Frequently Asked Questions What is a volume study? A volume study is an ultrasound exam that takes a measurement of the prostate gland. This measurement is used to plan the seed placement into the prostate. Do I need to have a volume study, I had an ultrasound with my biopsy? Yes. The volume study is used strictly to measure the size of the prostate gland. The measurement that is obtained is used for planning seed placement. Unlike the biopsy there is no needle used and no specimen is obtained during a volume study. How long does a volume study take? You will be here for about one hour. The volume study will take about 20 minutes and then you will have time to discuss your treatment with the Doctor. If all looks good for seed implant, a Registered Nurse will take an in depth health history. If indicated, blood tests, an EKG, and a chest x-ray may also be done at this time. How soon after my volume study can I have the seed implant? Your seed implant can be scheduled in two to four weeks following your volume study provided you have medical clearance and you don't need hormone therapy before your seed implant. The doctor said that my cancer has spread beyond my prostate, can I still have a seed implant? Seed implant may still be a treatment option for you in combination with other treatment modalities. You should consult with the your Urologist and Radiation Oncologist. I had a TURP in the past, can I still have a seed implant? You may still be a candidate if only a small amount of tissue was removed. You should consult with the radiation oncologist. Can I drive home after a volume study? Yes. There is no anesthesia used. Can I drive home after a seed implant? No. You are given anesthesia and you need to have a responsible person drive you home. How long does the seed implant take? You will be at the Center for three to four hours. You will spend approximately 30 minutes in the pre-op area. The actual seed implant takes approximately one hour. Following the seed implant you will spend approximately one to two hours in the recovery area. How long do the seeds stay in me? The seeds are encapsulated in titanium and they remain in your prostate forever. What is a clear liquid diet? Any questions regarding a clear liquid diet should be referred to the clear liquid diet instructions. My daughter is pregnant. Are there any restrictions with regards to how close I can be to her? A pregnant woman should maintain a short distance - arms length - from the patient. See discharge instructions for details. (Iodine-125, Palladium-103) These recommendations should be followed for one year following an implant. Detailed, written instructions will be given to you after your implant. This information is based on recommendations from the American Association of Physics in Medicine. There are available leaded undergarments which decrease exposure by approximately 95-97 percent. This allows for unrestricted contact. Click here for more information: www.atnuke.com/ancLAB/anclead/leadwear2.html I have grandchildren that I see often. Are there any special precautions I should take after the implant? Yes, there are precautions that should be observed with regards to infants and children. The precautions change as time passes from the date of implant with regard to time and distance. The recommendations come from the American Association of Physics in Medicine and vary depending on the isotope used. These instructions are included in your discharge information. Iodine-125, Palladium-103) Note: This does not mean that children can't hug, kiss or sit next to you on the couch for limited amounts of time. These instructions pertain to the physical contact of sitting on top of the implant when a child sits on your lap. What is the difference between the Iodine and Palladium seeds? Radioactive palladium produces radiation more rapidly than iodine. Palladium seeds have been used in prostate cancer for about ten years, while iodine seeds have been used for prostate cancer for about 20 years. So far, the cure rates with palladium and iodine appear to be about the same. Both Isotopes are short lived or decay rapidly. This means they deliver the required dose in a short amount of time. The half life of Palladium-103 is 17 days and Iodine-125 is 60 days. What kind of physician typically performs the procedure and in what kind of setting? Prostate seed implantation is performed in an out-patient setting by a team of physicians consisting of a urologist, a radiation oncologist and an anesthesiologist. A radiation physicist and certified medical dosimetrist are involved in the planning of seed placement. Are there any side effects from non-surgical seed implantation? Complication rates with radioactive seed implants are less than those of radical prostatectomy or external beam radiation. After a radioactive seed implant, less than one percent of patients who have not had prior surgery will become incontinent, and about 15 percent of the men treated under the age of 70 will become impotent. In men older than 70 the impotence rate is usually higher. Some men experience mild discomfort in the groin area for two to three days, which is managed very effectively with over-the-counter analgesics such as Advil and Aleve. Some blood may be seen in the urine and ejaculate for a few weeks after the procedure. This is normal; however if there is persistent bleeding, one should consult his urologist. What are the advantages of prostate seed implantation over other treatment options? Prostate seed implantation is associated with lower rates of impotence and incontinence compared to traditional treatments, such as radical prostatectomy and external beam radiation. Prostate seed implantation is a one-time, low-impact procedure. Patients can return to normal activity (including work) within one to three days, with little or no pain. Surgical patients remain in the hospital for 5-7 days and require weeks of recovery at home. External beam radiation patients must visit a radiation treatment center almost daily over a seven to eight week period. Prostate seed implantation can usually be performed on an out-patient basis. This translates into considerable cost-savings to the healthcare system. The cost of a radical prostatectomy is higher than that for seed implantation. What kind of patient is best suited for prostate seed implantation? Prostate brachytherapy (seed implantation) is an alternative for men who have early stage prostate cancer (cancer that has not spread outside the prostate gland.) Seed implantation is also an attractive option for men whose poor health precludes radical surgery, or who may be unable to undergo 35-40 daily excursions for external beam radiation therapy. Does the radiation from seed implants pose any danger to organs or tissue surrounding the prostate? To his sexual partner? The procedure performed properly; seeds are implanted with pinpoint accuracy; they pose minimal risk to surrounding organs or tissue. This results in low complication rates to normal structures and maximizes radiation dose to the prostate. Seeds represent minimal risk to a sexual partner; however, patients should abstain from sexual activity for two weeks after the procedure. Are patients radioactive after the seed implantation? No. Although the seeds are radioactive, patients are not. Since the radioactivity has low energy and the placement is so precise, virtually all the radioactivity is absorbed into the prostate. How effective are seed implants compared to conventional therapies? According to ten-year results, patients treated with Iodine-125 / Palladium-103 showed a similar cancer-free success rate, with lower complication rates compared with radical prostatectomy and external beam radiation. Will the seeds that are implanted set off alarms like the ones at the airport? No. There should be no problem with security systems.