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Prostate Cancer (continued)

Summary

Radioactive seed implantation with either I123 or Pd103 offers a reasonable alternative to surgery or external beam therapy in the management of prostate cancer. Current data suggests that it is comparable to surgery at 5 years and, in unpublished data, Blasko et. al. state that this is maintained at 7 to 8 years post therapy. What is not known are long term results to 10 years and beyond. In order to displace surgery as the mainstay of therapy for localized prostate cancer long term comparative trials will be required.

However, with the current data available and the ease of administration and low morbidity, seed implantation is a reasonable option for those well selected patients with low stage disease who are either not surgical candidates or who do not wish to undergo surgery due to its higher rate of treatment related morbidity. Future areas of research include the benefit of radical prostatectomy for PSA failures after seed implantation or neoadjuvant/adjuvant hormonal therapy with interstitial therapy for more aggressive lesions. Until such data is known, radioactive seed implantation is an excellent option for the well informed patient with prostate cancer and should be included in the discussion of treatment options of prostate cancer.