The use of radioactive seed implantation after external beam radiation therapy has five-year disease-free rates around 50%. Because this approach delivers radiation to very localized areas, it is not an optimal treatment for men with tumors that have spread beyond the prostate. Studies to date have indicated that men with low pre-therapy PSA levels and low Gleason scores will likely do well, whereas those with more distant disease and short PSA doubling times fare worse.
As with brachytherapy used as a primary therapy, side effects tend to be less frequent and less severe compared with other therapies. However, some studies have found urinary incontinence rates of up to 25-50% in men undergoing “salvage” brachytherapy, so careful consideration of existing urinary function and expected loss of function should be discussed fully with your doctors before any decision is made.