Prostate Cancer Center
Chularat 3 International Hospital
Prostate brachytherapy is a new non-surgical treatment for prostate cancer
Prostate brachytherapy is a new treatment technique used to effectively combat prostate cancer in Thailand. Only a few leading hospitals in the country are offering this treatment procedure to prostate cancer patients. Brachytherapy is reportedly as effective as treatment by surgery and external beam radiation which carry unfavorable side effects, particularly the problems of erectile dysfunction resulted from damage to the nerves controlling penile erection. The other common side effect is urinary incontinence and rectal bleeding.
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When there is a concern about the risk of developing prostate cancer, the doctor may recommend prostate screening tests. Most prostate cancers are first found during screening with a prostate-specific antigen (PSA) blood test and a digital rectal examination (DRE). If a DRE or PSA test detects an abnormality, a further test to collect samples of prostate tissue will be required. There are two techniques to collect sample of cells from the prostate: |
Dr. Viroon Donavanik, MD, a highly-recognized radiation oncologist specializing in prostate brachytherapy from the United States, has successfully treated more than 2,600 prostate patients for more than two decades. He is also currently a prostate brachytherapy specialist at Chularat 3 International Hospital. Dr. Viroon has introduced brachytherapy as a new alternative in treating prostate cancer in Thailand. The technique is as effective as prostatectomy, but the patients do not have to go through invasive surgery or experiencing various side effects from external-beam radiation therapy. Brachytherapy patients will not have surgical wounds, resulting in a short recovery time. More importantly, this treatment procedure has relatively low impotence rate and there is no risk of urinary incontinence.
“To determine the optimum prostate treatment option, the doctor will evaluate and choose the most effective method that has the highest chance of success with minimal side effects,” said Dr. Viroon.
1.Using a device to pass a thin, hollow needle through the wall of the rectum into the prostate to draw out samples of tissue for testing. This biopsy technique collects small amount of tissues from certain parts of the prostate but the risk of infection can be as high as 30 %.
2.Transperineal biopsy which is done by using a device to insert a needle into the prostate through the perineum (area of skin between the anus and scrotum). MRI and ultrasound are used to guide this procedure. This technique enables collection of larger amount of tissues from different parts of the prostate and the risk of infection is non-existent. The accuracy rate of this diagnostic test is more than 80%. Transperineal biopsy is performed only at Chularat 3 International Hospital by Dr. Viroon Donavanik.
Treatment
When the biopsy confirms presence of cancer, the next step is to determine the extent or stage of the cancer. Not all prostate cancer patients can be successfully treated with only brachytherapy. Prostate brachytherapy is considered as the best treatment option for those diagnosed with Stage 1 and Stage 2A cancers which are still confined within the prostate gland. The patients diagnosed with Stage 2B may have to supplement brachytherapy with external beam radiation therapy and also hormone therapy. Those with Stage 3, where the cancer has spread beyond the prostate to the seminal vesicles or other nearby tissues, are required to have brachytherapy, external beam radiation therapy and also hormone therapy For men with Stage IV, where the cancer has grown to invade nearby and/or distant organs, hormone therapy is the only treatment option to slow down the progression although in special circumstances the same treatment for stage 3 cancer can still be applied.
There are three types of low dose-rate (LDR) brachytherapy sources that are most commonly used to treat prostate cancer. They are in a form of tiny radioactive particles the size of a grain of rice, called radioactive seeds, implanted directly into the tumor enabling them to deliver radiation right at the malignant cells without affecting the normal healthy tissues around it. These three types are: iodine 125 seeds (with half-life of 60 days), palladium 103 seeds (half-life of 17 days) and cesium-131 seeds (half-life of 9.7 days).
Prostate brachytherapy procedure requires no surgical incision because the radioactive seeds are inserted into the prostate gland using needles which pass through the perineum. The small needle holes should heal within 3 to 4 hours. The patient should be able to resume normal activities after 24 hours. However, it is recommended to avoid strenuous activities which may irritate the prostate, such as running or riding a bike, for one to two weeks.
When considering its effectiveness as well as fewer side effects , prostate brachytherapy is becoming more favorable in early stage prostate cancer than the other treatment options.
CONTACT
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ID Line oncchularat
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Tel. 091-770-6639
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