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How experienced are the Radiation Oncologists at the Center for Prostate Care?
Our physicians have performed more prostate seed implants than the rest of the area’s physicians combined. In recent years, we have treated more than 3000 men. We have been doing implants in North Florida since 1980, and regularly train other physicians throughout the United States, Europe, Asia, and Africa. Indeed, FROG is one of the top five leading providers of high-quality prostate seed implants in the United States. We have patented devices, published research in major medical journals, and presented seminars around the world. Based on our experience, we know that the Radiation Oncologist plays a critical role in the implant team in determining the amount of radiation to be placed and its location and spacing. Their experience is vital to achieving a good result with minimal side effects.
Should I consider Proton Beam radiation?
No. Proton Beam radiation is a left over technology that first originated in the 1950’s. Current studies show that it is not only extremely costly and time consuming, but also much less effective than seed implants. One study from the largest proton center in the country, at Loma Linda, in fact reported that the 5 year success rate with proton therapy was only 73% * ! This is in comparison to 10 year success rates with seed implants of greater than 90%. For this reason, most centers have decided not to pursue this older technology and have focused their attentions on more innovative seed implants and IMRT.
Should I consider temporary high-dose rate radiation implants?
At this time, we believe NO. There are currently no results available beyond five years for this treatment, compared to 13 years from a prostate seed implant. In addition, all men who have high-dose rate implants must have several weeks of external radiation AND multiple implant procedures with anesthesia. At times, men may have the needles sticking out of their body for up to 24 hours while they receive several radiation treatments. During this time period, the needles can cause significant discomfort, and even move to potentially harmful locations. In contrast, a prostate seed implant is a one-time only outpatient procedure that takes less than one hour. There is no significant movement of the seeds once they have been implanted.
What about Cryotherapy?
Cryotherapy is when part of the prostate is frozen. While some believe this technology is improving, there are no major studies available with results at more than 5 years. In addition, side effects such as impotence and incontinence are much greater with cryotherapy than with seed implants, and in fact, are similar to more radical surgery. Most centers reserve cryotherapy for the treatment of prior external radiation failures, and not for the up front treatment of newly diagnosed men. This procedure should only be performed by experienced Urologists.
Are all men with prostate cancer eligible for seed implants?
We believe that all men without evidence of metastasis (cancer spread to other organs) have a chance to be cured of their cancer by a prostate seed implant and/or IMRT. We recommend that men diagnosed with prostate cancer consult with both a Urologist and a Radiation Oncologist. Based on extensive data, we can tell you what your risk of having disease outside the prostate is. We will review your past medical history and current physical condition and discuss the pros and cons of surgery, external radiation, and seed implants. We have seed implant protocols to treat men with both early and advanced stage disease.
What is most important is that men take their time and feel comfortable with their decision. If a man chooses prostatectomy, we suggest he have this performed by an experienced Urologist. If he chooses a seed implant, we recommend that our uniquely experienced Radiation Oncologists treat him with the Real-Time Implant Technique.
I’ve heard some people say that they do not think the PSA blood test is important for cancer screening. What do you think?
Both the American Cancer Society and the American Urological Association strongly feel that regular PSA blood tests and physical exams lead to prostate cancer being diagnosed to an earlier, more treatable stage and, thus, can potentially save lives.
Do you participate in research on prostate cancer?
Yes. All patients treated at the Center for Prostate Care are tracked in a computerized database. Their implants are all analyzed for quality, and their results are carefully monitored. We participate in both local and national studies.
How does radiation kill cancer cells?
Radiation, in this case, X-ray or Gamma-ray radiation can damage a cancer cell’s ability to multiply, ultimately leading to its death. Cancer cells are much more sensitive to radiation damage than normal cells and are less likely to repair any damage done.
Is it all right to give hormone blockers and radiation together?
Yes. Not only is it all right, research has shown that the combination can improve results in men with more advanced or aggressive prostate cancers.
How long will I be out of work with a prostate seed implant?
Most men can return to work and their normal activities in 24-48 hours.
Since I have radioactive seeds in my prostate, am I at risk to other people?
No. The amount of radiation given off outside the body is almost none. For peace of mind, we do recommend that you do not hold pregnant woman or young children in your lap for one to two months following your implant.
Will I have to wear a urinary catheter after a seed implant?
Most men go home without a catheter, although some may wear it for up to 24 hours.
Can I have surgery if the cancer re-grows in the prostate after radiation?
Yes, however, it is very unusual for cancer to regrow in the irradiated area.
What can I do if I was previously treated with external radiation for prostate cancer and now my PSA is rising?
We are one of the few centers in the world experienced enough to safely provide prostate seed implants to men who did not respond adequately to prior treatment using external radiation. Some studies have shown that up to 2 out of 3 men can be successfully treated in this manner. At the time of consultation, we can recommend some simple tests to help determine if this is a safe and potentially effective option for you.
How do I know if I was cured by a radical prostatectomy?
The answer is quite simple. A PSA blood test done two months after surgery should reflect a PSA < 0.2 If this is not the case, you may have some cancer cells left behind that should be irradiated. In this circumstance, we may recommend IMRT external radiation, as there is no prostate in which to accurately implant the seeds.
Is there any hope if I am diagnosed with late/advanced stage prostate cancer that has already spread?
Yes. There are many promising hormonal and chemotherapeutic treatments on the horizon. Any member of our team will be happy to discuss these with you and refer you to a medical oncologist for additional evaluation.
What should I do now?
If you have not been diagnosed with prostate cancer and are concerned that you may be at risk or would like to be screened, you should consult your physician for a physical exam and PSA blood test. If you have been diagnosed with prostate cancer and would like to consider a prostate seed implant, you should discuss this with your Urologist and contact the Center for Prostate Care at 904-636-6911.
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Treating Cancer 
