Patients still denied prostate cancer therapy despite proven efficacy

The results of a study just published in the British Journal of Urology International1 add further support to the routine use of brachytherapy for the treatment of prostate cancer,

The study, carried out at St. Luke’s Cancer Centre in Guildford, prospectively followed 300 patients treated with low dose brachytherapy between March 1999 and April 2003. The results showed a survival rate of 93% after five years for early-stage prostate cancer which compared favourably to other treatment options such as surgery and hormone therapy2.  In addition, brachytherapy treatment was well tolerated and two thirds of patients with normal erectile function at the start of treatment maintained function at two years.

Brachytherapy involves inserting approximately 100 tiny radioactive seeds into the prostate gland to kill the cancer cells. This is typically done under a general anaesthetic either as a day case or an overnight stay, thereby reducing patient time in hospital and avoiding many of the side effects often associated with surgery.

The National Institute for Clinical Excellence (NICE) guidelines3 has previously stated that current evidence on the safety and efficacy of brachytherapy for localised prostate cancer is adequate to support the use of this procedure, provided that the normal arrangements are in place for consent, audit and clinical governance.

However, according to Professor Stephen Langley from St. Luke’s Cancer Centre, who led this study, patients are still being denied this treatment, “Although brachytherapy is a proven therapy for early stage prostate cancer, many PCTs are still not funding this procedure,” explains Professor Langley. “This has resulted in a postcode lottery which denies patients access to an effective therapy option with a low side effect profile.”

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1.Khaksar SJ et al. Biochemical (prostate-specific antigen) relapse-free survival and toxicity after (125)I
low-dose-rate prostate brachytherapy. BJU Int. 2006 Dec;98(6):1210- 5. Epub 2006
2. Kupelian PA et al. Radical Prostatectomy, external beam radiotherapy <72 Gy, external beam radiotherapy ≥72 Gy, permanent seed implantation or combined seeds/external beam radiotherapy for stage T1-T2 prostate cancer. Int.J.Radiation Oncology, Biol, Phys. 2004, 58 (1) 25-33
3. IPG132 Low dose rate brachytherapy for localised prostate cancer – guidance

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