New Prostate Cancer strategy tested - single dose radiation

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Regular Member

Date Joined Jan 2009
Total Posts : 51
   Posted 12/17/2010 5:29 PM (GMT -6)   
Here's a new treatment method that looked interesting:
I'm not sure whether or not you need a subscription to the Detroit Free Press to see the above link results, so here are a few snippets from the article:
"In what a leading doctor hails as a new era of prostate cancer treatment, a Detroit-area man became the first in the world last month to undergo single-dose radiation for prostate cancer, a temporary implantation of a higher dose of radiation with the promise of fewer side effects. 
The outpatient procedure was performed on a Beverly Hills man at Beaumont Hospital in Royal Oak on Nov. 29. It is part of a research study by Dr. Alvaro Martinez,   chairman of radiation oncology, to chart the effectiveness of the treatment.
Martinez describes it as a new era of prostate cancer treatment in which less is more. Men go home the day of the procedure.
The treatment temporarily   places a radioactive pellet the size of a grain of rice into the tumor. The pellet releases radiation when a computerized machine moves it across tiny plastic needles placed in the prostate. Unlike other pellets, or seeds, that are placed in the prostate permanently, the procedure leaves no radioactive material behind, Martinez said.
It also holds the promise of fewer complications associated with other types of radiation and surgery for prostate cancer, he said.
The operation takes three hours to place the pellet, but the radiation treatment is only 15 minutes, Martinez said. The pellet is removed right after the treatment."

Have a great, and healthier, holiday everyone!


Age: 60, 59 at DX
PSA: 1/20/00 7.9, 7/22/00 3.3, 10/25/01 4.9, 10/19/04 5.1, 9/26/07 5.98, 8/28/08 7.68, 9/23/08 7.36, 10/23/08 8.64, 12/18/08 6.39
Prostate size: 96 gm (est.), post-surgical: 112 gm
Biopsy: 11/7/08 Positive 2 of 15 cores, both in rt apex, composite tumor quantity 5% prostate involved, Gleason 7 (3+4), Gleason pattern 4 accounts for 15% of tumor
Stage: T1c
DaVinci robotic surgery: 3/9/09, Dr. M. Hugh Solomon at St. Joseph Mercy Hospital, Ann Arbor, MI
Nerves: Spared left nerve bundle and partial sparing of right nerve bundle
Cath removed: 3/19/09
Pathology results: Gleason: 3+3=6, Tumor Quality: 3% of prostatic tissue; max. linear extent 4 mm, location: bilateral (apices), no extracapsular extension, no seminal vesicle invasion, no perineural invasion and no angiolymphatic invasion. Margins: Focal involvement (1mm) of left apical margin
Pathologic stage: pT2c N0 Mx
Left inguinal hernia 3 months post-surgery (repaired via open surgery), also had right inguinal hernia 2 years pre-surgery (repaired laparoscopically) 
PSA's post surgical:  2  mo.= .06, 4 mo.=.02, 7 mo.=.02, 10 mo.=.01, 13 mo. = .02

Elite Member

Date Joined Oct 2008
Total Posts : 25355
   Posted 12/17/2010 7:16 PM (GMT -6)   
Very interesting
Age: 58, 56 dx, PSA: 7/07 5.8, 10/08 16.3
3rd Biopsy: 9/08 7 of 7 Positive, 40-90%, Gleason 4+3
open RP: 11/08, on catheters for 101 days
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos marg
Incont & ED: None
Post Surgery PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA: 1/10 .12, 4/8 .04, 8/6 .06 11/10 Not taking it
Latest: 6 Corr Surgeries to Bladder Neck, SP Catheter since 10/1/9, SRT 39 Sess/72 gy ended 11/09, 21 Catheters, Ileal Conduit Surgery 9/23/10

Veteran Member

Date Joined Jul 2010
Total Posts : 3596
   Posted 12/17/2010 8:18 PM (GMT -6)   
This sounds like a modification of the form of treatment known as high-dose Brachytherapy, where the "seeds" are removed after a short period of time..It's usually repeated the following day, a two-shot radiation treatment..A very high dose of radiation can be administered in this manner and it is confined to a small area..

I suspect it's only effective with sharply defined tumors that were detected very early because the lethal range of the radiation is not very great when only a few pellets are used..

Veteran Member

Date Joined Dec 2010
Total Posts : 3550
   Posted 12/18/2010 8:18 AM (GMT -6)   
This really isn't all that new as Dr. Jeffrey Demenes at UCLA has been performing it since 1981 and Martinez in Detroit is nearly 20 years. What is relatively new is High Dose Radiation (HDR) in monotherapy form. Demenes started about 8 years ago doing monotherapy HDR on very early stage PCa. Normally HDR is combined with IMRT external radiation. As I remember, Demenes recently published five year results of monotherapy on about 500 procedures.

I chose HDR brachytherapy rather than low dose permanent brachytherapy for its improved accuracy and less side effects. My urologist and rad-onc have teamed on more than 1,000 procedures and it was actually my urologist that recommended it over surgery. My case followed the standard procedure of two sessions one week apart. Each session was fine tuned to get the radiation exactly where they wanted it. Side effects have been minimal and I did not miss any work. I have also been on external beam IMRT with 25 treatments ending next Monday.

My rad-onc has also started the HDR monotherapy, but only in cases where it is obvious that the cancer is still within the capsule. If there is any question it may be out, then he uses the combination of HDR and IMRT. I was T2b, Gleason 7, and some perineural invasion and was thus not a candidate for the mono therapy.

Veteran Member

Date Joined Dec 2008
Total Posts : 3149
   Posted 12/18/2010 8:52 AM (GMT -6)   
JNF-yeah and this doesn't seem all brand new, HDR has been around quite awhile. It is a great marketing blitz to mention such and has always been a decent choice to look it, and consider. There are other reknown docs whom have been doing this for many years. Beware of any newbie docs whom recently put up their shingle for doing HDR or brachy.....years ago one guy got brachy seed(s) in his seminal vessicals and that had to get corrected. Caveat emptor applies to medical treatments.

Post Edited (zufus) : 12/18/2010 7:55:45 AM (GMT-7)

Veteran Member

Date Joined Dec 2010
Total Posts : 3550
   Posted 12/18/2010 12:54 PM (GMT -6)   
My understanding is that with HDR the seed can't get stuck as it is attached to a wire and inserted into the catheters that have a closed pointed end.

After my procedure they showed me the catheters, 15 in all. They are thin plastic straws that are sharply pointed at one end so that it can penetrate the skin and tissues. During the procedure the seed is run through a tube into and out of each catheter providing a high radiation exposure to the programmed areas.

I am aware of permanant seeds that shift and get into the wrong places. They are tough to remove. My urologist and rad-onc have had a number patients that had complications from low dose permanent seeds. The seeds shift, the body changes during the 60-90 days they give off radiation, and the placement using ultrasound is not as accurate as the HDR which uses ultrasound and CT scan for more accurate placement. All reasons I chose the HDR.
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