Private Sector Offers Brachytherapy

by Jean McGeorge

(article reprinted from New Zealand Doctor 10 May 2000)

A new treatment for low grade prostate cancer that promises less invasivetechniques and fewer side effects is now being used in New Zealand.

Brachytherapy, which involves implanting up to 140 tiny radioactive seeds directly into the prostate, results in less incontinence and impotence than external radiotherapy and surgery.

Oncologist John Matthews, who, along with urologist Derek Rothwell, brought thetechnique to Epsom’s Brightside Hospital, says after 10 years the therapy has similar results to other forms of prostate cancer therapy.

Brachytherapy was refined during the mid-1980s by the Seattle Prostate Institute and uses three-dimensional computer mapping equipment to plan the best distribution of seeds for the tumour.

The radioactive seeds can deliver up to twice the dosage of other treatments and radiation levels fall off very quickly away from the prostate.

The seeds are permanent, but the effective dose is delivered over about four tosix months.

Dr Matthews says brachytherapy can be used as the sole treatment for early lowrisk cancers and in conjunction with external VEAM radiotherapy in intermediateand higher risk patients. He says it is minimally invasive and has a quick recovery time.

"Patients are discharged the following day and may return to their usual activities very early, usually within a week."

Patients can experience mild to moderate urinary problems which usually settle within four months of receiving the implants. Long term, there is a 15 to 50 percent chance of impotence.

Brachytherapy is currently only available through some insurance companies and costs over $20,000. Dr Matthews expects the technique to extend to other centres and is hoping to introduce it to the public sector.

Auckland Hospital is investigating the feasibility of funding brachytherapy.

For summaries of research into the technique: www.docguide.com