1. Thanks for this posting (information reminder). My wife's brother is a "good-prognosis" prostate cancer patient, and had this done. This should help to allay any fears that he may have.

Posted at 1:27PM on Jan 10th 2007 by Greg Pawelski

2. Kristina -- I was recently treated with brachytherapy at the Seattle Prostate Institute for early stage prostate cancer. I am very interested in the 15 year study you noted on brachytherapy. Dr. Peter Grimm of the Institute mentioned the study when I was there in November. Is it published anywhere that I can read?

Posted at 10:08AM on Jan 12th 2007 by Robert Francis

3. Robert and friends - I wanted to see what the study said too and went to www.pubmed.gov, entering the search string " sylvester je [au] AND 2007 [dp] ". If you do that (disregard the quotes) you will get a free abstract of the study. If you click on "Elsevier Full Test Article", you can either buy a copy of the paper or possibly be granted access as a patient. You can also go to a medical library open to the public that carries this major journal. To find the closest library, go to http://nnlm.gov/members/ .

This is very good news as it confirms earlier reports of continued success with brachytherapy by one of the country's premier brachytherapy centers. The three lead authors edited a 2004 book covering all therapies that is especially strong in its coverage of brachytherapy. The book is: "The Prostate Cancer Treatment Book." It provides insights into their approach.

Low and intermediate risk men did very well in this study. As expected, men with high risk cases (like mine) did not fare as well. The abstract states that "BRFS [Biochemical Recurrence Free Survival, meaning the PSA did not rise in a way that signaled recurrence] using the Memorial Sloan-Kettering risk cohort analysis (95% confidence interval): low risk, 88%, intermediate risk 80%, and high risk 53%. Grouping by the risk classification described by D'Amico, the BRFS was: low risk 85.8%, intermediate risk 80.3%, and high risk 67.8% (p = 0.002)."

Note that failure in this study meant that the cancer recurred, not death. There are several tactics that can be effectively employed after recurrence, hormonal therapy being a common next step.

Also, some of the recurrences were no doubt quite mild, perhaps requiring no further attention, while others were more urgent.

Brachy is pushing surgery aside as the treatment of choice for many men, and this study will probably boost that trend.

Jim Waldenfels

Posted at 9:06PM on Jan 13th 2007 by Jim Waldenfels

4. If you are interested in learning more about the latest brachytherapy techniques, as well as a good summary on post-treatment short and long-term complications, etc. you might want to visit the Seattle Prostate Institue website. I am a newly diagnosed prostate cancer patient (stage T1c) and am looking at brachytherapy as a possible treatment. The website link is:www.seattleprostateinst.com. Click on "For Patients", then go to "About Seed Implantation".

Posted at 8:50PM on Mar 8th 2007 by Michael DeLongchamp