There are many myths and misconceptions regarding prostate brachytherapy. Below are the most common:
Myth: If a man is ‘young’ (under age 62), he should have surgery because ‘he will do better’.
Fact: Published data has demonstrated brachytherapy to be an excellent and equal treatment option for younger patients. There is no scientific data to suggest younger patients have better cure rates with surgery. This has long been a misconception on the part of some physicians. In fact, there are numerous studies that show that there are no differences in cure rates with young patients (age 62 or less) versus older patients1-2,4. All treatment options should be offered to patients. A recent study concluded that of patients with prostate cancer treated with a monotherapeutic approach, better urinary continence was exhibited in those who underwent radiation-based therapies. Furthermore, higher sexual function scores were seen in men who selected brachytherapy.
Myth: Surgery can not take place after brachytherapy.
Fact: This is not true, and in the rare cases when surgery is needed after brachytherapy, it can be done successfully. However, it is important to keep in mind that having a local recurrence (when the cancer comes back in the prostate) is very rare; if prostate cancer treatment fails, it is usually metastatic (spreads outside the prostate). In such a situation, removing the prostate is of no value.
Myth: With surgery, an individual with prostate cancer will be 100 percent cured.
Fact: Cure rates for early stage prostate cancer have been proven equal for brachytherapy, surgery and external beam radiation. For a low risk patient, cure rates average 95% for all three treatments. Sharkey et al found that for low risk patients, brachytherapy resulted in 99% cure rates, while surgery resulted in cure rates of 97%4. After radical prostatectomy, pathologically advanced disease is detected in 38% to 52% of patients5. Therefore, although cure rates are excellent for many different treatment options, it is a myth that surgical removal results in 100% cure.
Myth: The seeds only work to contain cancer for 10 years, after which the cancer can come back.
Fact: This statement is false and has no scientific merit. The radiation has a lifespan and destroys the cancer cells. Once the cancer cells are destroyed, a patient can remain cancer-free for a lifetime.
Myth: A patient should not have sexual relations with his partner, because he can give prostate cancer to his partner.
Fact: Prostate cancer, as well as other types of cancer, is not a contagious or infectious disease. It cannot be ‘spread’ by any type of physical contact with anyone.
Myth: Once a patient has a seed implant, that patient is radioactive and should make sure his bodily fluids do not come into contact with anyone.
Fact: The seeds are encased in titanium and there is no contamination of any bodily fluids, including blood, sweat and urine. There is no way a patient can ‘contaminate’ any type of food or other products.
Myth: Radiation, including the seed implant, makes a patient feel sick and causes his hair to fall out.
Fact: The seed implant delivers low energy radiation to the prostate. This does not make a patient’s hair fall out or produce any type of physical change to his appearance. Unless a patient tells a person that he has had a seed implant, the person will never know. There are no visible side effects, scars or incisions that will suggest a patient has had a procedure. Many people mistake radiation therapy for chemotherapy, which is a treatment protocol in which drugs are used to systemically treat cancer. Chemotherapy can make a person feel sick and lose their hair. However, radiation therapy is NOT chemotherapy.
References:
- Ho, AY et al. Young Men have Equivalent Biochemical Outcomes Compared to Older Men After Treatment With Prostate brachytherapy Volume 69, Issue 3, Supplement, Pages S90-S91 (1 November 2007)
- Merrick, GS et al. brachytherapy in men age less than or equal to 54 years with clinically localized prostate cancer. BJU Int’l (98), 324-328, 2006.
- Frank SJ, et al. An assessment of quality of life following radical prostatectomy, high dose external beam radiation therapy and brachytherapy iodine implantation as monotherapies for localized prostate cancer. J Urol, Jun 177(6), 2151-6, 2007.
- Sharkey J, et al. 103Pd brachytherapy versus radical prostatectomy in patients with clinically localized prostate cancer: a 12-year experience from a single group practice. Brachytherapy, 4(1): 34-44, 2005.
- Ganswindt U, et al. adjuvant radiotherapy for patients with locally advanced prostate cancer-a new standard? Eur Urol, Jun 23, 2008.
