Your
physician will review with you whether you may be a candidate
for a prostate seed implant. This will depend on many
factors:
Your Medical Health
As patients will require anesthesia for the seed implant, the
patient will to be medically fit to tolerate anesthesia.
A thorough review of your past medical history including
recent heart problems, especially heart attacks, strokes, use
of blood thinners, breathing problems, heavy smoking, etc.
Your Anatomy
Your radiation oncologist will determine if your pelvic
structure is suitable for a prostate seed implant by carrying
out an ultrasound or CT scan to determine possible
interference of the pelvic bones in accessing the prostate
during surgery.
Your Prostate Size
The number of seeds implanted into the prostate depends on the
size of the gland. The average prostate size increases
with age but the average prostate for a 65 year old white male
is roughly 35-50cc. The larger the gland, the more seeds
that need to be implanted and as such the greater the overall
radioactivity. This leads to greater side
effects. An ultrasound study must be carried out several
weeks prior to the implant to determine if it exceeds 60cc in
volume. If so, then patients are encouraged to begin a
course of hormone blockers for at least 2-3 months to shrink
the prostate to less than 60cc. The complication rates
increase significantly for a prostate gland greater than 60cc.
Your Urinary Flow
Patients with significant urinary flow problems will have a
higher probability of urinary complications with the
procedure. Urinary flow can be measured many ways but
the simplest is using the American Urinary Association (AUA)
Symptom Score. Patients with AUA < 20
are the best candidates for seed implantation.
to determine your AUA
score.
Your Type of Prostate Cancer
Prostate seed implants are most effective for early stage of
prostate cancer. Typically, seeds alone are most
effective in patients with low risk prostate cancer and in
some intermediate risk patients. Even if a
patient is not a candidate for just seeds alone, it may be
combined with radiation therapy and/or hormone blockers
depending on the patient's PSA, Stage and Gleason score.
to go back
to the definitions of
Prostate Cancer Stages, PSA or Gleason Score Definitions and
Low, Intermediate and High Risk Prostate Cancer.
