Studies presented at the annual meeting of the American Urological Association
(AUA) in New Orleans show positive results for the treatment of early-stage
prostate cancer using brachytherapy or "seeding." The studies,
conducted by Nelson Stone, md, Professor of Urology and Radiation Oncology
at the Mount Sinai School of Medicine, demonstrate that seed implants perform
comparably to other conventional treatments for localized prostate cancer,
offering patients another treatment option.
"This is the largest study series presented on brachytherapy at
the American Urological Association meeting in the last 10 years,"
Dr. Stone said. "The findings indicate that brachytherapy is a viable
option for many of the more than 340,000 new prostate cancer cases diagnosed
Brachytherapy, or interstitial radiation, is a technique for prostate
cancer treatment in which rice-sized radioactive seeds of palladium-103
or iodine-125 are inserted into the prostate through a one-time, minimally
Study Reviews Patient Selection
Richard Stock, md, associate professor of radiation oncology at Mount
Sinai School of Medicine, and Dr. Stone presented a study to determine
appropriate criteria for patient selection. During the study, more than
200 patients with early-stage (T1-T2) prostate cancer were treated with
radioactive seed implants. The cure rates using brachytherapy were comparable
to those reported for traditional treatments of radical prostatectomy and
"An estimated 200,000 prostate cancer cases will be treated this
year with radical prostatectomy or external- beam radiation which have
high rates of complications, including impotence and incontinence,"
Dr. Stone said. "Brachytherapy has fewer side effects that can negatively
impact a patient's quality of life, while these studies further confirm
brachytherapy's effectiveness as a course of treatment."
Favorable Outcome Results
Dr. Stone also conducted a study of more than 300 patients to determine
whether localized prostate cancer could be eradicated by brachytherapy.
The outcome data suggest that current prostate cancer seed implant techniques
result in high negative prostate biopsy rates, indicating no persistence
of the disease. "This study demonstrated that all patients with localized
prostate cancer, regardless of the aggressive nature of their prostate
tumors, can be effectively treated with brachytherapy," Dr. Stone
Cost-Effectiveness of Treatment Options Compared
In addition, Jeffrey Chircus, md, and Dr. Stone conducted a 2-year cost
analysis of the current prostate cancer treatment options available for
localized prostate cancer in the managed-care setting, including radical
prostatectomy, external-beam radiation therapy, cryo-ablation, and prostate
seed implantation. This analysis suggests that the large cost differences
between treatment options may affect managed-care contracting.
Overall, the analysis indicates that the primary and secondary treatment
costs for radical prostatectomy and external-beam radiation are similar,
and yet, when compared to brachytherapy are at least 60% more expensive.
Although cryoablation offers a minor cost-savings over radical prostatectomy,
brachytherapy appears to be the most cost-effective treatment option available.