The review funded by Cancer Research UK, in which academics at the Universities of Manchester and Leeds, The Christie NHS Foundation Trust and Leeds Teaching Hospitals NHS Trust screened 2,197 articles is published in the journal Frontiers in Oncology this week (9/09/21).

Despite advances in radiation treatment for prostate cancer, an established technique, it can reoccur in some patients most often within the prostate gland itself.

Localised recurrence is treatable and in many cases curative, however there is no consensus on the best option.

According to the research, more patients who had low-dose-rate (LDR) brachytherapy had side effects compared to high-dose-rate (HDR) brachytherapy and external beam radiotherapy (EBRT).

In LDR brachytherapy, doctors implant permanent low dose radioactive seeds in the prostate which remain in place but can sometimes move.

HDR brachytherapy, uses high-activity radiation sources that are temporarily placed within applicators inserted within the prostate, typically over 1-3 treatment sessions. The applicators are removed after each treatment with nothing left inside the patient. Both types of brachytherapy require a general anaesthetic.

EBRT delivers a high dose of radiation, with the aid of high precision computers, to the tumour while sparing the healthy tissue around it.

It is the least invasive radiation treatment and the patient does not require a general anaesthetic. With advances in this type of radiation treatment, EBRT can now be delivered to men with prostate cancer in 5 treatment sessions usually over the course of 2 weeks.

Short term side effects of treatment may affect both the urinary system and gastrointestinal system including pain, bleeding, frequency and urgency.

In the longer term, treatment may cause urethral strictures, a narrowing of part, or all of the tube that carries urine outside the body from the bladder.

The review found that in both the short and long term, LDR brachytherapy was associated with a much higher frequency of urinary and gastrointestinal problems than HDR brachytherapy and EBRT.