Up to 79% preservation of potency and less than 2% incontinence are the striking results of a clinical study in which over 300 men received an innovative treatment for prostate cancer. HDR (high dose rate) brachytherapy in combination with an innovative new image-guidance technology was shown to be just as effective as conventional therapies, but much less likely to cause the common side-effects of impotence and incontinence.
Conventional Therapy vs, HDR Brachytherapy and the New Image-Guidance Technology
Standard treatments for prostate cancer are surgery (prostatectomy) to remove the prostate, and radiotherapy. Normally, radiotherapy is delivered from an external source situated at a distance (a process known as teletherapy or external beam therapy), and is therefore directed over the entire prostate area. This makes it virtually impossible to avoid penetrating healthy tissue, including the sensitive urethra running through the middle of the prostate, and the neurovascular bundles (on either side at the base of the prostate) that control penile function. After surgery or conventional teletherapy, between 40-100% of men will be left impotent, and 35% of surgery patients will suffer incontinence.
In brachytherapy, on the other hand, the tumour is irradiated from the inside. In prostate cancer therapy, this is achieved by introducing small tubes into the prostate at specific points, and then inserting a radioactive isotope either temporarily (HDR) or permanently (tiny implants) into each tube to deliver the appropriate dose.
Until recently, the precision of HDR brachytherapy was determined by positioning of the tubes based on CT imaging. However, CT scans tend to produce indistinct images of the prostate. Furthermore, the images have to be taken after rather than during the tube insertion, and so can prove inaccurate as the position of the prostate and other internal organs adjacent to it may move.
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