Jan. 31, 2012 -- For most men with prostate cancer, having radioactive seeds implanted in the prostate is associated with fewer serious side effects than either surgery to remove the prostate or having a beam of high-energy radiation aimed directly at the cancer, researchers say.
The analysis of the Medicare records of more than 100,000 prostate cancer patients also shows that treatment with radioactive seeds, called brachytherapy, is cheaper than surgery or external beam radiation therapy (EBRT).
Studies have shown that all three treatments are "pretty much equally effective" for treating the 80% of prostate cancer patients diagnosed with low- and intermediate-risk disease, says researcher Jay Ciezki, MD, a radiation oncologist at the Cleveland Clinic.
"So it comes down to quality of life and cost. Based on our analysis, we have to conclude that brachytherapy is the optimal treatment choice," he tells WebMD.
An expert not involved with the work says the new study would not influence his choice of treatment for his patients, however.
Ciezki presented the findings at a news briefing in advance of the fourth annual Genitourinary Cancers Symposium, being held later this week in San Francisco.
Prostate cancer is expected to be diagnosed in more than 240,000 men in the United States in 2012, according to the American Cancer Society.
Ciezki and colleagues analyzed data on 137,427 men from National Cancer Institute Medicare data collected between 1991 and 2007.
Of the total, 43% of men were treated with surgery (called prostatectomy), 44% with external beam radiation therapy, and about 13% with brachytherapy. Researchers looked only at side effects that required a procedure to correct them.
Over a six-year period, on average, 8.8% who had external beam radiation therapy, 6.9% of patients who underwent surgery, and 3.7% who had brachytherapy needed a procedure to fix a therapy-related effect.
A total of 7.1% of patients who received external beam radiation therapy experienced problems such as incontinence or bladder bleeding, compared with 6.7% of those treated with prostatectomy and 3.4% of those treated with brachytherapy.
And 1.7% of EBRT patients had gastrointestinal side effects such as rectal bleeding, compared with 0.1% of prostatectomy patients and 0.3% of brachytherapy patients.
Brachytherapy was the cheapest treatment: $2,557.36 per year. Prostatectomy was slightly more expensive, at $3,205.71, followed by EBRT at $6,412.29.