March 16, 2009 -- Question: Is targeted reseeding recommended if my PSA continues to rise after seed implantation?
Answer: If the PSA continues to rise after a seed implant, the question is whether or not the implant was adequately performed or whether or not there is disease outside the prostate that wasn't adequately irradiated. With the current techniques that we employ now, the quality of the implants, and the delivery of radiation specifically to the prostate, the likelihood of needing a reseeding process to place more seeds within the prostate, I would say, is extremely rare.
If a PSA continues to rise after the implant, I would be concerned that the disease is outside the irradiated field. And in that case, a different type of treatment may be employed.