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Thread: brachytherapy (seeds) success rate

  1. #1

    brachytherapy (seeds) success rate

    "Brachytherapy regarded as superior treatment for prostate cancer
    <excerpt>
    September 2, 2009
    In an 11-year study, the Prostate Cancer Foundation of Chicago, a non-profit organization that funds patient support programs, clinical research and public education, analyzed 9,137 patients between 1997 and 2008 who were treated for prostate cancer with brachytherapy at Chicago Prostate Center. 67.5% of the patients were regarded as low risk, 29.36% as intermediate, and 1.01% as high.

    Of those patients, overall cure rates were 96%, 84%, and 75% for low, intermediate, and high risk patients, respectively. When combined with external beam radiation therapy in intermediate and high risk patients, the brachytherapy results far exceed those of surgery..."
    http://www.news-medical.net/news/200...te-cancer.aspx



    "Recurrence Rate Similar Between Common Treatments for Early Prostate Cancer
    According to a recent article published in Radiotherapy and Oncology, cancer recurrence rates, as determined by prostate specific antigen (PSA) levels, are nearly equivalent between patients treated with a radical prostatectomy, external beam radiation and interstitial radiation therapy for localized prostate cancer." Note from Rep: "interstitial" refers to seeds.
    Us TOO International http://www.ustoo.org/Article_1.asp?d...ticle&id=23576

    "After 12 years the American Society for Therapeutic Radiology and Oncology (ASTRO) defined the biochemical-free recurrence at 81%, ASTRO-Kattan at 78%, ASTRO-Last Call at 74%, and Houston at 77%. Using the ASTRO-Kattan definition, patients at low risk could achieve 89% biochemical-free recurrence, those at intermediate risk 78%, and those at high risk 63%."
    http://www.prostate-cancer.com/brach...val-rates.html
    "12-Year Outcomes Following Permanent Prostate Brachytherapy in Patients with Clinically Localized Prostate Cancer"
    Louis Potters, Carol Morgenstern, Emil Calugaru, Paul Fearn, Anup Jassal, Joseph Presser and Edward Mullen The Journal of Urology 173 (2005) 1562-1566
    Replicant

    Dx Feb 2006, PSA 9 @age 43
    RRP Apr 2006 - Gleason 3+4, T2c, NXMX, pos margins
    PSA 5/06 <0.1, 8/06 0.2, 12/06 0.6, 1/07 0.7.
    Salvage radiation (IMRT) total dose 70.2 Gy, Jan-Mar 2007@ age 44
    PSA 6/07 0.1, 9/07 (and thereafter) <0.1
    http://pcabefore50.blogspot.com

  2. #2
    Seattle Prostate Institute results:
    10 year followup: Procedures in 1987-1993
    83% progression free with Paladium 105
    87% progression free with I 125
    Local control 97%
    Metastic free survival 97%
    http://www.prostate-cancer.org/educa...lantation.html
    JohnT
    psa at diagnosis 40 in nov-08
    gleason 6 and 7
    Treatment choice seeds and IMRT

  3. #3
    Experienced User
    Join Date
    Aug 2009
    Location
    San Jose, CA
    Posts
    64

    Verrry interesting

    Thanks for these links, guys. Very interesting. Overall now, I am more undecided after reading these studies.
    Age 52
    RRP 11-5-09
    Post Surgical Gleason 3+4 = 7
    Stage T1C
    Pre-surgical PSA: 5.3
    Post-surgical PSA: Undetectable at 13 weeks

  4. #4
    JB,
    Brachytherapy is worth another look. It is the most cost effective, convenient and has the least side affects of all the local treatments.
    I had seed implants in May, a 45 min procedure that was painless. I was home an hour later and played golf the next day. I had frequent urination and urgency for about 4 weeks that was very tolorable and didn't interfere with my daily life. No other side affects. I may get ED in about 3 years, but should be OK with meds like Viagra. ED rate is about the same as nerve sparing surgery.
    JohnT
    psa at diagnosis 40 in nov-08
    gleason 6 and 7
    Treatment choice seeds and IMRT

  5. #5
    Because of my location and possible diagnosis (2nd biopsy a few days ago), I've been following news on Cleveland Clinic. The CC Taussig Center recently posted outcomes from brachytherapy compared with surgery and external beam therapy. There was also a news story on that along with the Chicago results posted above. I suppose I can't post the websites due to forum policies, so I won't attempt it.

