Boston Herald Reporter Alexi Cohan recently joined Dr. Peter Orio on the “front lines” in order to learn more about brachytherapy for prostate cancer treatment. This article details the brachytherapy procedure process and the benefits that it brings both the patient and their clinicians.
From the article: “The elegance of the procedure is its simplicity. We don’t change the anatomy,” said Orio. “An hour out of your life to cure cancer. It’s amazing.”He was right about elegance. The procedure lasted 58 minutes, and the patient was soon whisked away to recover for the next hour before he was sent home with minimal pain or side effects.
The procedure is inexpensive, and within about a year many patients have less than a 1 percent chance that the cancer will come back, according to Orio. You can read the full article from the Boston Herald by clicking here.
In addition to being the Director of Prostate Brachytherapy at South Shore Hospital in clinical affiliation with the Dana-Farber/Brigham and Women’s Cancer Center, Dr. Orio is also the current President of the American Brachytherapy Society (ABS). We thank Dr. Orio for making time to help build awareness among the general population about brachytherapy’s importance as an option for men diagnosed with prostate cancer.
Isoray is committed to raising awareness about prostate cancer and ensuring patients have the right information to support their treatment decisions.
The International Journal of Radiation Oncology recently published a study titled Survival Benefit of Adjuvant Brachytherapy After Hysterectomy With Positive Surgical Margins in Cervical Cancer. This study aimed to evaluate the effects on survival rate in patients with cervical cancer after undergoing a combination of brachytherapy and external beam radiation treatment (EBRT). All of the patients involved in the study had previously had a hysterectomy with positive surgical margins.
From the abstract:
Logistic regression was used to evaluate predictors of [brachytherapy] use and for propensity score matching. Survival was compared between patients receiving EBRT alone and those receiving EBRT combined with [brachytherapy] for adjuvant treatment.
In women with positive margins after hysterectomy for cervical cancer, the combination of EBRT and [brachytherapy] showed significantly improved overall survival compared with EBRT alone.
Out of the 1,719 patients studied, 778 (45.3%) of them received brachytherapy in addition to EBRT. Patients who received brachytherapy treatment resulted in an overall survival rate of 79.4 percent, with those who underwent EBRT alone resulted in a survival rate of 71.9 percent. The results of this study demonstrate the value of brachytherapy beyond prostate cancer treatment.
Treatment for recurring gynecologic cancers can be challenging, often involving radical surgery and very limited treatment options. The Cesium-131 isotope developed by Isoray Medical is an emerging treatment option for patients with recurrent gynecologic cancers due to its energy profile and 9.7 day half-life.
There is a growing amount of evidence that brachytherapy’s role as a prostate cancer treatment modality should not be limited to low-risk cases, but should also include patients with higher risk disease.
The Journal of Clinical Oncology recently reported on an analysis of 42,765 patients with high-risk, clinically localized prostate cancer with complete prognostic data who were treated with either radical prostatectomy (RP), external beam radiotherapy (EBRT) combined with androgen deprivation (AD), or EBRT plus brachytherapy with or without AD.
The analysis showed, “There was no statistically significant difference in survival between RP and EBRT plus brachytherapy with or without AD. EBRT with AD was associated with lower survival”
“Too many men dealing with the challenges of high risk prostate cancer are still not aware of the different treatment options that are available to them,” said Isoray Vice President Michael Krachon. “The time for that to change is long past due. Many of these men could be effectively treated with brachytherapy — in an outpatient setting, at lower overall cost and impact to their long-term quality of life.”
Isoray’s proprietary Cesium-131 isotope is the next generation of brachytherapy. With a shorter half-life and higher energy than other commonly used radioisotopes, Cesium-131 by Isoray has been shown to be a highly effective cancer treatment when planned appropriately. Treatment with Cesium-131 results in patients making a quick recovery from their treatment and then experiencing a speedy return to their baseline urinary function.
With the 2018 edition of the American Brachytherapy Annual Meeting in the books, it is fitting to take a few minutes and highlight our top ABS 2018 Insights.
