Prostate Cancer Percent Treated By Brachytherapy

July 21, 2009 by  
Filed under Prostate Cancer

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Brachytherapy is a form or radiation treatment for prostate cancer that required implanting radioactive material into the tumor in the prostate gland or close to it. The procedure is also referred to as internal radiation therapy, interstitial radiation therapy, or seed implant therapy. It is often performed under local anesthesia, it spares healthy, nearby tissue, and it appears to be at least as effective as prostate type of cancer surgery (radical prostatectomy) for men with early-stage prostate carcinoma.

Many men choose this rather different form of radiation therapy in which the surgeon puts the radioactive, rice-size pellets directly into the prostate, where they emit radiation from within the gland because implantation is relatively simple, requires minimal hospitalization (lasting perhaps a day or two) and leaves no surgical wound. Of course it is limited in scope if a tumor extends past the prostate; but then brachytherapy may be combined with external-beam radiation therapy (EBRT) to attack the outer reaches of the mass. The seeds emit low-energy X-rays that only travel short distances. They eventually become inert but remain in the prostate permanently; and the risk of exposure to others is generally taken as insignificant.

Back in the days when permanent seed implant therapy became available (decades ago) its long-term results were unsettling, especially because the pellets had to be placed without the aid of imaging technology. This caused parts of the prostate to end up with few or no radioactive seeds. Then came the days when brachytherapists performed the procedure with the help of a template placed between the scrotum and rectum, making it about as effective as external-beam radiation or surgery for treating men who have low-stage tumors that seem relatively unaggressive. Some radiation oncologists even now combine external beam radiation and brachytherapy for intermediate to high risk situations.

Multiple retrospective analyses have been carried out which demonstrated that overall survival and disease free survival outcomes aren’t that different when brachytherapy is compared to prostatectomy and EBRT. Impotence rates are also similar, but radiation treatment generally appears to have lower rates of incontinence than surgery, although there are increased rates of mild rectal bleeding.

Prostate cancer treated by brachytherapy is best done for early stages of the disease, if curing the cancer is sought. The percentage success and non relapse rates are encouraging for the technique to be growing in popularity in the medical community.

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