In the majority of cases, high dose rate brachytherapy occurs as combination therapy with external beam radiotherapy. Very rarely, high dose rate brachytherapy can occur in isolation.

For high dose rate brachytherapy treatment, the patient is admitted the afternoon prior to the procedure so that the bowel preparation can be completed. The hospital stay is usually two and a half days. In general the patient is admitted Wednesday afternoon and discharged Saturday morning.

On the morning of the procedure the patient is taken to theatre and placed in stirrups with the legs in the air on the operating table. A catheter is placed into the bladder via the penis to drain urine. An ultrasound probe is placed in the rectum to enable Dr Swindle to visualise the prostate.

Multiple hollow stainless steel needles are then inserted into the prostate under ultrasound guidance. They are then fixed to the patient by a special grid and remain in the patient until the completion of the treatment.

This procedure is usually performed under a spinal anaesthetic. During the treatment period when the needles are in place the patient needs to be on their back or side and the patient is not allowed to mobilise. On three separate occasions, the patient is taken to the radiotherapy department where radioactive wires are placed down the hollow needles directly into the prostate.

These radioactive wires are connected to a device known as a remote afterloader which is what generates the radioactivity within the wires. These radioactive wires are then left in the patient for approximately 10 minutes on each occasion and deliver a high dose of radiotherapy directly into the middle of the prostate. Once the radioactive wires are removed no radioactive material is left within in the prostate, unlike low dose rate brachytherapy where radioactive seeds are left within the prostate.

After each treatment in the radiotherapy department, you will be transferred back to the urology ward. Once the third treatment has occurred, the hollow needles are removed and the catheter is removed the following morning.

Using sophisticated computer software, the dose of radiotherapy can be tailored to the configuration of the prostate by changing the timing and placement of each radioactive wire. This allows delivery of a high dose of radiotherapy directly into the prostate, thereby minimising the dose of unwanted radiotherapy delivered to other nearby vital structures such as the rectum and bladder.