High Dose Rate Brachytherapy
A type of internal radiotherapy that involves placing thin tubes into the prostate gland.
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.
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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.
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“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
How does high dose rate brachytherapy work?
- 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.
What happens before my high dose rate brachytherapy treatment?
- 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 brachytherapy
- 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.
Take 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.
What happens on the day of my treatment?
- 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 your
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
done 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.
Will I have pain during or after high dose rate brachytherapy?
- 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.
Will I need to take time off work during or after my high dose rate brachytherapy?
- 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.
Are there any special instructions after high dose rate brachytherapy?
- No special instructions.
- You will not be radioactive after high dose rate brachytherapy so you can mix with people normally.
Will I still be able to have children after high dose rate brachytherapy?
- 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).
Will I need to use contraception after high dose rate brachytherapy?
- 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.
More information about brachytherapy
Elekta is a radiation equipment manufacturer. They have a resource website that is all about brachytherapy. It offers views from patients and from healthcare professionals.
- There is a section on their website that is all about brachytherapy and prostate cancer (this link will open in a new external tab). They also have a useful downloadable guide: ‘Brachytherapy: The Precise Answer for Tacking Prostate Cancer’ (this link will open in a new tab - It is in PDF format so may not be compatible with screen readers). Listen to the PDF
Local services offering high-dose rate brachytherapy
Our services search tool will allow you to search for hospitals near you that offer high dose rate brachytherapy.
Frequently asked questions about high dose rate brachytherapy: A patient's view.
Listen to trainee consultant therapeutic radiographer Sam and prostate cancer patient Ian as they discuss Ian's treatment with brachytherapy.
About this information
- This information was reviewed in January 2024. Date of next review: 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.
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What are the risks of high dose rate brachytherapy?
Short-term side effects
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.
Long-term side effects
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.
Where does this information on risk come from?
- 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
- TThis information was reviewed in January 2024. Date of next review: 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 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
68 out of 100
Effect on relationships
Ability to make good connections with others
42 out of 100
Sexual activity
Ability to reach sexual arousal, either physically or emotionally
68 out of 100
Sense of self
Knowing who you are and what motivates you
55 out of 100
Wellbeing and quality of life
Feeling good and functioning well in your personal and professional life
68 out of 100
Mental and emotional health
Ability to think clearly, make good decisions, and cope with your emotions
58 out of 100
Fatigue
Feeling of constant physical and/or mental tiredness or weakness
77 out of 100
