How successful is prostate brachytherapy?

Choosing the Right Treatment: Personalised Care and Proven Success in Prostate Brachytherapy

The right treatment for you will depend on the stage of your cancer, your age, possible side effects, quality of life considerations, whether your disease might potentially develop over time, and of course, your own personal preferences. The Medical Team at The Prostate Brachytherapy Centre will discuss all your treatment options with you.

Prostate brachytherapy is one of three types of radical therapies that are commonly used to treat localised prostate cancer (that is, prostate cancer that has not spread outside the prostate gland). Brachytherapy has been used to treat patients with localised prostate cancer in the USA for over 30 years, so we have long-term results from the treatment of these first patients which show that this form of treatment is highly effective in treating patients with early prostate cancer.

Brachytherapy has been shown to be just as effective at curing prostate cancer as the other conventional radical treatments, such as surgery (radical prostatectomy) or external beam radiotherapy (EBRT).

However, none of the available radical therapies can always guarantee a complete eradication of the cancer.

If you have a radical prostatectomy to remove the whole of your prostate gland there is still a chance that not all the cancer cells will have been removed and your cancer may return. The follow up program is the same across all treatments requiring the regular measurement of PSA for at least 5 years to ensure no sign of recurrence. The success rates for each of the three radical treatments have been shown to be the same in a number of studies in the USA involving many thousands of men.

For example, one research study of nearly 3,000 patients with early prostate cancer was carried out in the USA between 1990 and 1998. The success rates known as relapse free survival (the percentage of patients who would be expected to be free of prostate cancer 5 or 7 years after treatment) are shown below:

Success rates at our Centre

At The Prostate Brachytherapy Centre, we have a detailed record on the outcomes of treatment in all our patients. This means that we can tell new patients about the long-term success of this treatment when carried out by our team. This commitment to the long-term follow up of all our patients has also provided the data for many of our published papers in numerous international medical journals (Click here access the papers). These peer reviewed papers are some of the most extensive ever published for brachytherapy and indeed any prostate cancer treatment.

Some of the patients we have treated had early prostate cancer (stage T1 or stage T2) whilst others we treated had more progressive or advanced disease. Some of the patients have received additional hormone therapy, some had additional external beam radiotherapy (EBRT) and some had both additional hormone therapy and additional EBRT.

We tend to divide patients into low, intermediate, and high-risk groups when reporting the clinical outcomes of treatment. Patients with low risk prostate cancer have a PSA level below 10ng/mL and stage T1 or 2 tumours and Gleason score of 3+3=6 or lower. Patients with intermediate risk prostate cancer have either a PSA level over 10-20 ng/mL ng/mL, stage T2 tumours or Gleason score of 7. Patients with high-risk prostate cancer have PSA over 20 ng/mL or stage T3 tumours or Gleason Score 8-10.

In recent years we published the outcomes of ~600 young men, 60 years old or younger, that we have treated with brachytherapy for prostate cancer over a 15-year period. (Link to paper 1). This work has shown success rates in excess of over 95% for low and intermediate risk cancers and for men with high-risk disease 93% were still alive at 10 years.

We have recently presented the outcomes of ~3000 of our patients with follow up reaching 20 years. (link to paper 4). Of these men more than 97% were either alive or, if they have died, have not died from prostate cancer. These outstanding results match or exceed any results published for any prostate cancer treatment worldwide. Indeed, using recently published Office of National Statistic’s data, often used by the life insurance industry, we were able to show that men we had treated with brachytherapy had a greater chance of being alive compared men in the general population matched by aged and affluence. (link to paper 3).

The side effect profile is also of great importance when considering treatment options. At The Prostate Brachytherapy Centre less than 1% of our patients experience urinary incontinence at any time (link to paper 1) and now over 83% of patients can expect to retain their potency (link to Paper 2). Indeed, four of our patients have even fathered children 4 years after their implant.

Clinical Papers

• Paper 1 – Long-term oncological outcomes and toxicity in 597 men aged ≤60 years at time of low-dose-rate brachytherapy for localised prostate cancer – PubMed
• Paper 2 – Novel prostate brachytherapy technique: improved dosimetric and clinical outcome – PubMed
• Paper 3 – Net survival of men with localized prostate cancer after LDR brachytherapy – PubMed
• Paper 4 – Long-term survival after low-dose-rate brachytherapy for prostate cancer: the Royal Surrey experience – PubMed