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YOUR HEALTH: A targeted treatment that avoids prostate cancer surgery

Brachytherapy involves radioactive seeds placed in or near the tumor itself.
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CHICAGO, Illinois – Dave Ricordati was 56 when doctors diagnosed him with prostate cancer.

His first thought was about his wife Kathy and their three children.

"Our youngest daughter is getting married in March and I want to walk her down the aisle. These are all the things you worry about as a dad, as a husband that you're going to miss out."

Dave didn't want surgery to remove the prostate.

"Quite honestly, I wanted to have sex and intimacy after the treatment and I don't think that treatment provided those options."

Instead, Dr. Brian Moran, medical director of the Chicago Prostate Cancer Center, treated Dave with brachytherapy.

BRACHYTHERAPY:   Brachytherapy is one of the more advanced cancer treatments. It involves radioactive seeds or sources being placed in or near the tumor itself, giving a high dose of radiation to the tumor while reducing radiation exposure to the surrounding healthy tissue.  Thin catheters are first placed in the tumor, and then connected to a High-Dose Rate (HDR) afterloader.  The machine contains one single highly radioactive pellet at the end of the wire, and it is pushed into each of the catheters under computer control.  The computer controls how long the pellet stays in the catheter and where it should pause to release its radiation.  It can provide very precise treatment that only takes a few minutes, and after a series of treatments, the catheters are removed and there are no radioactive seeds left in the body.  (Source: http://www.brachytherapy.com/)

Dr. Moran recently studied the effectiveness of an isotope called cesium 131.   It's designed to deliver the radiation dose with less concern about the patient exposing children and pets to radiation.

"Some patients come in and say 'You know, Doctor, I can`t be radioactive for six months', or it's usually five half lifes. With cesium there's some element of radiation present for a month," explained Dr. Moran.

72-year old Lee Gimbel is a volunteer with Alzheimers patients.  He wanted a treatment that would get him back to normal quickly.

"It was rather fast, rather routine," he remembered.

"It felt better than having anything surgical."

Dave Ricordati is back to playing men's floor hockey: a hobby he was afraid he would have had to give up if he had surgery.

"This is the least side effects with the same cure rate. I don't know why anybody would pick anything else to be honest."

NEW TECHNOLOGY:  Patients undergoing prostate brachytherapy with cesium 131 had excellent oncological outcomes at 5 years. Continual follow up is required to asses further the true cancer control ability of cesium 131, but intermediate-term outcomes show good results.  With a growing base of clinical experience, one study followed 485 patients of different risk groups treated with cesium 131 to measure if the disease progressed; at five years 98 percent of men with low risk disease showed no evidence of disease progression.  Another randomized study found the cesium 131 isotope was just as effective as other isotopes in the radiation seeds.   (Source: https://isoray.com/treatment/prostate-brachytherapy-cancer-treatment/ and Brain Moran, MD)

If this story has impacted your life or prompted you or someone you know to seek or change treatments, please let us know by contacting Jim Mertens at jim.mertens@wqad.com or Marjorie Bekaert Thomas at mthomas@ivanhoe.com.

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