July 4, 2008

Brachytherapy Showing Promise For More Than Prostate Cancer

Brachytherapy has shown promise for a few different forms of cancer and even for arteries which were unplugged from angioplasty. Low-dose rate (LDR) prostate brachytherapy is generally well tolerated in patients with a history of inflammatory bowel disease. Episcleral plaque brachytherapy is a complex procedure and should only be undertaken in specialized medical centers with expertise in this sophisticated treatment program. It is not yet known whether interstitial (within the tissue) brachytherapy is more effective with or without external-beam radiation therapy in treating prostate cancer.

The most common uses of this form of treatment involves the planting of radioactive seeds through 18 gauge needles into the prostate via a perineal template with rectal ultrasound guidance. High dose rate (HDR) brachytherapy is one of the latest advances in this type of treatment method as it's very effective for treatment of cervical cancer as an alternative to surgical removal of the cervix and uterus. Additionally, HDR brachytherapy is used to reduce the risk of recurrence of soft tissue sarcoma following surgery.

Permanent prostate brachytherapy is a form of low dose chemical implants (up to 120) rice-sized radioactive seeds into the prostate with guidance from ultrasound and X-rays. Low-dose rate treatment is also used in the treatment of coronary artery disease to prevent restenosis after angioplasty. High-dose rate (HDR) is usually an outpatient procedure.

Breast brachytherapy is a more localized means of treatment than standard external beam radiotherapy, so there is a lesser dose to undamaged tissue of the breast, heart, lung, muscle, skin and ribs. LDR (low dose) brachytherapy is the most commonly used of the two. LDR and HDR Brachytherapy is performed under anesthesia, and radioactive "seeds" are each placed in needles that are inserted into the target through the perineum (the area between the legs, scrotum and anus).

LDR brachytherapy makes use of iodine-125 and palladium-103 stored in titanium cases usually referred to as the "seeds". A big advantage of HDR brachytherapy is that the final doses are known before any radiation treatment is given.

Presently, at Wake Forest Baptist in North Carolina, cancers of the prostate, breast, lung, cervix and nasopharynx are being successfully treated with HDR brachytherapy. Endobronchial brachytherapy is an outpatient procedure again using radioactive sources placed within a bronchus (airway) to treat patients suffering from airway obstruction due to lung cancer and other tumors.

The utilization of brachytherapy is highly dependent on the experience of the physician and the available resources although, the flexibility of the HDR system allows it to be used for a wide range of malignancies.

HDR brachytherapy is most commonly used with cancers located near the outside of the body but with MRI assisted techniques, it's possible to adjust the isodose dissemination by taking into account tumor size and features as well as the topography of the risked organs.

Though it's true that HDR brachytherapy is currently used for the treatment of cervix cancer in the UK, most of the techniques are based on standard triple applicator procedures. While brachytherapy is not commonly used for the treatment of vulval cancer in the UK, there are some options for the management of these rare patients with small vulval or vaginal situations which are not surgical candidates.

Before the development of this type of treatment, surgery was the only option but now prostate brachytherapy is an alternative to traditional external beam radiation or surgery for men who have early stage prostate cancer (cancer that has not spread outside the prostate gland). The most common hindrance preventing brachytherapy is when there is benign prostatic hypertrophy and the long term prognosis for retaining erectile function after brachytherapy is similar to or slightly better than with surgery or external beam radiation.

Proton brachytherapy is considered the method of choice as opposed to neutron brachytherapy for treating small tumors for the fact that protons don't relocatd as far as neutrons. HDR treatment is given over the course of several minutes, but the entire procedure typically takes a few hours. Once a course of HDR is started, the treatment plan and computer guided isodose calculations are finished within 24 to 36 hours.

As always it's wise to discuss any new treatment options with your trusted doctor and/or cardiologist with experience in radiation therapy to see if brachytherapy is just what the doctor ordered for your unique situation.

Get more details on medical options open for prostate cancer sufferers at: T1C prostate cancer.

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