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Last Updated: Sunday, 30 January 2005, 01:35 GMT
'They put radioactive seeds into my prostate'
By Jane Elliott
BBC News Health Reporter

Patrick Mooney and Nurse Specialist, Janette Nichol.
Each year 27,000 men die from prostate cancer

Pensioner Patrick Mooney considers himself a very lucky man.

Just over a year ago doctors diagnosed him with prostate cancer during a routine check - now he is fit and healthy and credits a new form of therapy for his speedy and pain-free recovery.

Patrick was one of the first patients to receive the new form of brachytherapy, a type of radiation therapy for prostate cancer, at Guy's and St Thomas', Hospital. London.

Brachytherapy involves planting tiny pellets, known as 'seeds', loaded with radioactive iodine directly into the prostate gland, meaning less damage to the urethra, bladder and rectum.


And because the therapy is so localised it means patients often need less time off work and are less likely to suffer incontinence and erectile dysfunction.

Each patient has between 60-75 seeds implanted. These emit high doses of radiation directly into the cancer cells. They remain in the body, but over time become inactive.

I'm very lucky that this service was available at the right time for me
Patrick Mooney

In the past the patient would need two hospital visits for their treatment. One for the san and one to place the seeds.

Now doctors at Guy's and St Thomas', can use 'real-time ultrasound' which allows them to insert the needles and release the seeds, while they are scanning the patient.

This gives the most up-to-date picture of the prostate and the best possible chance of targeting the cancer.

And Mr Mooney said his treatment had been a great success.

"Apart from a few expected twinges which I've managed with painkillers, there have been no side effects. I'm very lucky that this service was available at the right time for me.

"Physically I felt fine with the minimal of discomfort. This has gone completely . The discomfort rapidly disappeared. There has been no pain no for months.


"I have problems urinating, but that is standard with this procedure, and I am having medication to balance that out.

"I have one friend who is a little older than me and he had it done privately and did not have the seeds.

"He had radiotherapy and monthly injections and he is still having discomfort. It was not as resolving.

Patrick Mooney
Patrick's cancer was diagnosed during a routine check

Mr Mooney, aged 74, had not had any symptoms of prostate cancer, but was referred by his GP for a routine check.

"My GP was of the opinion that I was of the age where things could happen and he thought it was not a bad idea that I had a PSA (Prostate Specific Antigen blood test, which is used to indicate cancer) test. I went for a test to the local hospital and it was high.

"I was sent into the chain and waited to see a specialist in Guys and they tested me again. The timing was very important because I entered the chain as this method was being used and the time fell right for me.

"The treatment they wanted for me was fitted by this treatment."

"It was fortuitous being in the right place at the right time. I was one of the first to go for the treatment."

Mr Rick Popert, Consultant Urological Surgeon, at Guys and St Thomas, who carried out Mr Mooney's operation said that the results of the new form of brachytherapy were proving very successful in low-risk cases (cases with a PSA of less than 10).

"Normally the prostate changes shape and size during an implant due to the number of needles that are inserted which means that the seed plan can be inaccurate by the time the seeds are implanted.

Prostate Cancer
Each year 27,000 men are diagnosed with the disease and 10,000 men die from it
Only men have a prostate gland, which is situated in the pelvis at the base of the bladder.
The prostate's main job is to make some of the fluid of semen

"As we carry out the procedure on the same day using real time ultrasound, we can be confident that the seeds are being accurately placed.

"We use an integrated computer software programme which means that we can adjust the treatment plan during the procedure.

"In low risk patients the outcome is comparable to removal of the prostate."

Day case

"We visualise the prostate, place needles between the prostate and the anus in the perineum. The probe visualises the prostate through the back passage.

"You can then say to the computer 'this is Mr Mooney's prostate and this is where the needles are. Give us a plan which will minimise damage to the urethra, bladder and rectum'."

"Patients have responded very well. They have all had good responses in regard to their PSA tests. It is far too early to say it has cured them because we will have to wait for another 15-20 years to know that."

Symptoms of prostate cancer
Urinary problems, including difficulty, increased frequency and flow problems
Lower back, pelvis, hip or thigh pain
Rarely blood in the urine

"We are the only centre in the UK using this and it is much more user friendly. A lot of patients like the idea of just having one visit."

The hospital now does about four of these ops each month and they are funded by an award of nearly 900,000 from the Guy's and St Thomas' Charity.

"If we select the patients who are a low risk and whose tumour is not developing quickly then the prospects are good.

With the addition of brachytherapy the hospital is one of the few in the country to offer the full range of treatments for prostate cancer including external radiation therapy, open radical surgery and keyhole surgery.

Chris Hiley, of the Prostate Cancer Charity said brachytherapy was proving a popular and successful form of treatment, but he stressed it was not suitable for everyone.

"Brachytherapy is proving to be as successful as conventional treatments and men particularly like it as it is less invasive and requires only a short hospital stay."

Prostate cancer care improves
09 Nov 04 |  Health

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