Prostate Cancer Treated with Seed Implants (Brachytherapy) shows Paradoxical Utilization

Prostate Cancer Treated with Seed Implants (Brachytherapy) shows Paradoxical Utilization per Presentation at the American Brachytherapy Society Spring Meeting 2015

Written By: Dr. Charles Meakin

Brachytherapy
Dr. Steven Frank gave a talk on the use of brachytherapy or seed implantation for prostate
cancer as a “model for value in the changing healthcare environment.” He reported the data on
Standard outcomes; Control of Cancer based on PSA, maintenance of sexual function,
maintenance of normal urinary and bowel function, and finally cost (to patient and hospital/
insurance providers). He concluded Prostate seed implant or Brachytherapy scored the
best on all 4 measures compared with other standard options to include surgical options,
IMRT radiation therapy and Proton therapy.

Dr. Brad Prestige continued the discussion and noted paradoxical reduction in utilization of the
prostate seed implant despite the published good results and 30% reduced cost over the other
options. The falling utilization is possibly related to greater active surveillance, more self
referral, greater use of robotic surgery and proton therapy, and improvements in external beam
treatment and negative publicity from the veterans administration incident with prostate seed
implant. With the anticipated arrival of Accountable Care Organizations (ACO) and more
focus on prostate seed implantation for the treatment of prostate cancer, seed implantation
may have a rapid resurgence. One concern of the American Brachytherapy Society is the
availability of trained radiation oncologists who still perform this valuable procedure.

SERO physicians have performed prostate seed implants since the mid 90s working with our
urologic peers. SERO continues to manage a robust prostate seed implant program at most of
the centers and have over 10 physicians trained in this technique. Since inception of the
prostate seed implant program at SERO, thousands of patients have enjoyed the good results
discussed above at a lower cost of care. All prostate cancer patients deserve a Multidisciplinary
Approach as recommended by the American Urologic Society and Commission on Cancer
which should include a direct evaluation by a radiation oncologist who is skilled in this
procedure.