Brachytherapy: A Highly Effective Prostate Cancer Treatment
A radioactive seed implant, also known as brachytherapy, is the technique of implanting radiation sources directly into the tumor. This technique allows the delivery of a highly concentrated, yet confined, dose of radiation directly to the prostate. Normal surrounding organs are spared excessive radiation exposure to reduce side effects and complications. Seeds are implanted through a needle which is inserted through the skin and into the prostate gland. The procedure is performed in a sterile environment and the patients typically go home within one day following the seed insertion.

At the Center For Cancer Care, brachytherapy by itself or in concert with 3-Dimensional conformal external beam radiation, has proven to be highly successful in the treatment of prostate and other cancers. Our team has successfully placed seeds not only within the prostate, but also outside of the prostate capsule (extra-capsular seed placement, or ECP). This innovation was developed and has been utilized in Tampa since 1991. ECP is especially appealing in a disease such as prostate cancer which commonly extends outside the prostate gland.

We are proud that our center has been recognized as one of the leading brachytherapy centers in the nation from the standpoint of patient numbers, variety of tumors treated and our overall experience with all types of brachytherapy. The Center for Cancer Care has created an outstanding implant team dedicated to prostate cancer research and treatment. Our success rate of over 90% has been demonstrated in the treatment of thousands of patients with long follow-up. UCH is currently the world leader in prostate brachytherapy using the Palladium 103 isotope.

Palladium Seeds
What are commonly referred to as seeds are actually tiny metallic cylinders made of titanium—3/16 in. by 1/32 in. diameter—which contain a radioactive material, in this case the radioactive isotope, Palladium.

Palladium-103 is a man-made radioactive material created through the use of a machine known as a cyclotron. Once the radioactive material has been created it is encased in a titanium shell which is then microscopically welded closed in order to completely retain the radioactive source.

Radioactive materials emit energy within a certain frequency of the of the electromagnetic spectrum in the form of photons (Gamma Rays) created by nuclear forces within the nucleus of the atom.

Palladium seed implants offer a host of advantages over other commonly used isotopes. Mainly, the energy of the radiation emitted from a Palladium seed is high enough to deliver an enormous dose to the prostate in continuous fashion, while sparing high radiation doses to adjacent organs such as the rectum and bladder. Additionally, Palladium-103 has the highest Radio Biological Effectiveness (RBE) of any of the commonly used radioisotopes. This isotope is therefore associated with a higher tumor cell kill while sparing normal cells maximally.

The Palladium Seeding Plan
Patients undergoing a seed implantation have a special ultrasound scan prior to the procedure. This, coupled with the rest of the staging studies or tests, is utilized to determine a target volume. From this target volume a computer seed placement coordinate plan is generated, showing the exact position where each source is to be placed. This is then modified by the physicians intra-operatively to fit the exact prostate anatomy.

Plans are formulated by physicists who are experts in the field of therapeutic radiation. The team at UCH is composed of world-class physicists and brachytherapy dosimetrists who have extensive backgrounds and experience in the discipline of therapeutic radiation oncology.

This means that your plan has been developed by a comprehensive team approach, all of whom have an extensive academic background in cancer care. This team effort means we can determine the best way the radiation can be delivered in your particular case without creating other dangerous side effects.

Our Experience
Experience has helped us determine who should and should not receive a seed implantation alone. Our data has helped us to determine what person would benefit from a combined approach treatment schedule such as 3-dimensional irradiation followed by seed implantation.

We have performed thousands of prostate implants with an extremely high success rate of local control along with a minimal complication rate. UCH's results are constantly analyzed, published and made available for both physician and patient reviews.

Many doctors may argue that seed implantation and irradiation can "burn bridges" and not allow future surgery if the cancer returns. The truth is that if surgery is opted for as primary treatment and the cancer returns, patients have few options since salvage irradiation is typically ineffective for "recurrence." Meanwhile, hormones only provide temporary cessation of cancer growth. Dr. Koval and Dr. Friedland do have numerous promising protocols for patients who develop recurrence after radiation.

For more information, please call the Center For Cancer Care in Tampa, Florida, at (813) 615-7238.

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