About this page. This is a plain English summary of high dose rate (HDR) brachytherapy. It does not replace medical advice from your own doctor or specialist.
For full information and references, please read the detailed page.
What is HDR brachytherapy?
HDR brachytherapy is a form of radiotherapy where the radiation is delivered from inside the prostate, instead of from a machine outside the body. It is sometimes called internal radiotherapy.
The aim is to give a higher dose of radiation directly to the prostate, while keeping the dose to the bladder and bowel as low as possible.
How it works, step by step
- Under a short anaesthetic, around 20 thin wires are placed into the prostate. This part takes about 30 minutes.
- You then have a CT planning scan. A physicist works out exactly how much radiation each wire should give.
- That same afternoon, radiation is delivered through the wires.
- You have a second treatment the next morning, then the wires are removed in the afternoon, and you go home the day after.
- After about a week's break, you have around five weeks of external beam radiotherapy to finish the course.
Who is it suitable for?
The prostate has to be a certain size to fit the wires. If it is too large, HDR brachytherapy may not be possible.
For more active cancers, hormone treatment is often combined with the radiotherapy, usually for around 12 months. Studies have shown this combination works better than radiotherapy alone in this situation.
Important things to know
- Brachytherapy is still radiotherapy. It can cause urinary urgency and frequency, bowel changes, and effects on erections, like other forms of radiation.
- Not every prostate is suitable. The size and shape of your prostate decides whether the wires can be placed safely.
- You will usually need a short anaesthetic for the wire placement.
- The decision between brachytherapy, external beam radiotherapy, surgery, or active surveillance depends on your cancer, your other health problems, and your preferences. There is rarely one obvious right answer.
What you can do next
- Read the full detailed page with references and patient brochures.
- Short version: external beam radiotherapy.
- Short version: seed (low dose) brachytherapy.
- Short version overview of treatment options.
- Request a second opinion on a treatment plan.
- Call 02 8382 6980 to make an appointment.