What should you know about HDR brachytherapy for prostate cancer?

HDR means high-dose-rate. A team uses imaging and thin applicator needles or catheters to guide the treatment. The radioactive source travels into the applicators for a planned period, then leaves the body; the applicators are removed afterward. This is different from low-dose-rate brachytherapy, where radioactive seeds remain in the prostate. HDR may be used alone in selected situations or combined with external radiotherapy, depending on the cancer and treatment plan.

The prostate, bladder and bowel sit close together, so planning aims to shape radiation around nearby organs. Temporary urinary irritation, bowel changes, tiredness or sexual difficulties can occur and should be discussed before treatment.

Tell the team about blood-thinning medicines, urinary symptoms, allergies and previous procedures. Arrange transport if sedation or anaesthesia is used. Afterward, drink as advised, take prescribed medicines and avoid strenuous activity until your team allows it. A short-term catheter may be needed if swelling makes urination difficult. Keep follow-up visits so urinary, bowel and sexual effects can be reviewed and treatment response monitored.

Seek urgent medical advice if you cannot pass urine, develop heavy bleeding, have severe or worsening pain, a high fever, shaking chills, chest pain or sudden breathlessness. Difficulty passing urine can require prompt treatment after prostate procedures. Contact your oncology team about persistent bowel bleeding or symptoms that are getting worse rather than settling.

Why is HDR suitable for my cancer? Will it be combined with external radiotherapy or hormone treatment? What anaesthesia and catheter care are expected? Which urinary, bowel or sexual changes should I report?