Intraoperatively
Planned LDR Prostate
Brachytherapy
Experience the Most Targeted Prostate
Cancer Treatment
Prostate Cancer Research Institute | Brachytherapy
Steven Kurtzman, MD & Ankit Agarwal, MD
LDR Prostate Brachytherapy
LDR (Low Dose Rate) Prostate Brachytherapy is a highly effective, minimally invasive treatment for localized prostate cancer. At Western Radiation Oncology, we implant tiny radioactive seeds directly into the prostate to deliver a continuous dose of radiation over time — all while sparing surrounding healthy tissue. This outpatient procedure offers a fast recovery, fewer long-term side effects, and excellent cancer control.
Why Choose LDR Brachytherapy with Palladium-103 for Prostate Cancer Treatment?
When facing a prostate cancer diagnosis, choosing the right treatment is crucial for achieving the best possible outcome. LDR (Low Dose Rate) brachytherapy with palladium-103 is a precise form of radiation therapy that offers unparalleled precision in targeting and treating prostate cancer cells, while minimizing damage to surrounding healthy tissues and organs.
LDR brachytherapy involves the insertion of tiny, radioactive seeds directly into the prostate gland. These seeds emit a continuous, low dose of radiation over several weeks, gradually destroying cancer cells while minimizing harm to nearby structures. Palladium-103, a radioactive isotope with a short half-life, ensures that radiation is delivered in a controlled and targeted manner.
By opting for LDR brachytherapy with palladium-103, you’ll benefit from:
When done with intraoperative real-time adaptive planning, LDR brachytherapy can deliver millimeter level precision and accuracy to sculpt the radiation dose to your specific anatomy and "dose-escalate" to areas of concern while minimizing radiation dose to surrounding tissues
Conventional radiation therapy may require daily sessions for several weeks, while LDR brachytherapy is a one-time outpatient procedure
The precision of LDR brachytherapy leads to fewer side effects and a reduced risk of complications, such as urinary incontinence and erectile dysfunction.
The vast majority of men return to their normal lives the day after the procedure with minimal to no pain or discomfort
High Long Term Disease-Free Cure Rates
96.2%1
Low to Intermediate Risk
Prostate Cancer
85-90%2
High Risk
Prostate Cancer
DOUBLES cure rate for patients with high risk prostate cancer,
as compared to conventional external beam radiation therapy alone.
1 According to the largest international study of 1597 patients receiving Pd-103 implants across the world. Tang, Outcomes after PD-103 versus I-125 for low dose rate prostate brachytherapy monotherapy: An international, multi-institutional study, Radiotherapy & Oncology 2023
2 According to the ASCENDE-RT trial (Morris, International Journal of Radiation Oncology, Biology, and Physics, 2017), brachytherapy boost increased the biochemical progression-free-survival rates from 62% at 9 years to 83% at 9 years. More modern studies using intraoperative planning techniques, such as the TRIP randomized trial in Japan (presented in 2023), show a 9-year progression-free-survival rate of 90% for patients with high risk prostate cancer who receive a brachytherapy boost.
Low Rate of Side Effects
Sexual function
Urinary Function
Gastrointestinal function
Protects sexual function, with lower rates of erectile dysfunction, extremely low rates (1%) of long term grade 3 urinary side effects, and rare gastrointestinal side effects1
1 The PROTECT randomized trial as well as several other studies have shown that brachytherapy has the lowest rate of erectile dysfunction rates of all active standard of care treatment options for localized prostate cancer. The TRIP randomized trial, which used modern intraoperative planning techniques, showed a low 1% risk of long term grade 3 urinary or bowel side effects.
Fast Recovery Time
Our Expert Team of Physicians
Physicians at Western Radiation Oncology have completed over 7,000 cases of prostate
brachytherapy and currently perform more than 700 a year – more than any other
physician group doing palladium brachytherapy in the world per year
Dr. Steve Kurtzman, MD
Dr. Kurtzman is a national leader in the advent of intraoperatively planned prostate brachytherapy. He has taught physicians across the United States his technique since the 1990s and served on medical advisory boards for multiple companies in the prostate brachytherapy space
Dr. Ankit Agarwal, MD
Dr. Ankit Agarwal has treated patients with prostate brachytherapy across California, Arizona, and North Carolina. He also published extensively on the treatment of prostate cancer and specializes in the use of intraoperatively planned prostate brachytherapy
Testimonials
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Patient NM
Doctor Agarwal is one of the most professional and personable physicians I’ve ever dealt with. He truly cares about his patients and explains things in a manner that everyone can understand. I have complete confidence in him and trust him to make the best decisions possible. He is a quality person.
D
Patient DH
I’d like to thank Dr Kurtzman and his staff for the excellent care I received. His advice and consultation were clear and thorough. He and his staff were always available for questions. Once the decision was made we were able to schedule and have the procedure performed on a timely basis. And the best news is the procedure was a complete success and I am now cancer free!
S
Patient SA
In a time of great uncertainty and fear Dr Kurtzman and his team calmed our fears. He took the time to explain the steps, why we were taking those steps and how we move past this to a happy long life. The ability to bring peace of mind and a smile to our faces meant the world to my husband and myself.
L
Patient LLM
There are moments in life that shake you to the core and hearing the phrase “you’ve got cancer” is high on the list. From the initial consultation with Dr. Kurtzman to weekly visits with Dr. Agarwal, I felt I received exceptional care. I always had my questions and concerns addressed and clearly explained to me. It was clearly evident that the technicians and doctors worked as a team to plan my treatments and make any necessary adjustments.
T
Patient TK
Brachytherapy ("seeds") for prostate cancer with Dr. Agarwal and Dr. Kurtzman went very well, with minimal post-op side effects or problems. Dr. Agarwal was kind, thorough, explained everything in detail and was very correct in his assessments and advice. I feel very fortunate to have him as my physician, and recommend him very highly.
FAQs About LDR Brachytherapy
No. The procedure is done under anesthesia, so you’ll be asleep the entire time. Afterward, most patients experience little to no pain and return home within a few hours.
The most common side effects are urinary symptoms, including:
- Frequent urination, especially at night
- Slowed urine stream
- Occasional urgency or burning
Mild rectal irritation or bruising in the scrotal area may also occur. These symptoms usually peak 7–10 days after the procedure and improve over the next few weeks.
Radiation exposure to others is minimal. As a precaution:
- Avoid having small children sit in your lap for 4 weeks
- Stay 3–6 feet away from pregnant women during that time
- Use a condom during intercourse for 4 weeks in case a seed is passed
Otherwise, you can safely interact with others, including sleeping next to your partner and being around pets.
Yes. Most patients are prescribed:
- Tamsulosin (Flomax) to help improve urination
- Naproxen (Aleve) to reduce inflammation
Be sure to check with your primary care doctor if you are on blood thinners or have kidney problems.
You’ll need a follow-up appointment 2–4 weeks after the procedure. Post-procedure imaging including ultrasound or CT scan will be performed to verify proper seed placement.
Your urologist will continue PSA monitoring every 6 months. It may take up to 2 years for your
PSA to reach its lowest point (nadir)
In rare cases, patients may experience urinary retention. If this happens, a temporary catheter may be placed to help you urinate. Contact your doctor immediately if you have difficulty urinating.
WRO is a multi-physician, multi-location cancer treatment practice specializing in advanced, targeted radiation therapy for prostate cancer.
