New look at an old treatment for prostate cancer

Prostate cancer is the second leading cause of cancer death among American men. Patients have several different treatment options, including two types of internal radiation therapy low-dose-rate brachytherapy or high-dose-rate brachytherapy. Both involve having radioactive seeds implanted near the tumor. For years, very few patients took advantage of the high-dose option, but that may begin to change.

64-year-old Greg Hildebrand didn't want to be sidelined for long after getting this good news slash bad news message from his doctor.

"Mr. Hildebrand, unfortunately we found cancer but not to worry, this is readily treatable," said Hildebrand's doctor.

To treat his prostate cancer, Hildebrand went with a procedure called high-dose-rate brachytherapy. Unlike the low-dose-rate radiation treatment, which permanently implants radioactive seeds directly into the prostate, the high-dose-rate radiation is removed the same day.

"The radiation is delivered right then and there later that day as opposed to having a permanent source inside you that slowly delivers the radiation over six to eight months," said Abhishek Solanki, MD, Radiation Oncologist at Loyola University Medical Center.

Hildebrand received two treatments over two weeks. His side-effects lasted only one month. Doctors say complications from the low-dose-rate treatment can last six months.

"It's cleaner, it's more direct, it's less intrusive," said Hildebrand.

HDR was clearly the better option for him, so how come not all doctors have embraced it?

"One of the reasons why is, from a resource perspective, for the staff and clinic, it's a little bit harder," said Dr. Solanki.

But for some patients, it may be the key to good health.

Dr. Solanki says more doctors are starting to consider high-dose-rate radiation brachytherapy as a treatment option now that there are 10-year studies showing it is just as effective as the low-dose-rate treatment and the cancer doesn't return in 80 to 90 percent of patients in a certain risk group.

A study by the Cleveland Clinic found that brachytherapy was the cheapest of all treatments for prostate cancer with an average cost of $2,500 dollars. Brachytherapy is used only in patients whose cancer has not spread to other organs.

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