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Seeds May Rival Prostate Cancer Surgery

Implanted Radioactive Seeds Less Likely to Cause Side Effects
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WebMD Health News

Oct. 5, 2004 (Atlanta) -- One of the largest and longest studies ever undertaken of radioactive "seed" implants for prostate cancer shows that men who undergo the procedure live at least as long, if not longer, than those who opt for surgery, researchers report.

In the study of nearly 1,500 Long Island prostate cancer patients treated with seed therapy, 93% were alive 12 years later -- "pretty much the same as we would expect with surgery," says Louis Potters, MD, medical director of the New York Prostate Institute at South Nassau Communities Hospital in Oceanside, N.Y.

Speaking at the annual meeting of the American Society for Therapeutic Radiology and Oncology, Potters says prostate cancer survival was even better when experienced doctors with solid success rates performed the procedure.

Seed Therapy Offers Faster Recovery

"There are a lot of advantages to the seed therapy," he tells WebMD. "It's minimally invasive -- no cutting, no suturing. You're discharged two hours later, with no physical restrictions. The procedure is well tolerated."

Prostate cancer surgery, on the other hand, can cause incontinence and impotence, Potters says.

John Blasko, MD, medical director of the Seattle Prostate Institute and discussant of Potters' talk at the meeting, agrees seed implants for prostate cancer offer certain advantages: "ease of treatment upfront, rapid return to normal activities, and lack of incontinence or impotence."

But, he says, prostate cancer surgery shouldn't be dismissed outright.

"People have a choice," says Blasko, who is clinical professor of radiation oncology at the University of Washington in Seattle. "Some men might prefer surgery because it offers answers upfront; you know right then and there if the cancer was confined to the prostate."

Also, PSA blood levels, which rise when a man has prostate cancer, stabilize within a few days to weeks after surgery, while they can take years to normalize after seed therapy. "This makes some people anxious," Blasko says. "Surgery gives them psychological reassurance."

Seeds for Prostate Cancer Becoming More Popular

Approximately 180,000 men in the U.S. are diagnosed with prostate cancer each year, and almost 90% have localized disease, meaning that the cancer has not spread to other parts of the body. These men are candidates for either seed therapy, called brachytherapy, or surgery. Another option is external radiation therapy, in which high-energy rays are used to kill prostate cancer cells.

More and more men are opting for seed implants: Some 35,000 to 40,000 procedures, representing about one in four cases of localized prostate cancer, were performed last year alone, says Potters.

Under ultrasound guidance, the rice grain-sized pellets are implanted into the prostate cancer. The number of seeds and where they are placed is determined by a computer-generated treatment plan tailored for each patient.

The approach allows a high dose of radiation to be delivered to the prostate while limiting damage to healthy surrounding tissues, he explains. The implants become inactive after about 10 months but remain in place permanently.

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