New therapy offers options for patients

SEEDS OF HOPE::The cancer therapy uses radioactive ‘seeds’ implanted into the prostate gland, and offers high survival rates and fewer side effects than surgery

By Alison Hsiao  /  Staff reporter

Tue, Jul 09, 2013 - Page 4

Brachytherapy, or radioactive “seed” implants, is now being used in Taiwan to treat men with prostate cancer, which had the third-highest increase in nationwide numbers of cases in 2010, according to data released by the Department of Health.

Fewer than 500 men diagnosed with early-stage prostate cancer, of the total 4,400 prostate cancer patients recorded in 2010, received radical surgery or external beam radiation therapy (EBRT), with the rest undergoing conservative management or no treatment at all, said Skye Hung-chun Cheng (鄭鴻鈞), director of the division of radiation oncology at the Sun Yat-sen Cancer Center.

The center has imported the innovative technology to offer men with early-stage prostate cancer a third option in addition to radical prostatectomy and EBRT, which both have their drawbacks.

“While radical prostatectomy, the removal of the prostate gland, can eliminate the cancer completely and has a nearly 100 percent 10-year survival rate, it carries the same risks as other major operations, including risks related to the use of anesthesia and blood loss,” said Lin Yu-hung (林育鴻), an attending physician of urology at the center.

“It may also have other long-term side effects such as erectile dysfunction and urinary incontinence,” Lin said.

“EBRT yields a similar 10-year survival rate to radical prostatectomy and is without many of the risks associated with surgical procedures. However, it takes longer to finish a course of EBRT treatment,” Lin added.

“Brachytherapy has the benefits of both forms of treatment, with a high survival rate and low risks. Plus it is a one-time treatment requiring only 1.5 to 2 hours,” Lin said.

As the term “radioactive seed implants” indicates, the therapy is conducted via implanting small radioactive rods into the prostate gland using ultrasound for guidance.

With the aid of a computer, the placement of the seeds and the required dose of radiation can be accurately calculated, said Huang Kuei-kang (黃奎綱), an attending physician in radiation oncology.

“The seeds remain in the prostate gland permanently, with 90 percent of their radioactivity decaying naturally within six months of the implant procedure,” Huang said.

However, the downsides are that the radioactive seed implants are mainly effective only for patients at middle or low risk of the cancer spreading, and the costs have to be met by patients, as the therapy is not yet covered by the National Health Insurance program, Lin said.