[1] In LDR brachytherapy, tiny radioactive particles the size of a grain of rice (Figure 1) are implanted directly into, or very close to, the tumour.

The procedure is less damaging than conventional radiation therapy, where the radioactive beam is delivered from outside the body and must pass through other tissues before reaching the tumour.

[4][5] Under a general anaesthetic, the radioactive seeds are injected through fine needles directly into the prostate, so that the radiotherapy can destroy the cancer cells.

[6] Unlike traditional surgery, LDR brachytherapy requires no incisions and is normally carried out as an outpatient (day case) procedure.

[9] No surgical incision is required; instead, the radioactive seeds are inserted into the prostate gland using needles which pass through the skin between the scrotum and the rectum (the perineum) and an ultrasound probe is used to accurately guide them to their final position.

{•figure•} shows the grid-like device used to guide the needles into the perineal area; co-ordinates or 'map references' on this grid or template are used to pinpoint the exact positions in the prostate where the seeds are to be placed.

[10][11] Doctors use a combination of factors such as cancer stage and grade, PSA level, Gleason score and urine flow (bladder emptying) tests to help them decide if a patient is suitable for LDR brachytherapy.

[10][11] LDR brachytherapy in combination with external beam radiotherapy may also be recommended for patients with later-stage cancer and higher PSA level and Gleason score.

[14] The rate of survival with no increase in average PSA levels after LDR brachytherapy is similar to that achieved with external beam radiotherapy and radical prostatectomy.

[7] LDR prostate brachytherapy (seed or polymer source implantation) is a very effective treatment for low to high risk localized cancer, with patients rapidly returning to normal activities.

[16] The complications include: In a 2006 study looking at patients' quality of life, LDR brachytherapy compared favourably with other treatment options.