1. Are any special tests utilized in advance of the treatment?

No.

2. Where is the procedure performed?

HDR is performed in operating room, using spinal anethesia and/or general sedation. The anestheisa and/or sedation ensures no discomfort during the procedure.

3. What preparations occur before the treatment?

You will lay on your back, knees bent and in holders (stirrups). When you are in position, the outer treatment area will be washed with a cleansing soap. A catheter will be inserted into your bladder and a transrectal ultrasound (TRUS) will identify the prostate gland. Once the preparations are complete, a template will be sutured in place to assist in the guidance of the implant needles. With the use of TRUS and fluoroscopic guidance, the implant tubes are carefully inserted through the skin surface to the prostate gland. The number of implant tubes will vary depending on the prescribed treatment.

4. What happens after the needles are in position?

X-rays are taken to verify the position of the implant needles. When the prescription is finalized and the HDR remote afterloader is programmed with your individualized treatment, you will be brought to the Radiation Oncology Department. The implant tubes are connected to the HDR machine via flexible cables to enable the radiation source to deliver the treatment. You may hear the machine moving the radiation source during the treatment, but you will not feel anything. Upon completion of the treatment, the radiation source automatically returns to the protective storage unit of the HDR machine. The implant tubes are disconnected and may be removed. You are not radioactive after the procedure.

5. How long does the actual treatment last?

The actual treatment takes only minutes, and the entire procedure lasts a couple of hours from start to finish.

6. Is only one treatment necessary?

Typically, three treatments are given during a day and a half time period.

7. How soon can I resume normal activities?

You may go home directly after completion of your treatment and return to a normal routine within a few days.

8. Will I experience any negative side effects?

One of the benefits of HDR remote afterloading is the lack of long-term side effects such as impotence and incontinence and short-term side effects such as nausea, hair loss and/or diarrhea, burning with urination and frequent urination.

9. What other benefits are associated with HDR?

Greater patient comfort, shorten treatment and recovery times and no unique pre-treatment reigmens (like special diets) are just a few of the other benefits. The accuracy of HDR enhances the chance of curing your cancer.

10. Is HDR a new procedure?

HDR is the latest advance in Brachytherapy -- the medical term for a radioactive source applied in or near a tumor.
Shortly after Marie and Pierre Curie discovered radium in 1898, Brachytherapy was first performed successfully to treat skin cancer on the face. Within a few years, radioactive sources were being used internally via an applicator or tube inserted in the body.
In the early 1990s, the average Low-Dose Rate Brachytherapy treatment ranged from 40 to 70 hours and required prolonged hospitalization and bed rest.
High Dose Rate (HDR) Remote Afterloading was developed during this time.