Prostate Seed Implantation (Prostate Brachytherapy)

Prostate Seed Implantation, also known as Prostate Brachytherapy or Radioactive Transperineal Seed Implantation, is an advanced form of internal radiation therapy used to treat prostate cancer. Unlike external beam radiation therapy techniques such as SBRT or VMAT, which deliver radiation from outside the body, seed implantation delivers radiation directly from within the prostate—targeting cancer more precisely and minimizing exposure to surrounding tissues.

How Is Prostate Seed Implantation Performed?

Prostate seed implantation is a minimally invasive, outpatient procedure performed at an Advanced Radiation Centers (ARC) facility, a hospital, or an ambulatory surgical center (ASC). Most patients return home the same day.

The procedure is performed by your Radiation Oncologist, sometimes in collaboration with a Urologist. Here’s what to expect:

  • Upon arrival, you’ll be greeted by our nursing staff who will answer any remaining questions and prepare you for the procedure.
  • You’ll meet the Anesthesiologist to review the anesthesia process.
  • Once in the procedure room and under anesthesia, your Radiation Oncologist will use ultrasound imaging to measure your prostate’s exact size.
  • A personalized treatment plan is created using 3D computerized planning software, calculating the number of seeds needed (typically 30 to over 100 depending on prostate size and any additional radiation therapies).
  • A Foley catheter is placed while you’re asleep to help visualize and protect the urethra during the procedure.

Using real-time ultrasound guidance, your doctor inserts thin needles through the perineum (the area between the scrotum and anus) to place the radioactive seeds precisely within the prostate. Each seed delivers a controlled dose of radiation to destroy cancer cells from the inside out. Once placement is complete, a rectal spacer may be used to protect the rectum from radiation exposure. Occasionally, a cystoscopy is performed to examine the bladder.

You’ll recover in a monitored area before heading home later the same day. Foley catheter removal instructions will be provided and are usually easy to follow at home the next morning.

This therapy is ideal for men with early-stage prostate cancer. Benefits include:

  • Short, one-hour outpatient procedure
  • Targeted radiation with limited downtime

However, it may not be suitable for patients with:

  • Significant pre-existing urinary issues
  • Very large prostates
  • Higher-risk prostate cancers (e.g., Gleason score ≥7, PSA >10 ng/mL, perineural invasion on biopsy)

In certain cases, external beam radiation can be combined with seed therapy. Your Radiation Oncologist will help determine the best treatment plan based on your unique diagnosis and health status.

Several weeks before your procedure, you’ll undergo a short planning scan at an ARC location. You’ll also need:

  • Medical clearance from your Internist or Cardiologist
  • Preoperative lab tests or evaluations, if needed

Our staff will provide detailed instructions, including your arrival time and what to expect.

After your seed implant, it’s important to follow a few safety guidelines:

  • Maintain a 3-foot distance from young children and pregnant women for:
    • 6 weeks (if Palladium seeds were used)
    • 3 weeks (if Cesium seeds were used)
  • You will receive a radiation ID card to carry with you for medical or travel purposes (you will not trigger airport detectors).

  • Avoid strenuous activity for at least 2 weeks.
  • Light exercise is allowed after the first week.
  • You may be prescribed medications to manage urinary or perineal discomfort.
  • Your Urologist may also provide supportive medications for pain relief and urinary function.

In the days and weeks following the procedure, some temporary symptoms may include:

  • Mild soreness or bruising in the perineal area
  • Urinary urgency, frequency, or discomfort
  • Fatigue
  • Blood in urine, semen, or stool (usually resolves within 2–3 weeks)
  • Mild rectal irritation

Most symptoms can be managed with medications like acetaminophen and urinary relaxants.

Possible long-term risks of prostate brachytherapy include:

  • Erectile dysfunction
  • Reduced or absent ejaculation
  • Rectal irritation or bleeding
  • Urinary obstruction or changes

These side effects vary by individual and can often be managed with appropriate care.

Follow-up is essential to ensure the treatment is working and to monitor your health:

  1. A post-implant scan is performed about 4 weeks after the procedure.
  2. Your first follow-up appointment with your Radiation Oncologist will occur around 6 weeks post-treatment.
  3. You will then be seen every 6 months for the first five years to monitor:
    1. PSA levels
    2. Side effects or symptoms
    3. Physical exam findings

PSA testing remains one of the most important tools in tracking your response to treatment over time. You’ll also continue regular follow-ups with your Urologist.

Prostate Seed Implantation at Advanced Radiation Centers is a safe, effective, and convenient treatment option for many men with prostate cancer. If you’re interested in learning more about whether this approach is right for you, contact our team today to schedule a consultation.