Brachytherapy for Prostate Cancer | iBrachy Center, Vivantes Clinic Am Urban

The iBrachy Center at the Vivantes Clinic Am Urban in Berlin is one of Germany’s most specialized centers for interstitial radiotherapy, providing high-precision brachytherapy for localized prostate cancer. The unit offers both Low-Dose-Rate (LDR) and High-Dose-Rate (HDR) brachytherapy. These "internal radiation" techniques are designed to deliver a concentrated dose of radiation directly into the tumor while sparing the surrounding healthy organs such as the bladder and rectum. The clinic utilizes two primary forms of internal radiation tailored to the patient’s risk profile. Low-Dose-Rate (LDR) brachytherapy, also known as seed implantation, is the gold standard for low-to-intermediate risk prostate cancer. During this single-session procedure, tiny, rice-grain-sized titanium capsules containing radioactive Iodine-125 are permanently placed in the prostate. These seeds emit low-level radiation over several months to destroy cancer cells from within. For patients with high-risk or locally advanced tumors, the center provides High-Dose-Rate (HDR) afterloading therapy. This technique involves temporarily inserting a high-activity Iridium-192 source into the prostate for a few minutes via hollow needles. HDR is often used as a brachyboost in combination with external beam radiation to escalate the total dose and maximize local tumor control. Treatment at the iBrachy Center is characterized by computer-assisted, three-dimensional dose planning. Using real-time transrectal ultrasound and often merging it with multiparametric MRI data, the physicians create a digital map of the prostate. This ensures that the radioactive sources are positioned with millimeter precision to cover the entire target volume while creating a steep dose fall-off at the borders of the urethra and rectum. The procedure is performed under general or spinal anesthesia in a specialized intervention suite. By avoiding a large abdominal incision, brachytherapy's scalpel-free nature allows rapid recovery, with most patients returning to their normal routines within a few days. The clinical outcomes at Vivantes Am Urban align with international high-quality standards for interstitial radiotherapy. For localized, low-risk prostate cancer treated with LDR monotherapy, the biochemical cure rate (PSA progression-free survival) is reported to be over 94% at 10 years, with a cancer-specific survival rate of 99%. These results are considered equivalent to radical prostatectomy but with a superior quality-of-life profile. The rate of permanent urinary incontinence at the center is less than 1%, and the preservation of erectile function is significantly higher than with surgical removal of the prostate.