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~IN DEPT HEALTH Fax:6516432152 Aug 2 '01 9:37 P.Ol Brachytherapy PltonD#~~) (,i.r3-z-' 2,8' FWl# Radio Active Prostate Seed Implantation By Donald E. DOllhit. B.SC., M.S. Director of Research, Cincinnati College of Mortuary Science BRACHYTHERAPY ("brachy"- Greek meaning short) the implanting of radioactive seeds either within or a short distance from a tumor of the prostate, is a widespread method of non-surgical treatment of cancer. The treatment application has increased significantly in North America due to jmproved access to medical care and early diagnosis of prostate cancer in large part to the development of the prostate specific antigen test (PSA). According to estimates provided by the American Cancer Society, approximately 180,000 new prostate cancer cases will be diagnosed this year. Of those, 37,000 are predicted to die as a result of the disease. BACKGROUND The newest method of delivery of the radioactive seeds demonstrates one orthe oldest forms of radiation therapy utilized by oncologists. As early as 1900, radioactive tubes and needles were surgically inserted through the lower abdominal wall, perineum or urethra into the prostate. These highly radioactive sources were left in the patient for a prescribed period of time and removed. This method was painful, required general anaesthesia, and was not widely available to patients due to its highly invasive nature and lack of trained physicians to administer the radioactive chemistry. The procedurc evolved to the point where, in the early] 990's, the seeds could be placed within the patient without surgery. A specialized delivcry system resembling a conventional syringe and needle is used in conjunction with specialized imaging. This allows the physician to more accurately place the seeds for optimal effect. Further, the procedure can be performed on an outpatient basis. CURRENT :METHODS AND CREMATION CONCERNS Typically, s().-120~.ueds of radio~tivc,~12' CT PaHadium-l 03 are implanted. The seeds, measuring less than one-fifth of an inch and vrm~ating the diameter of pendI~areplaca1~.Jt ij IlfI:.~oftumt:Jrgowth of the prostate. EawRseed emits an intense.~ot'radiation, but the fieRi of ntdioactivity is apf'fOximately the,., 'a.&iall,~ ~5'8troun__t___-orgmS' act as a shiel":_.:.. - There is minimal exposure to anyone with contact with the patient unless <ffherwise cautioned by the attending physician. Depending upon the treatment prescribed and the stage of the prostate tumor, the seeds will be left in place from three months to one year. The seeds will "give up" in excess of 90% of their energy within the first six months. Iodine-125, one of the radioactive substances of choice and in widespread use worldwide has a half-life of 60 days. It is totally inactiv~.m.M:~ves, m_ days. I-f. g.