Newer treatments for locally-advanced prostate cancer

If you think that one of the treatments may be suitable for you, it’s best to discuss this with your cancer specialist. They can advise whether the treatment could be helpful in your particular case.

Brachytherapy

Brachytherapy is a type of radiotherapy| that uses radioactive ‘seeds’ inserted into the prostate. It is available in some hospitals in the UK. It is sometimes called internal radiotherapy, implant therapy or seed implantation.

It can be carried out under a general anaesthetic or a spinal anaesthetic (epidural).

Brachytherapy is only suitable for a small number of men with locally-advanced prostate cancer. It is usually given in combination with external beam radiotherapy|. 

There are two ways of giving brachytherapy:

• Standard brachytherapy uses small radioactive metal ‘seeds’ that are inserted into the tumour so that radiation is released slowly. The seeds are not removed but the radiation gradually fades away over about six months. There is no risk of it affecting other people.
• Temporary HDR (high dose rate) brachytherapy involves placing tiny plastic tubes (catheters) into the prostate gland. Radioactive seeds are inserted into the catheters for a set period of time, and then withdrawn. After the treatment, the catheters are easily removed and no radioactive material is left in the prostate gland.

Brachytherapy may cause some swelling of the prostate, which can lead to blockage of the urethra, so a catheter is sometimes inserted into the bladder to drain urine. This may be removed after a couple of hours or left in place overnight.

Antibiotics are given after the implant, to prevent infection. Most men go home the day after the implant, but some leave hospital as soon as they have recovered from the anaesthetic and are able to pass urine normally. After the implant it is best to avoid heavy lifting or strenuous physical activity for two or three days.

HIFU and cryotherapy

Two other newer therapies for prostate cancer are HIFU (high-intensity focused ultrasound) and cryotherapy.

HIFU uses a high-energy beam of ultrasound to heat the affected area of the prostate gland and kill cancer cells. Cryotherapy uses liquid nitrogen, which freezes and destroys the cancer cells. These treatments are usually only considered for men with early prostate cancer, but they may be offered as part of the treatment for locally-advanced disease as part of a clinical trial. Your doctor can discuss whether these treatments would be suitable for you.