The clinical experience with Cesium-131 continues to build:
Dr. Manuj Agarwal of the University of Maryland presented his results from a long term follow-up of Cesium-131. He reported 8-yr progression-free survival of nearly 97%, with a favorable toxicity profile and recovery time. When asked about the need for an additional treatment isotope, Dr. Agarwal responded, “I think piggybacking on some of the previous thoughts on quality of life data, acute morbidity is a real complication that does cause men quite some distress. If we have an isotope now that has a more favorable acute GU profile might be worth exploring.”
Dr. Shilpa Larkin of the University of Kentucky presented on the use of Cesium seed implants for recurrent, advanced (stage III-IV) gynecological cancers. She reported good initial local control with a reduced cost and favorable patient experience for these patents.
Brachytherapy and Stereotactic Radiation Techniques:
The debate continues about the relative roles of SBRT and brachytherapy for boost treatment of prostate cancer patients. In a debate moderated by Michael Zelefsky, existing body of literature was reviewed, and the discussants agreed that brachytherapy continues to provide a more highly conformal dose to support treatment.
The cost-advantage of brachytherapy treatments is real
Nikhil Thacker and Ben Durkee moderated a socio-economic session the reviewing the shifting landscape of brachytherapy utilization and reimbursement. During the session, Dr. Peter Orio highlighted the evolving nature of healthcare reimbursement and the growing importance of quality metrics and performance. The session also featured perspectives of payors and administrators. The key conclusion: brachytherapy continues to be a valuable option to curb healthcare costs, and the delivery of quality procedures will have a positive impact on practices.
Growing your brachytherapy practice
Thursday’s lunch symposium discussed the clinical and marketing perspectives around building a brachytherapy practice.
Top insights shared from Dr. Steve Kurtzman on improving relationships with urologists:
Bring the procedure to them (hospital/surgery center of their choice)
Deliver good treatment/get great results (disease control and minimal complications)
Earn their trust (be available and accountable)
[Execute] Efficient Procedures (critical)
Educate (ASCENDE-RT Trial, SpaceOAR, etc.)
Work collaboratively (clinically and financially)
From Paul Snyder, VP of Healthcare for Write2Market – creating a good flow of fresh content does not have to be difficult or time consuming.
75% of traffic from search comes from page 1 rankings, 33% from ranking #1
70% of internet users (90% of U.S. adults) look online for health information
Commit 1 hr / mo – routine sets you free
Provide “commentary” on news, new scientific data / content co-op (leverage PCRI, PCF, Radiology Today, StatNews, industry partners like Isoray, etc.)
300 words including quoting the piece will get it done. Intro, your take + call to action
Make it consumable, educational, actionable
Dictate, transcribe, edit, post, share
Will you share what you learned here? We will.
If you are interested in working with us to generate a highly shareable story in a low-effort way, contact firstname.lastname@example.org to get the ball rolling.
Is the brachy community ready to embrace SEO and social media?
While we appreciate the inherent value our content marketing activities bring to our clinician partners and the broader patient community, it is the channels through which we share them that give them greater voice. We have been using fresh, educational content to grow our own social channels over the past two years. We are pleased to share that more than 2,300 people visited our own website from our social channels in the past 12 months totalling more than 3,800 total sessions. Our new users from search thanks to our SEO program have increased 44% to more than 10,000 in the same period.
We are most pleased that Dr. Chirag Shah, Director of Breast Radiation Oncology for Cleveland Clinic is leading the ABS charge into social engagement. We appreciated the expertise he shared, alongside Dr. Drew Moghanaki and Dr. Brett Cox, regarding the value of social media, a few best practices and the ability for social media to connect clinicians and the patient community as well. We look forward to working with Dr. Shah to engage a broader audience in our own clinician and patient communication and education efforts.
