Radiotherapy is a great treatment option for prostate cancer.


Radiotherapy has been a great treatment option for prostate cancer patients. This is especially true for early stage prostate cancer patients, but good cure rate for later stage patients have been seen as well.


Radiotherapy does have side effects though. And for prostate treatments these side effects are usually related to the rectum receiving too much “spillage” radiation. This radiation can damage the rectum, and can cause side effects such as diarrhea and bleeding in severer cases.


There is a very difficult trade off to be made in prostate radiotherapy. It is between giving enough dose to the prostate, and minimizing the side effects for the rectum. This is because the two organs are right beside each other. It is commonly thought that it is better to give a curative dose to the prostate, rather than giving less dose to the prostate to try and spare the rectum from receiving too much dose.


This is done because if you don’t give the prostate enough dose to cure the cancer, what was the point in radiotherapy treatment anyway? So the way around this is to set tolerance doses for the prostate. Allowing the rectum to receive some does, but not too much.


A Radiotherapy treatment for prostate is usually planned so that it does not exceed these rectums tolerance dose.But, these tolerance doses have been obtained from population studies, therefore some patients maybe more sensitive than other. So patients can still have side effects occur.

Protecting the rectum during Radiotherapy


Some prostate radiotherapy patients will be recommended by their radiation oncologist to have a temporary implant inserted during radiotherapy. This implant will be inserted between the prostate gland and the rectum.  This implant helps protect you rectum during radiation therapy by moving the rectum away from the prostate by as much as 1.5cm.


Increasing this distance between the rectum and prostate has shown to reduce side effects, including rectum pain by more than half. And nearly half of patients treated with the implant experience higher quality of living bowel function.


Studies have found that there were no adverse effects in using this implant. There were no infections or ulceration after the procedure. The procedure was also found to have a very high success rate of 99%.


Lets look more closely at this implant and answer some common questions patients have before this procedure.  

MRI showing how the spacer moves the rectum away from the prostate

Why should you get an implant inserted during prostate radiotherapy?


The implant insures that there is a separation between the rectum and the prostate. This allows the radiotherapy treatment to deliver the correct dose to the prostate, and reduces the dose given to the rectum. Ensuring that the cancer can be cured and the side effects are minimized.


Not all prostate cancer patients are suitable for the implant treatment. This will depend on you current medical history and stage of your cancer.

Where will this implant be located?


The implant will be located between the rectum and the prostate. This is to increase the distance between the prostate and the rectum during prostate radiotherapy.


The procedure of inserting the implant is commonly done in a hospital or outpatient clinic. The entire procedure does not take long. Usually less than 30 minutes.  Inserting the implant is a surgical procedure but it is minimally invasive.



Who will insert this implant?


The implant is inserted by a doctor. The procedure is usually performed under anesthesia or local sedation. Two liquids are injected in the inter-organ space between the prostate and the rectum. Once these two liquids are mixed, a chemical reaction occurs and the liquids form a gel.


There are no special requirements in terms of preparation for the implant. Your doctor might have individualized instructions for you depending on your medical condition.

How long does it take to get it implanted? And how long will the implant last?


The entire procedure normally take less than 30 minutes, although it will take you longer to recover completely from the anesthesia if you have been sedated.  


Depending on the manufacture of the implant, it can last for more than 6 months.  This is not an issue thought, as after you have had your procedure it is normal for you to return back to your normal activities. This also allows enough time for you to have your treatment, which can take up to 7 weeks.


Is it safe to have an implant inserted during prostate radiotherapy?


The implants are based on the previously used surgical sealants. These surgical sealants have been used during brain and spine surgeries for many years. Using this gel in radiotherapy is thus taking an already approved medical product and using it in a different way.


What is this implant made out of?


There are different types of implants on the market. Each manufacturer of implants will be slightly different. Generally the implant is made of two liquids which mostly contain water. When these combine they form a gel.


The material that the implant has been made out of has been proven to be safe in the body.


Will I feel this implant during/after the prostate radiotherapy?


Patients have reported some temporary discomfort after the initial implant procedure. This is related to the injects and is totally normal. Typically,  the implants have not given any user any prolonged discomfort at all.


When will I be able to go back to my normal activities?


Basically, you can go back to your normal everyday lift immediately. Although, you should wait for the sedation has worn off. The implant will eventually be absorbed by your body. It will remain intact for more than 6 months. But it should not affect you in anyway.


Lessening side effects for Prostate radiotherapy


The system of injecting a temporary implant between the rectum is a great idea. It will lower the side effects greatly. But not only that, treatment sessions could possibly be shorter, as the radiation can be delivered in a much simpler way because it isn’t trying to work as hard to avoid the rectum.


The implant can also be used in a similar way for prostate brachytherapy patients.