Follow-up After a Permanent Implant
Frequently Asked Questions about Permanent Radioactive
Seed Implants for Prostate Cancer
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Main FAQ Page
Prostate Cancer Issues
Logistics of a Permanent Implant
Side Effects of a Permanent Implant
Potency after a Permanent Implant
Radiation Safety after Permanent Implant
Pros and Cons of Implants
Follow-up after a Permanent Implant
What follow up will there be after seed
implantation?
The first visit is at 4-6 weeks after the implant and a CAT scan is performed
at that time in the Department of Radiation Oncology. Thereafter PSA and
DRE (digital rectal examination) are performed every three months for two
years. After two years, we recommend visits every six months. After five
years, we recommend a PSA every six months and physical exam at least once
a year. We like to alternate these visits between the radiation oncologist
and urologist. If the patient has a good internist or family practitioner.
We also encourage participation of the patients internist/family practitioner.
How effective are seed implants compared to conventional therapies?
According to 7-year results from a number of centers, patients treated
with Iodine-125 and Palladium 103-seeds show an overall 87 - 95% 7-year
cancer-free success rate for early stage cancer. 84% with the majority of
patients with PSA levels less than 1.0 ng/ml.
What PSA level should be hoped for over the long term? What is a good
level of PSA after seeding?
Most of the medial literature supports the observation that patients
achieving a PSA level less than 1.0 ng/ml have a better prognosis than those
whose PSA does not go lower than 1.0 ng/ml within two years after the implant.
There are many patients who have stable PSA readings above 1.0. As long
as the PSA is stable and not increasing we are satisfied.
When should PSA be checked after an implant
and how often should it be repeated?
We generally recommend the PSA should be obtained at each follow up visit.
Usually the PSA is performed at three-month intervals for the first two
years and then every six months thereafter. A number of processes can elevate
PSA and not all increases represent cancer. Each patient's PSA rise needs
to be evaluated individually.
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