Brachytherapy may be preferred cancer treatment for obese patients

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Obese men with early-stage prostate cancer may benefit more from brachytherapy treatment than surgery or external beam radiation therapy, according to a study published in the August issue of the International Journal of Radiation Oncology*Biology*Physics.

Being overweight does not present any unique technical challenges for brachytherapy as it does for surgery and external beam, according to Anthony Zietman, MD, one of the authors of the study and a radiation oncologist at Massachusetts General Hospital in Boston.

Increasing body mass index (BMI) is associated with prostate-specific antigen (PSA) failure after radical prostatectomy and external beam radiation therapy (EBRT). This has been specifically shown for overweight or obese men who undergo surgery (radical prostatectomy) or external beam radiation therapy. Zietman and colleagues said that the exact cause for this is unknown, but it is suspected that higher BMI can been associated with more aggressive cancers and with more technical difficulties during treatments.

Researchers at the Massachusetts General Hospital departments of radiation oncology and urology and the Boston Medical Center department of radiation oncology sought to determine if the same problems were seen in overweight and obese men treated with brachytherapy.

The study analyzed 374 prostate cancer patients who were treated with brachytherapy from 1996 to 2001. The authors concluded that unlike after surgery or EBRT, BMI is not associated with PSA failure in men treated with brachytherapy for prostate cancer, raising the possibility that “brachytherapy may be a preferred treatment strategy in obese patients.”