ESTRO: Brachytherapy achieves excellent results

Brachytherapy - more effective, gentler and cheaper than radical surgery

Urinary incontinence, erectile dysfunction, impotence? Particularly for younger patients with prostate cancer, expected side effects play a decisive role in the choice of therapy. Here, brachytherapy, a special form of "internal" radiation, has not only proved to be highly effective, but has also been shown to be low in side-effects. A recent study recently presented at the annual meeting of the European Society of Radiology and Oncology (ESTRO) clearly shows that those who are treated with brachytherapy instead of conventional surgery can expect a significantly better quality of life after the procedure without fearing a loss of healing. In addition, brachytherapy is much more cost effective than total surgery1.

Whether surgery, brachytherapy or external radiation - the cure rates are very good at 90 percent for patients with prostate cancer, regardless of the type of treatment. Once the decision for a therapy has been made, the focus should therefore be on gentle treatment methods,"emphasizes Dr. Stephan Neubauer from the West German Prostate Center in Cologne. Unfortunately, however, the reality, at least in Germany, still looks different, the urologist complains. Surgery is still the number one treatment for localized prostate cancer. And this despite considerable side effects such as erection problems, sexual disinterest or urinary incontinence. One in five also confirms complications caused by surgery, such as severe bleeding or intestinal injuries.

Best results for brachytherapy

More and more studies of brachytherapy confirm the highest score in terms of quality of life and patient satisfaction. In this ultra-modern form of radiation therapy, the tumour in the prostate is destroyed from the inside and the neighbouring organs such as the intestine, bladder and urethra are protected. The superiority of brachytherapy over total surgery has again been demonstrated by a systematic analysis of 55,000 patient data, recently presented at the annual meeting of the European Society of Radiology and Oncology1, examining cure rates, health-related quality of life criteria and the cost of treatment over a period of 10 years. The result is clear: both seed implantation in patients with a low risk and HDR afterloading in combination with external radiation in advanced stage prostate cancer is associated with a significantly higher quality of life compared to surgical removal of the prostate.

Lower costs through brachytherapy

Another advantage: Brachytherapy is the most cost-effective option for treating localized prostate tumors. Especially long regeneration times after surgical removal cause high costs for the patients themselves, but also for employers and health insurance companies. For example, the patient is ill for an average of 104 days after a total operation, while the patient can resume work the following day after brachytherapy. In addition, there is the costly and time-consuming treatment of therapeutic complications and side effects of the total operation such as urinary incontinence and impotence1. 

The aim of treatment in patients with a tumor limited to the prostate should always be to achieve healing and to avoid any restrictions on the quality of life caused by the disease,"said Dr. Neubauer. The USA is already a big step ahead of us in this respect,"says the urologist of the West German Prostate Center. While only 8 percent of patients in Germany are treated with brachytherapy, 25 percent in the USA are already benefiting from this gentle therapy, and far more men are already benefiting from it.

Literature:

Steuten LMG. Comparative cost / QALY of guideline-recommended prostate cancer treatments: a UK cost perspective. PD 0371;2nd ESTRO Forum, Geneva, Switzerland 2013.

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