With the rise in cases of men's prostate cancer comes a therapy known as brachytherapy. Low-dose rate prostate brachytherapy is usually well tolerated in patients with a history of inflammatory bowel disease. Episcleral plaque brachytherapy is a complex procedure and should only be undertaken in specialized medical centers with expertise in this sophisticated treatment program.

It is not yet known whether interstitial (within the tissue) brachytherapy is more effective with or without external-beam radiation therapy in treating prostate cancer.

Brachytherapy commonly uses radioactive "seeds" placed through 18 gauge needles into the prostate via a perineal template with rectal ultrasound guidance. High dose rate (HDR) brachytherapy is one of the latest advances in brachytherapy treatment methods and is performed as an outpatient procedure. HDR brachytherapy is effective for treatment of cervical cancer as an alternative to surgical removal of the cervix and uterus. Also, HDR brachytherapy is has been useful reducing the risk of recurrence of soft tissue sarcoma following surgery.

A less common form of this therapy is permanent prostate brachytherapy which is a form of LDR brachytherapy in which physicians implant between 60 and 120 rice-sized radioactive seeds into the prostate with guidance from ultrasound and X-rays. This also is becoming a more standard approach to coronary artery disease to prevent restenosis after angioplasty.

LDR Brachytherapy is performed under anesthesia, and radioactive "seeds" are each placed in needles that are inserted into the target through the perineum (the area between the legs, scrotum and anus). HDR Brachytherapy is performed under anesthesia, and catheters (hollow plastic tubes) are placed through the perineum to give access to the target areas.

LDR brachytherapy makes use of iodine-125 and palladium-103 stored in titanium cases usually referred to as the "seeds". A big advantage of HDR brachytherapy is that the final doses are known before any radiation treatment is given.

Some clinics utilize HDR brachytherapy for treating cancers of the prostate, breast, lung, cervix and nasopharynx. Endobronchial brachytherapy is an outpatient procedure again using radioactive sources placed within a bronchus (airway) to treat patients suffering from airway obstruction due to lung cancer and other tumors.

Though it's true that HDR brachytherapy is currently used for the treatment of cervix cancer in the UK, most of the techniques are based on conventional triple applicator systems and the use of the ring-tandem applicator is extremely rare. While brachytherapy is not commonly used for the treatment of vulval cancer in the UK, there are some options for the management of these rare patients with small vulval or vaginal recurrences not suitable for surgery.

Before the development of this type of treatment, surgery was the only option but now prostate brachytherapy is an alternative to traditional external beam radiation or surgery for men who have early stage prostate cancer (cancer that has not spread outside the prostate gland). The most common situation preventing brachytherapy is when a man has a prostate gland that is significantly enlarged from benign prostatic hypertrophy. Long term, the probability of retaining erectile function after brachytherapy is similar to or slightly better than with surgery or external beam radiation.

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