What is brachytherapy?

Brachytherapy is a type of radiotherapy. It is given from inside of the body. There are two types of brachytherapy:

  • High dose rate brachytherapy – sometimes called temporary brachytherapy
  • Low dose rate brachytherapy – sometimes called permanent seed brachytherapy.

Watch our short video to learn more about high dose rate brachytherapy. This animation was adapted in collaboration with Elekta. 

© Elekta All rights reserved. Elekta is independent from Prostate Cancer Research. 

HDR Brachytherapy

Important things to know

Who can have high dose rate brachytherapy?

You can have brachytherapy if your prostate cancer: 

  • Is contained within your prostate (localised or early stage) or
  • Has spread to the area just outside of the prostate (locally advanced).

What are the benefits of high dose rate brachytherapy?

  • There is usually only one treatment. So fewer visits to hospital than external radiotherapy
  • You can get back to work and normal activities quite quickly.
Jack
“The side effects I had with brachytherapy, were frequent bowel movements and some soreness for a few days after but that is about all can really remember.”
Jack
Frequently asked questions (FAQs) about high dose rate brachytherapy
  • Radiation damages prostate cancer cells. Cancer cells are not able to repair themselves very well. So, radiation can stop them from growing.
  • High dose rate brachytherapy puts a high dose of radiation inside the prostate for a short time. This means that the healthy cells around the prostate are less likely to get damaged. 
  • A few weeks before your brachytherapy you will have a pre-operative assessment. This will be at the hospital where you will be having your brachytherapy. You will:
    • Have blood tests 
    • Have heart monitoring (an ECG)
    • Be weighed
    • Be told what you need to do to get ready for your brachytherapy.

Getting ready for your HDR brachytherapypicture of 3 microenemas

  • You may be asked to:
    • Use a small enema the day before and on the day of your brachytherapy. An enema is when a small amount of fluid is squirted into your rectum. This helps to clear out your bowel. You can do this yourself.
    • Stop taking aspirin or other blood-thinning medicines. This can lower the risk of bleeding. Ask your doctor about your blood-thinning medicines.
    • tablets in a bottleTake some pills called Tamsulosin before and after the brachytherapy. This helps you to pee.
    • Take a course of antibiotics. This helps to stop infection.
  • If you are having a general anaesthetic, you will have to starve for about six to eight hours before your brachytherapy. 
  • You will not be allowed to drive for at least 24 hours after your general anaesthetic.
  • You will be visited by your doctor and the anaesthetist before you go for your treatment.
  • Your doctor will ask you to sign a consent form. This is a written record that says you have agreed to the brachytherapy and the anaesthetic. Always make sure you understand what is going to happen before you sign the form. Ask your doctor about any worries you may have.
  • When you have had your anaesthetic, your doctor will put a small, flexible tube into your bladder. This drains away yoururinary catheter in the bladder pee. This is called a urinary catheter. This will be taken out before you go home.

 

 

 

 

 

 

  • Very thin, tube-like needles are put into your prostate.
  • They go through the area between your back passage and your testicles (the perineum).
  • A small radioactive pellet is pushed into each needle one by one. The pellet stays in each needle for a short time. After about 20 minutes, the needles and radiation are taken out. This is usually surgerydone using general anaesthetic. This means that you will be asleep.
  • Some hospitals will use a spinal anaesthetic instead. This means that you will not be able to feel anything below your waist. The spinal anaesthetic will wear off after a few hours. 
  • The area between your back passage and testicles may feel a bit bruised and sore for a few day after your brachytherapy
  • Having a poo may feel uncomfortable for a few days.
  • You will need to take time off work to go to your planning and treatment sessions.
  • You will be asked to take it easy for a few days after the treatment
  • You should be able to get back to normal activities after about seven-to-10 days. 
  • Ask your doctor when you can go back to work and normal activities. 
  • No special instructions.
  • You will not be radioactive after high dose rate brachytherapy so you can mix with people normally.
  • Radiotherapy of any type can affect the amount and quality of your sperm. This may mean that you will have problems getting someone pregnant.
  • If you think you may want children, please talk to your doctor before starting treatment.
  • You may be able to have some of your sperm saved and frozen. This is called sperm banking or sperm cryopreservation. You can learn more about sperm banking on the Human Fertilisation and Embryology Authority website (this link will open in a new external tab).
  • Cancer Research UK also have information about sperm collection and storage. For more information visit Cancer Research UK's website (this link will open in a new external tab).
Sperm banking
  • You may still be able to get someone pregnant.
  • There is a chance that the radiotherapy may damage your sperm. This may harm babies who are conceived during your treatment.
  • So, you should use contraception during and after your course of radiotherapy.
  • You should talk to your healthcare team for advice about safe sex during and after radiotherapy.
  • You may also have problems getting and keeping an erection, and painful erections. You can get more information about sexual problems from your healthcare team. 