Thanks to our interviewees & stay tuned
We would like to thank ABS for its partnership in helping build further awareness for the value brachytherapy brings to the health care community through video interviews with the following clinicians at ABS 2018: Dr. Brett Cox, Dr. Alex Hsi, Dr. Steve Kurtzman, Dr. Brian Moran, Dr. Atef Omari, Dr. Peter Orio, Dr. Bradley Prestidge, Dr. Mark Rivard and Dr. John Sylvester. Thanks to all who participated. Stay tuned as we work through the editing process, publish and share them with the community.
We at Isoray are excited to be part of the team leading the way to a resurgence in utility and positive patient outcomes of this value-based therapy. We hope you found our ABS 2018 insights of value. Stay tuned for more new original content including clinician and patient stories. We look forward to working with you all along the way.
To the benefit of patients and urologists worldwide, focal therapy for prostate cancer bridges the sizable gap between active surveillance and radical prostatectomy. Its ability to provide effective disease control, minimize the potential for chronic incontinence and erectile dysfunction and deliver the peace of mind that comes with action instead of watchful waiting explains why many clinicians with whom we have spoken recently believe focal therapy for prostate cancer will become the dominant form of treatment in the not-too-distant future.
Dr. Matthew Ercolani, FACS
Urologist Matthew Ercolani, MD, FACS recently shared with us his thoughts on the benefits of focal therapy for appropriate candidates and the status of existing focal modalities.
“For low or mild-to-intermediate risk categories, focal therapy is minimally invasive, easy for the patient and better than active surveillance, particularly when it comes to quality of life and patient satisfaction,” Dr. Ercolani says. “Among the three existing focal therapy modalities for prostate cancer currently available in the United States, each appear to have their own advantages based on the location of the lesion or lesions.”
An “a la carte approach to focal therapy for prostate cancer”
Dr. Ercolani points us to a 2016 opinion piece by Drs. Arjun Sivaraman and Eric Barret with the Department of Urology, Institut Montsouris from European Urology. “According to the limitations and complication profile, better selection of an energy modality depending on the PCa characteristics can improve oncologic and functional results, and represents a step towards personalized medicine.”
The authors compare cryotherapy, HIFU and brachytherapy modalities and propose HIFU as the preferred modality for posterior tumors in close proximity to the rectum and laterally to the nerves given the shorter focal distance and more precise contouring of the target area.
For anterior cancers, “the ease of accessibility via transperineal needles and established oncologic efficacy make cryotherapy more desirable for cancers in anterior locations. And for apical cancers, “results for brachytherapy show superior continence rates, so this approach may be more appropriate for apical cancers very close to the sphincters.”
An effective, familiar, billable focal therapy for prostate cancer option
“Cryotherapy and HIFU are wonderful modalities, but done wrong they can be devastating,” Dr. Ercolani says. “It is unfortunate that brachytherapy is considered an outmoded modality given the advent of robotics, proton beam therapy and HIFU.
“Advancements in imaging allow for ultra-detailed maps of the prostate that enable the delivery of brachytherapy seeds to just one quadrant. The flexibility to deliver fewer seeds to a highly targeted area decreases the risk of disease spreading compared to active surveillance, while only slightly increasing the risk of radiation damage to nearby healthy tissues and organs. It’s almost a no-brainer.”
Brachytherapy is familiar and comfortable for most urologists, is consistently covered by insurers and – thanks to the newly available Cesium-131 isotope – a cutting edge option urologists can offer in an outpatient setting. When used as a focal therapy modality, brachytherapy also allows for definitive treatment in the unlikely event of a salvage requirement.
“Brachytherapy is a great option for focal therapy of low risk prostate cancer,” Dr. Ercolani says. “It is proven effective, quick, well-tolerated by patients, easily billed and allows for all other options should additional treatment be needed. What can I do that’s better than active surveillance with the lowest level of risk of damaging something? Focal therapy is the answer every time. The urology community needs to know that brachytherapy has evolved in the past 20 years and should be closely considered in most, if not all, low grade, localized prostate cancer cases.”
If you are a urologist willing to take another look at brachytherapy, contact email@example.com to arrange a call, visit or meeting onsite at AUA 2018.
