Oncology

Study: Surgery unneeded for prostate cancer

Radioactive seeds produce good outcomes

The results of a 12-year study indicate that brachytherapy, or implanting radioactive seeds into the diseased prostate, is as effective as removing the prostate surgically with shorter recovery and fewer side effects such as incontinence and impotence. The study was presented at a medical meeting of radiation oncologists held recently in Washington, DC.

"Increasingly, patients are seeking, if not demanding, accurate estimates of their prognosis," explains study author Haakon Ragde, MD, medical director of prostate brachytherapy at Northwest Hospital in Seattle.

"Physicians also require such estimates, based on the most precise and up-to-date information, when planning therapy," Ragde says. "For the clinician and patient alike, a vital question has long awaited an answer: Is brachytherapy effective in the long term?"

Impressive cure rate

Ragde says the answer to that question is a resounding "yes." The Northwest Prostate Institute now has data on 215 consecutive patients treated with brachytherapy with a 12-year observed follow-up. The overall cure rate is 70%, equal or better than the best cure rate reported for any other prostate cancer treatment, Ragde reports.

Roughly 80% of those patients were considered at high risk for extra-prostatic extension
of the malignancy based on the size of the module and prostate-specific antigen levels; they were treated with a combination of external beam radiation therapy and seeds. The cure
rate at 12 years for those high-risk patients
was 79%.

In addition to its excellent cure rate, brachytherapy has several other advantages to traditional radical prostatectomy and external radiation, notes Ragde. Those include:

• Brachytherapy is performed on a cost-effective outpatient basis.

• The patient is in the operating room no more than 45 minutes and is discharged from the outpatient facility about two hours later.