Seed implants significantly decrease mortality compared with active surveillance
Prostate cancer patients cut their risk of dying of the disease in half when they receive brachytherapy treatment within six months of diagnosis compared with those who don’t receive active treatment (watchful waiting/active surveillance), according to a study presented at the American Society for Therapeutic Radiology and Oncology (ASTRO) conference in Los Angeles this week.

The study involved about 11,000 men who were 65 years old and older and newly diagnosed with localized prostate cancer in Ohio between 1999 and 2001. Researchers at the Case Western University School of Medicine in Cleveland examined the group’s survival rate after seven years to see if they could detect a benefit between different common treatments for localized prostate cancer.

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, according to Ester Zhou, MD, PhD, lead author of the study.

Brachytherapy, the implantation of radioactive seeds into the body to kill cancer cells, is preferred by many men because it is just as effective as external beam radiation therapy (EBRT) and surgery, has a much faster recovery than prostatectomy, and can be done in one visit, unlike EBRT.

“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 Zhou. “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.”

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