Prostate Brachytherapy: An Option in the Treatment of Early Stage Prostate Cancer

Permanent prostate brachytherapy is now well established in the therapeutic armamentarium of the clinical urological oncologist. Technological developments have revolutionised the procedure and have resulted in the ability to deliver high doses of radiation to the gland in a consistent and reproducible manner. Ten-year data confirm that it is equally as effective as either radical prostatectomy or radiotherapy in patients with similar prognostic factors. We describe the technique in place at our centre and review the anticipated side effects and long term outcome. As in many aspects of prostate cancer management, there are a number of controversial issues. These include the potential role of neo-adjuvant hormone therapy and also the possible use of combined external beam and brachytherapy. These issues are also briefly reviewed.