Hi, I’m Dr. Scholz. Let’s talk about prostate cancer.
Brachytherapy seeds will be the first in this series because in many ways it can be argued
to be the best treatment or at least the best standard treatment for Teal. Treatment for
Teal involves a variety of comparisons and choices. There are more options for Teal than
for any other stage. This video is going to simply cover radioactive seed implants. This
is not to imply that in some cases other individuals with other situations of Teal might not need
a different type of therapy. So the decision making for Teal is not an issue of right or
wrong, but one of being better or worse compared to the other treatment options. There was
a time actually before robotic surgery came along that permanently seeds were the most
popular treatment, but due to the financial incentives, either beam radiation such as
IMRT or surgery became much more popular. Surprisingly, studies contradict that decision.
Studies show higher cure rates and lower side-effect rates with seed implants compared to either
surgery or beam radiation.
Permanent seeds are administered as an outpatient procedure. They can be done under limited
anesthesia. Skillful seed implanters can do a permanent seed implant in less than an hour.
This sort of convenience contrasts sharply with beam radiation which might take 5-9 weeks,
and surgery which requires a catheter for a week afterward and recovery periods that
may take months or in some cases years. It’s not more expensive, seed implants are relatively
economical.
What are the negatives about seed implants? Men that have very large prostates or men
that have a lot of pre-existing urinary problems could experience worsening of those symptoms
with seed implants. Sometimes detractors complain about the possibility the seeds migrating
outside the prostate. This indeed used to be a problem, but now with modern technology,
they’ve strung them together so that no longer happens. The other concern is radiation
emitted around the patient since the radiation remains in the patient as he walks around
for the next 30 days or so, but the radiation only travels a centimeter or two and it doesn’t
get outside the body. Permanent seed implants do not cause radiation exposure to surrounding
people.
Like all types of prostate cancer treatment, seed implantation is a skill, and you need
to go to experienced skilled practitioners to have it done properly. One thing that is
always important to remember when selecting treatment is to select a physician with a
lot of experience and known special skills. Every type of treatment requires skillful
administration and the possibility of mistakes and less than proper administration are a
genuine risk.
So in summary, seed implants compared to other options tend to be more convenient, tend to
have fewer side-effects, and tend to have higher cure rates than all the other options.
In addition, although insurance covers most of these things, if you look at the actual
costs they are lower than the other options. Unfortunately, they are under-utilized because
the industry is more tuned to using other types of treatment that actually reimburse
better for physician salaries and payments.
Thanks for watching. Subscribe to our channel and for more information visit PCRI.org.