Access to LDR brachytherapy
You're diagnosed with prostate cancer and you're interested in LDR brachytherapy as a form of treatment, what next? Here we explain a little about the process from diagnosis to referral for treatment.
Men find out that they have prostate cancer in a wide variety of ways. Following a diagnosis of prostate cancer your General Practitioner (GP) and specialist hospital team can provide you with more information about prostate cancer treatment options.
If your disease is low risk then you may also be offered 'active surveillance' or 'watchful waiting', which means that you will be tested regularly and monitored to see if your cancer starts to grow, or grow more quickly.
Depending on the type, grade and stage of the cancer, the specialist team will discuss with you when to treat it, and if so, the best options for treatment. If your cancer is localised and is of low to intermediate risk the treatment options include radical prostatectomy (surgery), external beam radiation and LDR brachytherapy (seed implantation) (Click here to view the treatment selector chart). While studies have shown that each of these treatments is equally effective at curing the cancer, they do have important differences with regard to their impact on quality of life and disruption of normal routine that should be carefully considered Your doctor and specialist nurse should be able to answer your questions (also see Is LDR brachytherapy right for me). You can also contact other groups such as prostate cancer charities in your region or country.
If you decide that LDR brachytherapy is the right choice for you, then you should ask your GP and/or specialist team to refer you to a hospital which performs this procedure. Brachytherapy can only be done in a hospital which has a Radiotherapy Department because it requires special equipment and the hospital must be able to handle radioactive material. There are radiotherapy centres that carry out the procedure in many countries around the world.
Referral to a radiotherapy centre performing LDR brachytherapy
Depending on which country you are in, seed brachytherapy will be available as a public or private treatment or often both.
In countries where brachytherapy is available in the public health care system you will be referred to specialist in a centre where the procedure will be carried out. In most of these systems there is unlikely to be an issue in funding your treatment given the medical approval that seed brachytherapy has received as a treatment option for prostate cancer.
If you want to be treated privately you should contact your private health insurance company,, and follow their procedure for referral to an LDR brachytherapy centre for treatment. Again, you will have a good amount of choice as to which centre you can attend.
Family Doctor/GP referrals
Men concerned about the risk of prostate cancer because of their age, race and family history of prostate cancer sometimes decide for themselves that they want to have a prostate specific antigen (PSA) blood test and rectal examination in order to find out if they have prostate problems. Sometimes a doctor may suggest these tests based on a man reporting certain symptoms. If your family doctor (GP) identifies a potential prostate problem because PSA test results are higher than expected or the rectal examination shows the prostate gland is enlarged they will typically refer you to a hospital specialist team (urologist, oncologist and specialist nurse) for further tests.
The specialist team will usually want to obtain prostate biopsies. This is because a definite diagnosis of prostate cancer can only be made by taking cells from the prostate gland and then looking at them under a microscope. Small amounts of the tissue that makes up the prostate gland are taken from any suspicious areas. Some tissue will be removed from different parts of the prostate to make sure they don't miss any areas of cancer. The result of the biopsies will help confirm the type, grade (Gleason Score) and stage (T1-T4) of the cancer, all of which are important to know before deciding how to treat the cancer.