Nick Mardle was back on his motorbike weeks after receiving low-dose-rate brachytherapy for prostate cancer in Hawke's Bay.
Nick Mardle was back on his motorbike weeks after receiving low-dose-rate brachytherapy for prostate cancer in Hawke's Bay.
A Hawke’s Bay man has become the first patient in the region to receive low-dose-rate (LDR) brachytherapy, a “minimally invasive” internal radiotherapy treatment for prostate cancer.
Nick Mardle, 64, now based in Nelson, underwent the procedure at Royston Hospital in Hastings in February this year, after being diagnosed with cancerin 2025.
“It’s not a death sentence,” Mardle said.
“For me, it actually changed my life. I’m more self-aware, I’ve got better attitudes, and my fitness has improved hugely.”
His journey began in November 2023, when a routine PSA blood test showed a concerning rise.
Despite 18 months of monitoring and inconclusive scans, a biopsy arranged by Hawke’s Bay urologist Dr Kenny du Toit confirmed the cancer.
While the diagnosis was “still a fright”, Mardle said it wasn’t entirely unexpected, with both his brothers having previously undergone prostate cancer treatment.
After researching his options, he chose LDR brachytherapy, a targeted form of internal radiotherapy where tiny radioactive seeds are implanted directly into the prostate.
During the procedure, the clinicians use imaging to place seeds in the prostate and carefully avoid sensitive structures.
The seeds remain in place and become inactive months after they have been inserted, and the radiation dose has been delivered.
The seeds remain in place and become inactive months after they have been inserted, and the radiation dose has been delivered.
The treatment, introduced in Hawke’s Bay earlier this year by a team of professionals including du Toit and radiation oncologist Dr Dorothy Lombe, had previously only been available in Christchurch and Tauranga.
“LDR brachytherapy is a well-established treatment of prostate cancer and should be available to many men in New Zealand, not just a small group in certain locations,” du Toit said.
“It is very well tolerated and a good option, particularly for older men.”
Lombe said treatment decisions depended on individual circumstances, but the option offered “an effective and minimally invasive” alternative for suitable patients.
Tiny radioactive seeds used in low-dose-rate brachytherapy are implanted into the prostate.
For Mardle, the appeal was clear: faster recovery, fewer side effects, and less disruption.
He said the procedure was done in the afternoon during a three-hour operation, and he was discharged after a day in hospital.
“Within a couple of weeks, I was pretty much back to normal, and riding motorbikes.”
Born in Hastings, Mardle said he felt “privileged” to be the first patient in Hawke’s Bay to undergo the treatment, paving the way for other men.
A CT image showing radioactive seeds used in LDR brachytherapy.
Despite the breakthrough, access remains limited.
Mardle’s treatment was co-funded by private medical insurance, costing him about $20,000 out of pocket, including travel costs from Nelson.
He said approval from his insurer came at the last minute, after a period of uncertainty while he was already in Hawke’s Bay for the procedure.
“I would have mortgaged my house and paid whatever it cost,” Mardle said.
“I suspect it might have been $50,000 or $60,000, and I would have paid that down in my own funds because it was so important to me to have this minimal invasion and fast recovery time.”
LDR brachytherapy is currently only available privately, with costs varying depending on insurance coverage.
Health NZ executive national director clinical Richard Sullivan said more than 4000 men are diagnosed with prostate cancer in New Zealand each year, with a five-year survival rate of 92% and declining death rates.
“While LDR brachytherapy is considered an effective treatment, particularly suitable for those wishing to minimise time off work or reduce regional travel for radiology, a review looking into the sustainability of the treatment would be required if it was to be reconsidered for the public system.”
Through the public system, current treatments available include active surveillance, radiation therapy, chemotherapy, surgery to remove the prostate or prostate tissue, hormone therapy, cryosurgery, and immunotherapy.
“The National Cancer Clinical Network is working hard to identify areas of prioritisation to deliver optimal cancer care pathways for the New Zealand population based on international guidelines,” Sullivan said.
