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