this happen in 20 years of implants. (occurred once after cryo and external beam salvage attempt). No idess for gift basket (ur other?).
Fortunately Rare. 20 years doing seed implants, I have seen urethro-rectal fisutulas twice, fortunately not in my patients. In experienced hands this should not happen, and careful technique can help avoid this. Today most brachytherapists use axial and sagital ultrasound to ensure proper placement of needles and seeds so these rare complications can be avoided.
Is it okay for me to take a male enhancement pill even if I had prostate cancer eight years ago and got the radio active seeds? I'm in my 60's. My health seems to be great.
It. It is perfectly reasonable to use an ed medication such as cialis, levitra, (vardenafil) viagra if you are in otherwise good health. Best wishes.
I. I would be careful if you are thinking about taking one of the herbal or male supplement pills marketed to increase penis size. Many of these products contain dhea or other male hormones tha could theoretically stimulate growth of prostate cancer cells. Talk to your cancer doctor before starting one of these medications. They also are not likely to be very effective. Medications for erection problems such as viagra, levitra, (vardenafil) and Cialis do not have any male hormones and are perfectly safe to take ate prostate cancer treatment as long as your hear is strong enough for sexual activity and you are not on certain blood pressure lowering medications or certain drugs to ease urination. Again, talk to your doctor and get a prescription rather than getting these mess other ways.