In addition, studies have suggested that the dose rate of the isotope used previously, iodine-125, was too low to eradicate more rapidly dividing cells. A newer isotope with a higher dose rate, Palladium-103, is now available. At the Virginia Prostate Center, a Palladium103 seed implant program was initiated in 1994. The transperineal ultrasound guided technique is currently used to insert 20 to 25 needles and 80 to 100 seeds. This is usually done under spinal anesthesia as an outpatient procedure.
Most patients resume normal activity in less than a week.
Complications have been minimal. Outcome analyses from multiple centers across the country show results at five years post-treatment, which appear similar to external beam therapy and surgery. Candidates must be chosen carefully, however. Implant is best suited to patients with small, localized tumors with low Gleason scores. For this type tumor, there is usually a fairly high risk of disease extension to the areas surrounding the prostate or to the pelvic lymph nodes.