Prostate cancer is the most frequently diagnosed cancer in males in the United States. There will be 218,890 new cases of prostate cancer diagnosed this year. Approximately one in six men will be diagnosed with prostate cancer in their lifetime. The good news is like many cancers, prostate cancer is easier to treat when discovered early.
Prostate screenings with digital rectal exams along with Prostate Specific Antigen tests (PSA) have a significant impact in the detection of early stage prostate cancer. Men diagnosed with early stage prostate cancer have several treatment options including: radical prostatectomy, radiation therapy, cryotherapy and observation. Personal preference, age and health status will all have an impact on the type of treatment a man will receive for prostate cancer and should be discussed with your physician.
One of the areas where there has been significant treatment enhancements is in the area of radiation therapy. Radiation therapy can be delivered via three different methods: external beam, seed implantation or external beam combined with seed implantation. Each of these methods may be combined with a course of hormonal suppression which will be discussed more in a following article.
During radiation therapy, radiation oncologists and technicians specifically determine the location of the tumor cells and may insert tiny metal pellets into the prostate. Over the course of several months, the seeds give off radiation to areas in the prostate, killing the cancer cells in the prostate. External beam therapy most often is delivered by a technique utilizing radiation therapy.
Prostate Seed Implants have been used successfully for many years with excellent results. The earliest seeds used were Iodine Seeds. Palladium Seeds were added as an alternative 20 years ago, and both seeds can deliver excellent results. Recently cesium-131 seeds have also become available for prostate implants.
Cesium seeds offer some unique advantages combining the best qualities of Iodine and Palladium seeds. Iodine seeds are used because their energy is sufficient to allow good coverage of the prostate gland while minimizing the risk of uncomfortable symptoms or recurrences. However it takes 60 days for the seeds to deposit one half of the radiation within the prostate.
Palladium seeds have a much quicker delivery of the radiation to the prostate and the tumor. This can lead to a quicker recovery from the side effects that may be experienced following implant therapy. Palladium seeds however have a lower energy. This means that more seeds are needed to cover the prostate gland, which may increase the risk of overdosing or under dosing the prostate gland.
Cesium seeds have an energy that is very close to that of Iodine seeds as well as a quick delivery thus combining the best of both Iodine and Palladium seeds. Cesium seeds can be combined more easily with external beam therapy and can be used before or after external beam therapy.
Depending upon the size and location of a patients tumor, all three seeds will have a role to play. The good news is that urologists, radiation oncologists and patients now have an additional option available to treat prostate cancer.
September is Prostate cancer awareness month. Penn State Cancer Institute at Mount Nittany Medical Center will offer prostate cancer screenings on Tuesday, September 25, 6-8:30 p.m. at the Medical Center and on Wednesday, September 26, 6-8:30 p.m. at the Penns Valley Medical Center. Limited appointments are available. To schedule, call 814.234.6106.
Jerome Derdel, MD, is the medical director of radiation oncology at Mount Nittany Medical Center.