    Here is a quote from the news story regarding the CC outcomes.
    "The Taussig Cancer Center at Cleveland Clinic has released their similar 2008 outcomes, demonstrating brachytherapy to be superior to surgery in all cases. For low risk patients, the study found a 95% survival rate after five years, 89% for intermediate risk, and 71% for high risk patients. This research concluded that, for low risk patients, brachytherapy was equally successful as external beam radiation, but more successful than a radical prostatectomy."

    The posted results cover years from 1996 to 2008 for ~8000 total patients. They report 12 years of outcomes (biochemical relapse-free survival rates) for surgery and EB and 11 years for brachytherapy. I thought it was interesting that for low risk patients the EB survival rates for 12 years are slightly better than for surgery, while the brachytherapy results for 11 years are also better than surgery. However, the differences are not very large and perhaps not statistically significant. The differences for intermediate and high risk are larger. For high risk, both radiation schemes are better at all years, while for intermediate risk, radiation is better at 5 years but tends to converge with surgery at 7-10 years out.

  6. #6
    Experienced User
    Join Date
    Aug 2009
    Location
    San Jose, CA
    Posts
    64

    Cleveland

    Holler, thanks for that info. I just read the release. Very interesting reading. Definitely will have an effect on my choice!
    Age 52
    RRP 11-5-09
    Post Surgical Gleason 3+4 = 7
    Stage T1C
    Pre-surgical PSA: 5.3
    Post-surgical PSA: Undetectable at 13 weeks

  7. #7
    Senior User
    Join Date
    Sep 2009
    Posts
    123
    Does everyone have to get hormone shots before all types of radiation? even proton beam at Loma Linda? and seeds?

    doesn't that give you ED for sure?

  8. #8

    hi problem

    No, not everyone gets hormone therapy before radiation, but some do, especially those at high risk (high Gleason, positive seminal vesicles, etc). In addition, some forms of therapy are not effective on large prostates, so sometimes men go on hormone therapy to reduce the prostate volume before treatment.

    Since it blocks testosterone, hormone therapy pretty much kills your sex drive (libido) but that recovers once you're done, or when you take an extended break. So it's not like it causes some kind of permanent or persistent ED.

    A friend who has been on hormone therapy says that it makes every woman seem like a close relative--there's just no sexual interest there. It can (I think) be more disturbing for one's sexual partner than oneself, since the patient simply isn't interested in sex while on the therapy.

    Those of you who are on or who have been on ADT can correct me if I got any of this wrong. Please do.
    Replicant

    Dx Feb 2006, PSA 9 @age 43
    RRP Apr 2006 - Gleason 3+4, T2c, NXMX, pos margins
    PSA 5/06 <0.1, 8/06 0.2, 12/06 0.6, 1/07 0.7.
    Salvage radiation (IMRT) total dose 70.2 Gy, Jan-Mar 2007@ age 44
    PSA 6/07 0.1, 9/07 (and thereafter) <0.1
    http://pcabefore50.blogspot.com

  9. #9
    Senior User
    Join Date
    Sep 2009
    Posts
    123
    Thanks for your reply!

    My doc just suggested surgery, so I don't have any info on radiation.

    I've been reading thread after thread and running searches here, seems like most of the men who have surgery end up doing radiation after the fact, as it seems the surgery may make the cancer spread if it's already in the nerves, or outside the gland. and I guess, if it's outside then radiation is the choice, but they don't really know this until they open you up?

    Is your crystal ball handy?

  10. #10
    Replicant,
    You are correct. On HT you can still get an errection, you just don't want to. You can take Casodex alone to reduce prostate size prior to seeds or radiation and it has about 20% of the side affects of Lupron with just as good results.
    JohnT
    psa at diagnosis 40 in nov-08
    gleason 6 and 7
    Treatment choice seeds and IMRT

 

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