Brachytherapy and Fertility


Pros and Cons of Brachytherapy

There is no fail-safe, or fool proof, form of cancer treatment. All have benefits as well as risks. The same holds true for brachytherapy. Perhaps the single biggest advantage of brachytherapy is its effectiveness in treating cancer. Several long-term studies have put the recurrence-free survival rate somewhere between 77 and 93 percent [source: Prostate Cancer Treatment Guide].

Initially, brachytherapy offers quick treatment and fairly quick recovery compared to other prostate cancer options. This is especially true for low-dose treatments. Since the radiation seeds are confined to the prostate, this is little impact on the bladder, urethra or rectum. Men with bowel problems such as irritable bowel syndrome (IBS) often tolerate brachytherapy treatments well.

On the flip side, the very radiation that is being used to kill off cancer cells will diminish the prostate's normal productivity. The prostate will not produce the same amount or quality of semen until it has the chance to recover. Most men report a decrease in their amount of ejaculation [source: Prostate Cancer Treatment Guide]. The treatment can also lead to bruising of the patient's sexual organs, as well as the inner thighs and rectum [source: The Prostate Cancer Charity].

Also, brachytherapy, similar to surgical options, can lead to erectile dysfunction issues, but on a different timeframe. Because radiation takes longer to affect surrounding nerve tissue, including the adjacent erectile nerves, these problems are expected to develop anywhere from three to five years after treatment [source: Prostate Cancer Foundation]. There is also some concern that the radiation treatments can affect the vessels that supply the blood necessary for an adequate erection [source: Prostate Cancer Treatment Guide]. A patient's age and health can also result in problems with erectile dysfunction.

Some patients have complained of painful ejaculations initially after treatment, which can dull desire. However, most also report that those symptoms fade with time. A patient's ejaculate can also appear discolored -- red or brown -- following treatment. This is normal.

Though rare, seed migration can also be an issue. While these rogue seeds often pass through the urinary tract, they can also be passed during ejaculation [source: Prostate Cancer Treatment Guide]. As a result, doctors will encourage their patients to use condoms during sex the first few times post-treatment.

During brachytherapy treatment, patients may find they have a more frequent and urgent need to pass urine, more discomfort when passing urine, and bowel problems, such as diarrhea, trouble controlling bowel movements, and rectal bleeding. After treatment, they can develop problems with emptying their bladders, or experience an inconsistent or weak urine stream. These issues can sometimes be managed through physical therapy or medication.

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Sources

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  • Prostate Cancer Foundation. "Brachytherapy Following External Beam Radiation Therapy." PCF.org. (June 3, 2012) http://www.pcf.org/site/c.leJRIROrEpH/b.5841703/k.5D66/Brachytherapy_Following_External_Beam_Radiation_Therapy.htm
  • RadiologyInfo. "Brachytherapy." RadiologyInfo.org, with Radiological Society of North America and American College of Radiology. Revised, Sept. 15, 2011. (June 2, 2012) http://www.radiologyinfo.org/en/info.cfm?pg=brachy
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  • The Prostate Cancer Charity. "Permanent seed brachytherapy." Updated November 2010. (June 2, 2012) http://www.prostate-cancer.org.uk/info/prostate_cancer/treatment_brachytherapy.asp
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