Prostate cancer is the most common cancer, particularly in men. Because of its non-aggressive nature in many patients, routine screening is not recommended. However, this cancer can also develop rapidly and, if not diagnosed early, it may spread to bone, lungs, liver and lead to death.
Prostate cancer is rare before age of 50.
What treatments today?
When prostate cancer is found, there are now three main treatment options:
radical prostatectomy, which involves surgical removal of the prostate and seminal vesicles;
External Beam Radiation Therapy (EBRT) using linear accelerator with or without IMRT ;
and finally brachytherapy which delivers radiation directly to the tumor using radioactive implants or High Dose Rate (HDR) afterloaders. Both techniques are effective and lead to results comparable to those of radical surgery.
Brachytherapy is the only treatment without significant incidence of incotinence or impotence.
Brachytherapy can be used as monotherapy (alone) or given as additional radiation in addition to external beam radiation therapy (additional radiation dose to the prostate only) . The high-dose therapy (HDR - High Dose Rate) means the high dose irradiation for a brief period.
Many patients can benefit from this treatment only:
Localized prostate cancer
In this setting the tumor is inside the prostatic gland, no regional or distant spread. Histologic type must be low (gleason less or equal to 7) and the PSA level in the blood less than 15.
Locoregional disease
The tumor invades the prostate capsula or goes beyond , and or the histologic grading is high (gleason more than 7) or the PSA more than 15, and no distant metastasis.
In this case, brachytherapy is administered as a complement to external beam radiation, leading to very high doses of radiation to the gland itself.
In both cases, the procedure is the same. Brachytherapy of the prostate necessitate general anesthesia or spinal anesthersia. The whole procedure takes about two hours, and the patient is discharged from the hospital next day.
Contact us to know if you are candidate to prostate cancer brachytherapy