Dr. Bradley Prestidge, MD, MS, serves as Regional Medical Director of Radiation Oncology for Bon Secours Medical Group in Norfolk, Va. During the American Brachytherapy Society 2018 Annual Meeting, Dr. Prestidge shared with us his opinion on brachytherapy’s top benefits for prostate cancer patients and why Cesium-131 is his exclusive isotope of choice for low dose rate brachytherapy.
For Dr. Prestidge, it comes down to the biological effectiveness dose of delivering radiation internally versus external beam delivery, the convenience of one procedure versus 45 EBRT visits (typical for prostate cancer treatment) and rapid resolution of side effects.
Watch our quick-hitting interview with Dr. Prestidge from ABS 2018.
Among his many distinctions including 12 years of service as an active duty U.S. Air Force physician and consultant to the Surgeon General, Dr. Prestidge served the recent President and Chairman of the American Brachytherapy Society and is a member of both the American College of Radiation Oncology and American Society of Clinical Oncology.
Are you ready to put Cesium-131s similar energy and shorter half-life compared to Iodine-125, along with more rapid resolution of side effects, to work for your prostate cancer patients? Contact firstname.lastname@example.org to arrange a call or meeting.
Roughly the same number of American men will be diagnosed with prostate cancer (1 in 9) as women will be diagnosed with breast cancer (1 in 8) every year. However, for a variety of reasons, prostate cancer awareness does not employ the same level of awareness breast cancer does. In efforts to raise awareness around prostate cancer, we hope you will find useful, and more importantly share, our favorite prostate cancer patient resources 2018 edition.
It is of paramount importance for men to take an active role in their own treatment course to achieve the optimum quality of life post-treatment.
Prostate cancer is highly treatable and there are multiple organizations whose mission is to help educate as well as provide support to men and their families dealing with a prostate cancer diagnosis. The list of resources available is extensive. Here are just a few of Isoray’s recommended patient advocacy groups and organizations.
The Prostate Cancer Free Foundation The Prostate Cancer Free Foundation works to help people interested in, and affected by prostate cancer through education and research. The Foundation is supported by the members of the Prostate Cancer Results Study Group. The Prostate Cancer Results Study Group evaluates and compares the effectiveness and long term results of various prostate cancer treatments.
They find studies, analyze outcomes, and present the data in a clear, digestible way so that men better understand and can make informed decisions regarding their treatment. The graph is updated regularly and provided to a large network of patients and physicians around the world.
To take a look at the latest iteration of the chart click here.
Best left said in their own words: “The Prostate Cancer Research Institute’s mission is to improve the quality of prostate cancer patients and caregivers lives by supporting research and disseminating information that educates and empowers patients, families, and the medical community.
“The Prostate Cancer Research Institute (PCRI), a 501(c)(3) not-for-profit organization that is dedicated to helping you research your treatment options. We understand that you have many questions, and we can help you find the answers that are specific to your case. All of our resources are designed by a multidisciplinary team of advocates and expert physicians, for you. We believe that by educating yourself about the disease, you will have more productive interactions with your medical professionals and receive better individualized care. Feel free to explore our website or call us at 1 (800) 641-7274 with any question that you have.”
You are not alone
Take a look at some of our interviews with a few of the more than 12,000 prostate cancer survivors who chose brachytherapy with Cesium-131 as their treatment modality. https://isoray.com/about/videos/
Our “Blu” community puts patients first by delivering highly targeted treatment to the tumor, with limited dose to the surrounding tissue and a reduction in total radiation time compared to other options.
Still relevant: our 2017 favorite patient resources edition
If you or a loved one has recently been diagnosed with prostate cancer and want to know about all of your available treatment options, including brachytherapy, please contact email@example.com
If you are a physician and would like to know more about how Cesium-131 may improve patient outcomes, email firstname.lastname@example.org
Dr. Brian J. Moran is the Medical Director for the Chicago Prostate Cancer Center. The Chicago Prostate Cancer Center is a specialty center that practices low-dose rate brachytherapy and has performed over 20,000 low-dose rate prostate implants since they were founded in 1997.
