Together with Genesee Hospital physicist Margaret Henzler, Dombrowski then reviews the study and constructs a computer model of the prostate to determine the optimal activity and distribution of seeds needed to deliver a prescribed dose to the prostate. On the day of the implant, the patient receives spinal or general anesthesia. An ultrasound probe is placed in the rectum and adjusted so that the volume seen in the initial study is reproduced. Using ultrasound and a template as a guide, the physicians advance needles containing the Iodine or Palladium seeds into the prostate and deposit them in a grid-like fashion. After the procedure, which takes approximately two hours, team members perform a fluoroscopy to confirm the position of the seeds.
Titanium is an inert metal, which allows the implant to remain in the body forever.
Once placed in the prostate, the seeds essentially cover the organ with the radioactive field. The energy of the radiation is so low that most of it is completely absorbed in the prostate. After about three months in the case of Palladium, or a year in the case of Iodine, virtually all of the radioactivity is gone. It has a decreased risk of side effects, such as impotency and incontinence, and the treatment duration is shorter. Early survival rates appear to be equal to radical prostatectomy or radiation therapy, with data for seven years available.