Our services search tool will allow you to search for hospitals near you that offer high dose rate brachytherapy.
  
 

About this information

  • This information was reviewed in January 2024. We will review again in January 2026.
  • References and bibliography available on request.
  • If you want to reproduce this content, please see our Reproducing Our Content page (this link will open in a new tab).

What is risk?

  • Risk is the chance something bad could happen when we do something. Even simple things such as walking down the stairs can have risks. But we take risks because we think it will be worth it. We need to think about both the benefits and risks of what might happen when we do something.
  • You should always ask your healthcare team about both the benefits and risks of any treatment.
  • Remember if they tell you about a risk, it doesn‘t mean it will happen to you. They may say one man in 10 who has this treatment will have a side effect. But they can‘t tell you if you will be the ‘one’ man who gets this side effect.
Risk vs Benefit
What are the risks of high dose rate brachytherapy?

Straight after you have had your brachytherapy you may have:

 

  • Soreness or bruising around the area between your scrotum and back passage (perineum)
  • Blood in your pee 
  • Blood in your semen
  • Loose or runny poo (diarrhoea)
  • Problems peeing.

If you are having brachytherapy alongside another treatment, for example, external beam radiotherapy, you may be more likely to have symptoms. 

After your brachytherapy you may:

 

  • Need to pass pee more often
  • Have problems peeing
  • Have pain when you pass pee
  • Need to pass pee in a hurry
  • Find it uncomfortable to pass a poo
  • Have problems getting or keeping an erection.

These side effects may last six-to-12 months after your brachytherapy.

If you are having brachytherapy alongside another treatment, for example, external beam radiotherapy, you may be more likely to have symptoms. 

  • The information on the risks comes from very large clinical studies. These typically involved thousands of people being watched over many years. 
  • There may be local data from your area. You can ask your healthcare team if they have this information too. 

About this information

  • This information was published in March 2023. We will revise it in March 2024.
  • References and bibliography available on request.
  • If you want to reproduce this content, please see our Reproducing Our Content page (this link will open in a new tab).

What is the impact?

  • We asked real visitors to the infopool to share their experience of this treatment. They told us how this treatment had impacted their everyday lives in a number of different areas.
  • The numbers and images below represent how many people said this treatment had impacted them 'a lot' in each of the different areas. As this site is new, this is currently based on a relatively small group of people who have responded about this treatment. Please take this into account when reviewing the information below.
  • For example, imagine it says ‘25 in 100’ underneath ‘physical and social wellbeing’. This means that 25 out of 100 people who shared their experience of this treatment told us it impacted their ‘physical and social wellbeing’ a lot. However, it would also mean that 75 out of 100 people said it had not impacted them a lot.

Physical and social wellbeing

Enjoying activities such as walking or going out to the pub

67 out of 100

Effect on relationships

Ability to make good connections with others

40 out of 100

Sexual activity

Ability to reach sexual arousal, either physically or emotionally

67 out of 100

Sense of self

Knowing who you are and what motivates you

57 out of 100

Wellbeing and quality of life

Feeling good and functioning well in your personal and professional life

67 out of 100

Mental and emotional health

Ability to think clearly, make good decisions, and cope with your emotions

57 out of 100

Fatigue

Feeling of constant physical and/or mental tiredness or weakness

77 out of 100