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.

LDR brachytherapy with palladium-103 is the most targeted and precise form of radiation therapy available to treat your prostate cancer – Precise, Effective, and Minimally Invasive Radiation Therapy with Palladium-103 Intraoperatively Planned Brachytherapy Leads to Better Outcomes.

What Is Brachytherapy?

Brachytherapy is a type of internal radiation therapy where small radioactive sources are implanted directly into the body, close to the tumor. In prostate cancer, this involves placing radioactive “seeds” inside the prostate to deliver radiation from within.

What Is LDR Prostate Brachytherapy?

Low Dose Rate (LDR) brachytherapy involves placing tiny radioactive seeds—each about the size of a grain of rice—into the prostate. These seeds slowly release radiation over time to treat the cancer, and remain in place permanently. The radiation fades naturally over several weeks.

How Is the Procedure Performed?

The seeds are implanted using needles inserted through the perineum (the area between the scrotum and anus) under ultrasound guidance. The procedure is done while you are asleep under anesthesia. There are no incisions, and most patients go home the same day with little to no pain.

What type of radioactive seed is used at Western Radiation Oncology?

At Western Radiation Oncology, we use Palladium-103 (Pd-103) for prostate brachytherapy. This isotope delivers radiation quickly, with most of the dose given within the first month after implantation. Pd-103 is sealed within the seeds and becomes essentially inactive within two months.

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:

Highly targeted treatment

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

Shorter treatment duration

Conventional radiation therapy may require daily sessions for several weeks, while LDR brachytherapy is a one-time outpatient procedure

Lower risk of complications

The precision of LDR brachytherapy leads to fewer side effects and a reduced risk of complications, such as urinary incontinence and erectile dysfunction.

Minimally invasive procedure

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

Same day outpatient procedure

Procedure time:
30 minutes

Back to normal activities next day

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

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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

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Testimonials

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.