Will I have fewer long term side effects with a seed implant?

Yes - because high dose proton radiation is delivered externally from a machine, the radiation still must enter the body from the outside and pass through organs like the bladder and rectum and hips to reach the prostate, causing much greater side effects than seed implants. A paper from a leading proton facility showed that following proton radiation, 41% of men had long-term rectal bleeding and 47% had long-term bleeding with urination (Gardner, 2002). Incontinence rates after proton radiation are unknown.

In contrast to proton radiation, long term side effects are very rare with seed implants. Urinary incontinence occurs in less than 1% of men following a seed implant. Other severe urinary problems are also very rare. (Zelefsky, 2007)

Will seed implants allow for improved preservation of my erectile function?

YES - The best erectile function preservation rates are obtained with seed implants. By pinpointing the seeds directly in the prostate, there is minimal effect on nerves that help control erections. Studies show that up to 90% of men maintain their erectile function after a seed implant (Cesaretti, 2007). Erectile function has never been evaluated after proton radiation. Because proton radiation needlessly treats outside the prostate (where the nerves reside) to a high dose, much greater impotency rates are expected.

 

A dose map of a prostate being treated with protons shows the excess radiation deposited outside the prostate. This is what causes the higher side effects.

A similar dose map of a prostate being treated with a seed implant shows no excess radiation outside the prostate, as the seeds radiate the prostate from within.