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The Center
CPCC is the only center in the world dedicated
solely to the treatment of prostate cancer using brachytherapy
(radioactive seed implantation). As a result of the unique design
of our medical facility, we are the busiest implant center in
the world.
Management options of organ confined prostate cancer include watchful
waiting, hormone therapy, cryotherapy, external beam radiation
therapy (EBRT), radical prostatectomy (RP) or permanent radioactive
I 125/Pd 103 seed implant. For patients considered to have a life
expectancy of 10 years or more, we do not advocate watchful waiting,
hormone therapy alone or cryotherapy. In our opinion, there are
three reasonable treatment options for locally confined prostate
cancer one should consider.
Radical prostatectomy (surgery) has traditionally been the most
utilized therapy in men with a life expectancy over 10 years.
EBRT has been commonly utilized, but generally in men who are
not candidates for surgery. At the present time, there is minimal
long-term follow up or survival data in patients treated with
3D conformal radiation therapy (3D CRT) or intensity modulated
radiation therapy (IMRT). EBRT treatments are improving dramatically,
however, conventional standard EBRT with doses of 7,000 cGy or
less have not compared favorably with surgery and brachytherapy
at 10 years or longer. Currently, there is only one treatment
that has given equivalent results to radical prostatectomy in
patients followed beyond 15 years - prostate brachytherapy.
Brachytherapy (radioactive seed implantation) has risen rapidly
in popularity as primary therapy because it has shown survival
statistics essentially equal to surgery and is minimally invasive.
It is a procedure that has benefited from the technologic/digital
evolution that has occurred over the past two decades. Without
a doubt, we perform better implants now than 15 years ago, simply
because of technological advances. Therefore, one should expect
the already excellent results achieved with brachytherapy only
to improve in the future.
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SURGERY |
SEED
IMPLANT |
Conformal/
IMRT |
| WHERE |
Hospital
Stay
3-5 days |
Out-patient |
Out-patient |
| DURATION |
2-3
hour
operation |
1
hour procedure time;
3 hour total stay |
15
min/day,
5 days/week for 8 weeks |
| NEED
FOR CATHETER |
YES-
3 Weeks |
OCCASIONALLY
5-10% risk for few days |
RARELY |
CURE
RATES
LOW RISK |
59-83% |
78-87% |
13 year survival rate not available |
CURE
RATES
INTERMEDIATE RISK |
46-53% |
66% |
13
year survival
rate not available |
CURE
RATES
HIGH RISK |
22-29% |
36% |
13
year survival
rate not available |
| IMPOTENCE
RATE |
50-90% |
10-25%
(most patients
successful w/ Viagra) |
40-50% |
| INCONTINENCE
RATE |
3-6% |
0-1% |
0-1% |
| OTHER
RISKS |
Bladder
injury |
Bladder
irritability |
Radiation
cystitis |
| |
Bowel
injury |
Bowel
irritability |
Radiation
proctitis |
| |
Bleeding
(requiring transfusion) |
Bleeding
(rare) |
|
| |
Anesthetic
Complications |
Anesthetic
Complications |
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How
do I decide between radical prostatectomy and brachytherapy if
the numbers are essentially the same?
| |
PRO |
CON |
RADICAL
PROSTATECTOMY
(surgery) |
Get
prostate out |
Risks
of Surgery |
| |
Know
pathology immediately |
Prolonged
recovery |
| |
Emotional
Component -
Want the prostate out |
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| BRACHYTHERAPY
(seed implant) |
Short
out-patient procedure |
Unknown
effects
20-30 years down the road |
| |
Emotional
Component -
Want to avoid surgery |
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CPCC has been evaluated and favorably compares with the leading medical centers across the United States. Discerning patients and professionals in the United States, as well as internationally, have most frequently chosen CPCC for delivering their care of prostate cancer. The entire facility is dedicated to prostate brachytherapy. We are currently averaging 100 implants per month, versus other major medical institutions, which typically average no more than 10-15 implants per month. Our patients are carefully selected and we will recommend other treatment modalities if it is in the patient's best interest. In the past nine years, we have seen over 10,000 patients, and have implanted over 8,000 of them.
Using state of the art equipment, our staff is trained specifically for brachytherapy. Technique is continually improving, and currently, the average length of the procedure is 35 minutes. Further, the physics team has many years of experience planning prostate seed distributions and uses the most sophisticated prostate brachytherapy software. Careful analysis of our post-implant radiation dose distributions plays a key role in the success of patient outcomes. Research efforts are leading us in new directions to better understand the benefits and side effects of brachytherapy. This helps us to better educate physicians who perform the procedure, as well as to counsel men in the future who are considering seed implants.
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