“Today, over 85% of our [low-dose rate brachytherapy] patients are referred from former, satisfied patients,” says Moran. Because of this, Dr. Moran recognizes the value of brachytherapy in the community and the awareness in action. Former patients have even a monthly support group meeting that Dr. Moran and his Director of Research and Education attend.
Dr. Moran credits the baby boomer generation with this awareness in action. Whether it’s through social media or simply talking to a friend, patients are being introduced to brachytherapy through channels that weren’t available 10 years ago. Dr. Moran hopes to use these new channels to share patients’ stories and testimonials.
The more widely those stories are shared, the greater the opportunity for more men to take an active role in their treatment and reaching optimal quality of life thereafter.
That said, Dr. Moran notes that the internet is not always a reliable source and that he hopes to always provide patients with the most accurate and valuable information when making their treatment decision.
If you would like to learn more about how brachytherapy improves outcomes for many types of cancer patients, especially prostate cancer patients, contact email@example.com.
Dr. Bradley Prestidge, MD, MS, serves as Regional Medical Director of Radiation Oncology for Bon Secours Medical Group in Norfolk, Va. During the American Brachytherapy Society 2018 Annual Meeting, Dr. Prestidge shared with us his opinion on brachytherapy’s top...
Prostate cancer is one of the deadliest and most common cancers among men today. A recent article written by Melissa Matthews published by Newsweek reveals that late detection plays a key role in why prostate cancer is so fatal.
Matthews writes in the article:
“According to Orchid, a nonprofit focused on male cancer research, 37 percent of prostate cancer cases in the U.K. are diagnosed during stages three or four. Roughly 42 percent of men with prostate cancer reported visiting their primary care doctor complaining of symptoms at least twice before getting referred to a specialist. In the U.S., 172,258 men were diagnosed with prostate cancer in 2014, the most recent year tracked by the Centers for Disease Control and Prevention. Roughly 28,000 men died from prostate cancer.”
Diagnosing cancer in the earliest stages is the best way to increase the patient’s chance of survival, so why is late detection for prostate cancer so common? The lack of awareness for prostate cancer, the symptoms and the treatments available could have a large impact. Some prostate cancer patients are also unaware that treatments like brachytherapy are an available treatment for them. Or worse, the patient could be told that brachytherapy is not an option for them when it is. This was the case for Norm Long, a prostate cancer survivor who was originally told that surgery was his only treatment option. You can learn more about his story and experience with brachytherapy in the video below:
This lack of prostate cancer awareness could also stem from the subtlety of warning signs, a confusion over screening standards, or men’s relative ‘disinterest’ in their health. Regardless, thousands of men’s lives could be saved if there was increased awareness of prostate cancer’s symptoms and treatment options. There are some incredible prostate cancer awareness organizations and resources that exist to do just this. Click here to see some of our favorites.
Rebecca Porta, Chief Executive of Orchid, was quoted in the article saying, “Urgent action needs to be taken now if we are to be in a position to deliver world class outcomes for prostate cancer patients and their families in the future.”
You can click here to read the full Newsweek article, “Prostate Cancer is Often Diagnosed Too Late: 5 Warning Signs”.
If you would like to learn more about prostate cancer and treatment options, including brachytherapy, please contact firstname.lastname@example.org.
Dr. Brian Moran, Medical Director for the Chicago Prostate Center, discusses the value of low-dose rate brachytherapy and its disruptive innovation in the cancer treatment field.
Dr. Moran stresses how important it is for clinicians to recognize the value of brachytherapy and promote it in order to carry it forward. Low-dose rate brachytherapy has been very threatening to other practice modalities in the past, yet it has endured through an environment in which it has only been promoted by the experts and community physicians who practice it.
Dr. Moran explains how brachytherapy has taken full advantage of today’s technology to bring patients the best care possible and the best results. “Many of the doctors have worked hard and we’ve learned as we’ve gone,” says Moran. And he is obviously excited about what the future holds.
If you would like to learn more about brachytherapy and how it can improve patient outcomes, contact email@example.com.