Brachytherapy, a newer, less invasive treatment for prostate cancer has shown better results for high-risk and intermediate-risk patients than the traditional surgical approach, according to a study published in the March issue of Brachytherapy. The less invasive procedure, brachytherapy, showed a cure rate more than twice that of prostatectomy over a 12-year period. The study was performed at a urology practice in Florida between 1992 and 2004. The authors reviewed the outcome of 1,707 patients 12 years after they had chosen to undergo either brachytherapy or prostatectomy to treat prostate cancer.( Prostatectomy is the surgical removal of the prostate. ) All the patients in the study had organ-confined prostate cancers, which means that the cancer had not spread outside of the prostate.

The newest and most advanced type of Brachytherapy is high dose rate brachytherapy. Instead of placing radioactive seeds in the prostate a single high intensity radioactive source is delivered to the interior of the prostate over a short period of time, typically 10-15 minutes. The procedure utilizes a robot like machine to deliver the radiation. With this procedure there is no persistent radioactivity or foreign particles left in the prostate. Studies suggest that patients undergoing high dose rate brachytherapy experience less side effects and symptoms than with conventional seed brachytherapy.

Conventional brachytherapy is the implantation of small radioactive pellets (seeds). Radiation delivered by both types of brachytherapy radiation prevents the cancer cells from dividing for weeks or months.

For the study mentioned above, 1177 (brachytherapy) and 281 (prostatectomy) patients had sufficient data to be included in the review. Patients were classified as high risk, intermediate risk, and low risk. The authors found that the cure rate for brachytherapy in high-risk patients was 88 percent versus 43 percent for prostatectomy; for intermediate-risk patients, the cure rate was 89 percent versus 58 percent, respectively. Low-risk patients had similar cure rates with both procedures (99 percent versus 97 percent). Cure rate means that cancer did not recur over a specified period of time, in this case 12 years.

Based on their findings, the authors recommend that physicians offer both brachytherapy and prostatectomy as treatment options for men with organ-confined prostate cancer.

Source:Sharkey J, Cantor A, Solc Z, et al. 2005. 103Pd brachytherapy versus radical prostatectomy in patients with clinically localized prostate cancer: a 12-year experience from a single group practice. Brachytherapy 4:34-44.