Prostate cancer treatment: Is prostatectomy possible if brachytherapy fails?
My husband is considering radioactive seed implants (brachytherapy) to treat his prostate cancer. We've heard that if this treatment isn't effective, he can't have a radical prostatectomy later. Is this true?
- Lou / California
Answer
Prostate surgery after brachytherapy (salvage prostatectomy) is only performed in certain cases due to the significantly increased risk of fecal and urinary incontinence. Although the surgery can be performed at specialized centers, it is often an option of last resort as determined on a case-by-case basis. In general, prostatectomy is not an option for men with previous brachytherapy, as other treatments may be tried before a salvage prostatectomy.
Radioactive seed implants (brachytherapy) deliver radiation internally by implanting small, rice-sized radioactive pellets directly into the prostate. Potential complications of surgery on a man who's had radioactive seed implants may include:
- Impotence
- Incontinence
- Injury to the rectum
- Failure to heal
Selecting the right treatment for prostate cancer depends on many factors, including your husband's overall health, his age, the aggressiveness of his prostate cancer, and how he feels about the potential side effects. Treatment options include radiation therapy (either through an external beam or radioactive seed implants), surgery, hormone therapy and watchful waiting. Talk to your husband's doctor about the pros and cons of each treatment option before making a decision.
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