This Tiny Radioactive Implant is a Powerhouse for Treating Prostate Cancer

Nobody wants to hear they have cancer. And after a cancer diagnosis, good news can be thin on the ground. So it might be a pleasant change to hear that for the most common types of prostate and penile cancer, called adenocarcinomas, scientists have developed a tiny radiotherapeutic implant that can deliver targeted radiation to the affected area — and nowhere else.

Prostate cancer is almost a relief in terms of cancer diagnoses, because it’s often a slow-moving thing. It can even remain asymptomatic, which is different indeed from the cancers that can kill. In some cases, rather than having to leap for aggressive therapy like the dreaded triple whammy of chemo, radiation, and surgery, a person with prostate cancer can safely rely on a thing called “active surveillance” or “watchful waiting.”

(NB: this is a specific technique that only works if you have your oncologist’s specific permission, and that means you have to talk to your doctor before acting on anything you read on the internet.)

Even though there does exist a less-extreme path that prostate cancer can take, there’s still a continuum of severity and aggression, just like there is for any kind of cancer. And the more severe and aggressive cancers can require commensurate urgency in treatment. Radiation is one important kind of cancer treatment. But traditional radiation therapy has to get into the body from outside, and because of that, it tends to have serious side effects on the tissue that the beam has to pass through to get to the area being treated. As if hearing an affirmative cancer diagnosis wasn’t intimidating enough, having to contend with radiation burns? Can we possibly just avoid that whole party?

Well, yeah, as it turns out, sometimes we can. For those people who do require more aggressive treatments such as radiation, there’s a tiny implant among the relatively less-scary options for prostate cancer treatment.

Brachytherapy

The way to avoid pass-through damage is to avoid the pass-through itself. There is a way to treat prostate cancer by laparoscopically placing a tiny, flexible seed implant, impregnated with a carefully titrated dose of the right radioisotope, inside the prostate itself where the radiation is really needed. Because the implant is inside, there’s no beam, and no pass-through damage. The technique is called brachytherapy. When it’s used to treat the most common kind of low-grade prostate cancer, cure rates are the same as with a radical prostatectomy.

Beyond their utility in prostate cancer treatment, though, such tiny implants can be used to treat certain rare types of penile cancer. At a recent conference, Dr. Alexandre Escande presented results from clinical trials that show good outcomes for men who received a tiny wire implant as treatment for cancer of the penis. The wire itself is what delivers the radiation.

“These results show that brachytherapy is the treatment of choice for selected patients whose cancer has not spread into the sponge-like regions of the erectile tissue in the penis – the corpus cavernosum,” Dr. Escande told the conference. “It is effective at controlling and eradicating the cancer and allows a high number of men to preserve their penises.

“Another important finding was that if cancer did return, then this could often be dealt with successfully by a second round of brachytherapy or by surgery without the men being at higher risk of death from the disease,” Escande continued. “This suggests that brachytherapy is an adequate upfront, organ-sparing strategy, which is usually associated with only mild to moderate toxicities. Men still have a good body image, and also sexual and urinary function for the majority.”

“These are very encouraging results from an excellent study of a large group of men with a rare cancer who were followed up for a long period of time,” professor Yolande Lievens, the president of ESTRO, said. “These findings further endorse the important role of radiotherapy — brachytherapy in this particular situation — in organ-sparing curative approaches to cancer. The use of brachytherapy in this very rare cancer type not only translated into high survival rates of men with this disease, but also ensured that the impact on their quality of life was kept to a minimum.”

There’s been a wave of recent developments in prostate cancer therapy, which is another bit of welcome news. ESTRO has put forth a bunch of research developments and trials. In addition to this piece of news on brachytherapy, there’s also been recent news about good outcomes from single-dose radiation, also relevant to prostate cancer. Implants like this are also being used for thyroid cancer, with similarly good outcomes. Good news all around.

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