Prostate brachytherapy effective for both young and old

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Brachytherapy treatment is just as effective at curing prostate cancer in men under 60 as it is in older men, according to a study presented at the American Society for Therapeutic Radiology and Oncology (ASTRO) conference this week in Los Angeles.

Brachytherapy is a minimally invasive procedure where radioactive seeds are placed into the prostate to kill cancer cells. It is an attractive treatment option for patients with prostate cancer because it has a much shorter recovery time than surgery and studies have shown brachytherapy to be just as effective as surgery.

“Younger patients with prostate cancer are commonly believed to have more aggressive disease,” said Alice Ho, MD, the lead author of the study and a radiation oncologist at Memorial Sloan-Kettering Cancer Center in New York City.

As such, surgeons have usually advised younger men to undergo surgery to remove all or part of the prostate (prostatectomy) over other treatments such as seed implants because they believed younger men could physically tolerate surgery, plus they believed surgery was more effective than brachytherapy at curing prostate cancer in the long term. This meant that many younger men would undergo surgery without ever learning about other treatment options, like brachytherapy or external beam radiation therapy, Ho noted.

The retrospective study examined the outcomes of more than 1,700 men with localized prostate cancer who were treated with brachytherapy between 1990 and 2005 at Mount Sinai.

Her research found that there was no difference in prostate specific antigen (PSA) control rates of younger men versus older men treated with seed implants and that both groups have excellent five-year biochemical outcomes with the treatment. She also said that a greater percentage of younger men presented with low-risk disease, contrary to popular belief.

“These results suggest that brachytherapy is extremely effective in curing localized prostate cancer for men aged 60 and younger. When younger men are diagnosed with localized prostate cancer, they should be presented with all viable treatment options, including brachytherapy,” she said. “Every man with prostate cancer, regardless of his age, should have access to the treatment that is best for his cancer and lifestyle.”