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sues (Stages A, B, and C). Usually recommended to older men (over sixty-five years of age), side effects are fewer and less serious. They may include bladder inflammation, diarrhea, and bloody stools. While most men retain potency after treatment, as many as 50 percent eventually develop erectile dysfunction. While there is controversy about the effectiveness of radiation therapy versus radical prostatectomy, statistics have shown that the results of the two treatments are comparable in outcome up to ten years after treatment. 19
Brachytherapy
This procedure involves the implantation of radioactive seeds directly into the prostate, using hollow needles guided by real-time imagingusually transrectal ultrasound, CT scanning, or fluoroscopyto ensure proper placement of the seeds. Since radioactive seeds implanted in this way deliver radiation directly to the prostate without affecting surrounding tissue and organs, higher doses of radiation can be used. The seeds remain permanently in place within the prostate and become inert and inactive within six to twelve months. Complications accompanying this treatment are minimalusually urinary problems involving frequency urgency, or difficulty with urinationand tend to diminish by the time the seeds have lost their radioactivity. Nearly 90 percent of the men receiving this treatment retain sexual function, a very high percentage in relation to all other available curative treatments for prostate cancer.
While this treatment appears to be a good alternative for older patients or those who wish to avoid surgical procedures, it is still too soon to know its long-term effectiveness.
Cryotherapy
This procedure freezes prostate tissue by inserting probes containing liquid nitrogen through the perineum and into the prostate gland. Ultrasound imaging is used to guide the placement of the probes and to control the amount of tissue to be frozen. Although the treatment is performed easily (outpatient basis under general anesthesia) and recovery time is brief, the procedure can have many complications, including a 75 percent risk of impotence. In addition, long-term effectiveness of this treatment has not yet been established.20

 
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