RADIATION PROSTATE SEED IMPLANTS

INTRODUCTION

THE PROSTATE GLAND

The prostate gland is located at the base of the penis just below the bladder and in front of the rectum. It produces the fluid that transports semen during ejaculation The size and shape of the prostate gland vary considerably, but it is usually about two to three inches in diameter.

CANCER OF THE PROSTATE

HOW DOES RADIATION TREAT CANCER?

Even though the cancer is only visible in a portion of your prostate gland, there may be tiny amounts of cancer throughout your gland. For this reason, the entire gland is treated.

PLANNING THE IMPLANT

HOW IS THE IMPLANT DONE?

Remember, the implant procedure is not an operation requiring a surgical incision. Instead, thin needles are passed into the prostate gland through the skin between the scrotum and the rectum. As the needles penetrate through..the prostate, they are seen on the screen of the ultrasound machine and can be accurately guided to their final position. While the needles are being inserted, the ultrasound probe is in the rectum. The number of needles and seeds required vary from patient to patient depending on the size of the prostate gland. When each needle is in its correct position in the prostate the needle is slowly withdrawn while individual seeds are injected into the prostate. Both the probe and the needles are removed when the procedure is completed

The radioactive seed implant procedure is performed in the operating room and lasts about forty-five minutes to one hour. You usually receive a spinal anesthesia, leaving you numb from the waist down. You may also receive medication through an intravenous (IV) line which will make you drowsy.

After the seeds have been implanted, a catheter will be placed temporarily in your bladder to drain urine. After the implant, you will go to the recovery room for about two hours, until you have regained the feeling in your legs. While in the recovery room, you will have an ice bag placed between your legs to help reduce swelling of the Implant. area. The urinary catheter will be removed when you have regained feeling in your legs. Occasionally the catheter will be left in place for 24 hours.

There is surprisingly little discomfort after the implant, although some mild soreness is expected between the legs for one to two days. If you do feel discomfort, pain medication will be available for you.

WHAT PREPARATION IS REQUIRED BEFORE THE PROCEDURE?

Before the implant, you will he given specific instructions regarding some diet changes and use of enemas. The enemas will help move fecal material out of your lower bowel and rectum so that the ultrasound pictures of your prostate will be clear.

At midnight on the night before the implant, you should not eat or drink anything until after the procedure,

Approximately one week prior to the implant, you will have blood tests done and possibly an electrocardiogram (EKG) and chest X-ray. Your-doctor will determine which tests are necessary The test results are used to inform the anesthesiologist of your ability to tolerate anesthesia.

You will he asked to arrive at the St. Joseph Medical Center one hour prior to surgery. If you use aspirin or blood thinners such as coumadine for any reason, you must stop taking it altogether at least two weeks prior to the implant in order to prevent excessive bleeding

WHAT TO EXPECT AFTER SURGERY?

You may notice some blood in your urine; this is normal and should subside in approximately 24 hours. If, after 24 hours, the bleeding persists or if you.begin to pass blood clots, you should contact your urologist,

You should avoid heavy lifting or strenuous physical actively for the first two days once you are home, After that you may return to your normal activity level.

FOSSIBLE SIDE EFFECTS FROM THE PROSTATE IMPLANT

IMMEDIATE POSTOPERATIVE SIDE EFFECTS:

I Slight bleeding beneath the scrotum

2. Blood in the urine

3, Bruising and tenderness between the legs

These side effects are caused by the needles used to place the seeds. Usually twenty to twenty-five needles are used. The seeds themselves, and the catheter and other instruments used during the procedure, also can contribute to these side effects. If you should experience severe pain or severe bleeding, you should call your urologist.

A catheter is placed into the bladder during surgery and is removed several hours later, In some instances, it is left in overnight. It is normal to have some blood in the urine which will drain from the catheter. This bleeding may continue for several days, so do not be alarmed. If it becomes severe and/or is associated with large blood clots, call your urologist. Drinking plenty of water helps prevent blood clots and flushes the bladder.

After the catheter is removed it is normal to experience some burning with urination. If you cannot pass your urine within six hours after removal of the catheter, you need to contact your urologist or go to the Emergency Room for care. This is particularly true if you have a feeling of bladder fullness or bladder discomfort,

LATER SIDE EFFECTS

1 Frequent urination

2 Burning with urination

3 Sense of urgency

4 Weaker urinary stream

These later side effects are due to the irritative effects of the radiation seed implants into the prostate and can last for several weeks to months. The radiation causes swelling and irritation of the prostate which causes the above symptoms. Drinking plenty of fluids and avoiding caffeine-containing beverages may help to relieve these symptoms, If they are bothersome, medication from your radiation oncologist or urologist may be helpful.

Brainerd, MN 56401