Radiation seed implant decreases risk of death over watchful waiting/active surveillance for prostate cancer

Prostate cancer patients cut their risk of dying of the disease in half when they receive radiation seed implants (brachytherapy) to treat their cancer, compared to those who don't receive active treatment (watchful waiting/active surveillance), within six months from being diagnosed with localized prostate cancer, according to a study presented October 31, 2007, at the American Society for Therapeutic Radiology and Oncology's 49th Annual Meeting in Los Angeles.

The study may be used to improve the selection of appropriate treatments, since no single method of prostate cancer treatment has been shown to be clearly optimal for men diagnosed with localized disease.

Brachytherapy is a procedure where a radiation oncologist places small radioactive seeds into the prostate to kill the cancer cells while the man is sedated. This treatment is preferred by many men because brachytherapy is just as effective as external beam radiation therapy and surgery, but can be done in one visit, unlike external beam which is given over six to eight weeks, and has a much faster recovery over surgically removing the prostate, a major surgical procedure.

Watchful waiting/active surveillance, also called observation, is an option for prostate cancer patients where doctors monitor the cancer through frequent tests to see if the tumor causes symptoms or appears to be growing. Unlike many other cancers, most prostate cancers grow very slowly and sometimes watching the cancer – instead of actively treating it – is the preferred choice, especially among older men who wish to avoid the side effects of treatment, including problems with urination and sexual function.

“This is the first time that a population-based cohort study has compared brachytherapy to watchful waiting/active surveillance in the treatment of localized prostate cancer,” said Ester H. Zhou, M.D., Ph.D., lead author of the study and an epidemiologist at the Case Western University School of Medicine in Cleveland. “We were pleasantly surprised to find that patients who had brachytherapy in conjunction with external beam radiation therapy and/or androgen deprivation therapy had much better survival than those patients who didn't receive active treatment, and that it was shown to be just as effective as radical prostatectomy in lengthening the lives of prostate cancer patients.”