The American Brachytherapy Society finds many men diagnosed with Prostate Cancer are not presented with a highly effective minimally invasive treatment option: Prostate Brachytherapy Seed Implants.
We live in an era of information overload, frequently confusing and contradictory. The challenge and difficult task of evaluating and understanding available treatment options for prostate cancer is not immune to this quandary.
Other than skin cancer, prostate cancer is the most common cancer and is the second leading cause of cancer death in American men, behind lung cancer. About 1 man in 9 will be diagnosed with prostate cancer during his lifetime. The American Cancer Society estimates about 164,690 men will be diagnosed and about 29,430 men will die from prostate cancer in the United States in 2018.1
A Prostate Cancer diagnosis can be devastating and understanding the available treatment options can be overwhelming and is often more perplexing and confusing than the diagnosis itself. Leading to the confusion, there are many treatment options for prostate cancer, some more effective than others. With so many options available, many men will NOT be offered clinically effective procedures with minimal side effects and high quality of life secondary to physician bias of offering procedures that they do rather than what may be most effective for the patient.
Prostate Brachytherapy Seed implants, also known as Low-dose-rate brachytherapy (LDR-BT) is a highly effective minimally invasive treatment for organ-confined prostate cancer. It can be offered as a single treatment for low-risk disease, or in conjunction with external beam radiotherapy (EBRT) and/or androgen-deprivation therapy (ADT) for intermediate and high-risk disease.
Unfortunately, many men diagnosed with Prostate Cancer are never presented with Prostate Brachytherapy Seed implants as a treatment option and/or, more regrettably, presented with misinformation.
Modern-era Prostate Brachytherapy Seed implants have been globally performed and extensively studied since the late 1980’s. An abundance of data has been published demonstrating the undeniable efficacy of the treatment, quality of life, and cost effectiveness. https://prostatecancerfree.org/compare-prostate-cancer-treatments/
A noteworthy study recently published in JAMA® (The Journal of the American Medical Association) by a multi-institutional group of prostate cancer experts, concluded that men with high risk prostate cancer treated with external beam radiation therapy (EBRT), brachytherapy seed implant, and hormone deprivation therapy, were associated with significantly better prostate cancer-specific mortality rates (deaths caused by prostate cancer) compared to radical prostatectomy or EBRT with hormone deprivation therapy.2
Additionally, researchers from the British Columbia Cancer Agency, published a landmark, Level 1 evidence trial, that concluded men with Intermediate & High-Risk prostate cancer randomized to low-dose brachytherapy boost, EBRT, and hormone deprivation (versus men randomized to EBRT boost, EBRT and hormone deprivation therapy) were twice as likely to be free of biochemical failure (detectable and rising Prostate Specific Antigen (PSA)) at a median follow-up of 6.5 years.3
Peter Orio, DO, President of the American Brachytherapy Society and Vice Chair of Network Operations, Department of Radiation Oncology, Dana-Farber Cancer Institute, Harvard Medical School, commented: ”Men must be informed of their treatment options and understand the benefits of brachytherapy as a component of their care, as their first shot at a cure is their best shot. In medicine, knowledge is power and physicians have an obligation to provide patients both the knowledge and the power to make informed treatment decisions free of bias or financial incentive. Patients must not be allowed to suffer the consequences of not understanding their treatment options. Only a radiation oncologist who specializes in the delivery of brachytherapy should be the one to tell a patient whether they are a candidate for prostate brachytherapy, and patients must feel empowered to seek the opinion of an experienced brachytherapist when deciding on the care they want to receive.”
Disclaimer: Not all men are eligible for all treatments. Choosing a prostate cancer treatment is a very personal decision and men should be presented all the treatment options available to them based on their individual diagnosis and the data associated with any specific treatment.
1 https://www.cancer.org/cancer/prostate-cancer/about/key-statistics.html. Accessed, September 6, 2018
2 Kishan AU, Cook RR, Ciezki JP, et al. Radical Prostatectomy, External Beam Radiotherapy, or External Beam Radiotherapy With Brachytherapy Boost and Disease Progression and Mortality in Patients With Gleason Score 9-10 Prostate Cancer, JAMA March 6, 2018 Volume 319, Number 9 89.
3 Morris JW, Tyldesley S, Rodda S, et al. Androgen Suppression Combined with Elective Nodal and Dose Escalated Radiation Therapy (the ASCENDE-RT Trial): An Analysis of Survival Endpoints for a Randomized Trial Comparing a Low-Dose-Rate Brachytherapy Boost to a Dose-Escalated External Beam Boost for High- and Intermediate-risk Prostate Cancer, Int J Radiat Oncol Biol Phys. 2017 Jun 1;98(2):275-285.