Why are certain patients ineligible for brachytherapy?
Low dose rate (LDR) permanent seed brachytherapy can also be an effective alternative in some men with early prostate cancer. It involves ‘radioactive seeds’ being implanted in the prostate under anaesthetic. The seeds are left in the prostate permanently where they slowly lose their radioactivity and treat the prostate cancer over several months. This type of brachytherapy is most suitable for men with early localised prostate cancers that are growing slowly (Gleason grade 6). It is not usually suitable for men with high grade or more extensive tumours. There needs to be a careful assessment of prostate size before treatment as men with large prostates can have an increased risk of urinary side effects with this treatment and this can be another reason why some men are not suitable for seed brachytherapy. If TURP has been performed previously, the radioactive seeds cannot be sited correctly in the gland. Pre-treatment with prostate-shrinking drugs such as LHRH analogues can sometimes
