1000th patient treated with seed implantation

"We are proud," says Dr. Gregor Spira, senior physician and radiotherapist at the West German Prostate Center. In November 2006, the team of radiotherapists and urologists carried out the 1000th seed implantation in the treatment of localized prostate carcinoma, making it one of the largest implantation centers in Europe.

The demand for this modern form of radiation therapy as a gentle alternative to conventional surgery is increasing,"explains Spira. Together with his colleagues, the urologist Dr. Pedram Derakhshani and Dr. Stephan Neubauer, the radiotherapist treats not only patients from Germany but also from neighbouring countries such as the Netherlands, Belgium and France. The interdisciplinary medical team is one of the pioneers in Germany when it comes to the use of brachytherapy.

Irradiation from the inside

Brachytherapy itself is a radiation therapy in which the smallest radiation sources (seeds) are inserted into the prostate. The seeds destroy the tumor through high-dose, targeted radiation from the inside and the prostate gland remains intact. In contrast to the most common form of therapy, i. e. the complete removal of the prostate through surgery, the intervention and consequences of a minimally invasive method such as brachytherapy are minor. With the same healing rates, brachytherapy has a major advantage over total surgery:"The surrounding tissue outside the prostate is less affected. Most patients are spared the dreaded impotence that is a typical side effect of removing the prostate,"explains Dr. Stephan Neubauer. "As a result, urinary incontinence is practically non-existent."

Depending on the stage of the cancer, two brachytherapy techniques are available: In the early stages of seed implantation, at an advanced stage or in the case of aggressive cancers, afterloading therapy and, in the case of an already existing scattering of the diseased tissue, external radiotherapy alone. Dr. Spira:"The West German Prostate Center is one of the few institutions in which all procedures of modern radiotherapy for prostate cancer can be carried out.

The interdisciplinary centre in Cologne is based on the example of the USA: while more than 70 percent of all cancer patients in this country still have their prostate completely removed by surgery, brachytherapy has become the treatment of choice in the USA. More patients are already being treated with the modern radiotherapeutic method than underwent surgery.

Quality through experience and competence

A close cooperation between radiotherapists and urologists is a prerequisite for the optimal quality of treatment,"emphasizes Spira. Seeds, for example, must be placed with millimetre accuracy in order to achieve high efficacy and avoid side effects. Due to the large number of treatments that the well-rehearsed medical team has already carried out, the Cologne Centre has a very extensive database of treated patients. Currently, the data of 1500 brachytherapy patients are stored. Through the detailed documentation of follow-up checks and quality of life after treatment, therapy processes can be closely monitored. On the one hand, this ensures that we provide aftercare for our patients and on the other, we are subject to constant quality assurance,"stresses Dr. Pedram Derakhshani.

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