Radioactive Seeds May Be Superior to Other Prostate Cancer Treatments

A new study finds that treating prostate cancer with radioactive seeds may have fewer side-effects than surgery or a beam of high-energy radiation.

At a news briefing in advance of the fourth annual Genitourinary Cancers Symposium, being held later this week in San Francisco, Dr. Jay Ciezki, a radiation oncologist at the Cleveland Clinic, said analysis of the Medicare records of more than 100,000 prostate cancer patients between 1991 and 2007 shows that treatment with radioactive seeds (brachytherapy) is also less expensive than surgery or external beam radiation therapy (EBRT).

Dr. Ciezki told WebMD that since studies have shown all three treatments are “pretty much equally effective” for treating the 80 percent of prostate cancer patients diagnosed with low and intermediate-risk disease, “it comes down to quality of life and cost,” adding, “Based on our analysis, we have to conclude that brachytherapy is the optimal treatment choice.”

According to the American Cancer Society, prostate cancer is expected to be diagnosed in more than 240,000 U.S. men in 2012.

During the analysis done by Ciezki and his colleagues, they found 7.1 percent of patients who received external beam radiation therapy experienced problems such as incontinence or bladder bleeding, compared with 6.7 percent of those treated with surgery and 3.4 percent of those treated with brachytherapy.

In a cost comparison, brachytherapy was $2,557.36 per year, while surgery was $3,205.71 and EBRT was $6,412.29.

Still, not everyone is convinced. Andrew Lee, MD, MPH, a radiation oncologist at the University of Texas M.D. Anderson Cancer Center in Houston, says while the findings deserve more rigorous testing, they are in no way conclusive.

“The SEER-Medicare database offers very limited data, basing outcomes on procedural billing codes. We have no idea whether a patient had a side effect [that was treated with medication] or even whether the procedure is being done in the right setting,” he said.