Anthony V. D’Amico, MD, PhD, discusses the choice between external beam radiation therapy and brachytherapy in patients with prostate cancer.
In this video, Anthony V. D’Amico, MD, PhD, a professor and chair of genitourinary radiation oncology at Brigham and Women’s Hospital and Dana-Farber Cancer Institute, explains the factors involved in choosing between external beam radiation therapy and brachytherapy, a type of internal radiation therapy in patients with prostate cancer.
Essentially, these treatments are felt to be equivalent. And so we don't have a strong preference as to one or the other, it's really a matter of patient choice. Brachytherapy has more lower urinary tract symptoms in the short term compared to external beam, but it's done more quickly, in a single visit or two, and as a result, it may be more convenient with the short-term cost of more lower urinary tract symptoms. Not everybody is eligible for brachytherapy; they have to have a prostate below a certain size, typically 60 cubic centimeters, and they can't have significant lower urinary tract symptoms to begin with, as well. More commonly, brachytherapy is used as a boost after external beam in people with unfavorable intermediate- or high-risk disease, because it’s been shown to have a halving of progression or a reduction in relapse with this combined approach, as opposed to external beam radiation therapy alone.
Transcript has been edited for clarity.