University of Maryland Medical Center doctors reported today they are using a new non-surgical method of implanting radioactive "seeds" in prostate cancer patients that holds potential for a cure.
The technique, also described as less traumatic and more economical than a surgical approach, is designed for men who have early prostate cancer which has not spread to other sites and who are over 70 or in poor health and cannot undergo major surgery.
The current "gold standard" treatment for younger men is radical surgery which removes the prostate gland but with state-of-the-art techniques preserves potency.
"In the first six of our 11 patients we're getting at least a 30 percent reduction in the tumor and the prostate, which becomes enlarged," Dr. Stephen C. Jacobs, an oncology professor who heads the division of urology, said at a press conference. "We hope that means we've killed all the cancer and turned everything else into a scar."
He said it is too early to determine tumor shrinkage in the other five patients who have had the procedure within the last three months.
With the patient under regional anesthesia, needles are used to insert 40 to 72 tiny radioactive seeds directly into the prostate, the number used based the size of the tumor. Doctors use a specially-designed grid to guide the needles. A trans-rectal ultrasound or imaging machine is used to show exactly where the seeds are being placed.
The seeds are as thin as pencil leads and about a quarter inch PTC long. They are placed one to 1 1/2 centimeters apart. "The seeds are made of steel and what's important is what's inside -- radioactive iodine or Iodine 125," said Dr. Pradip P. Amin, assistant professor of oncology.
"Under anesthesia, the treatment is painless," said Dr. David T. Lewis, the retired head of the department of sociology at the University of Maryland Baltimore County and the third UM patient to have implanted seeds with the new technique.
"I came out of it without any significant side effects whatsoever," he said. "I feel at the moment that I'm clean. My PSA (prostate specific antigen which shows up in a blood test) has gone from the serious 26 range to 3."
Lewis had the procedure in October when he was 70. He had no symptoms but underwent the PSA blood test at the suggestion of a doctor. He urges all men who are 50 to take the blood test.
Up to 12,000 American men could benefit from the new technique, which is currently being used in only four medical centers across the country, Jacobs said.
In July 1990, The UM Medical Center became was the first on the East Coast to use the procedure. A new program is getting under way in Philadelphia. A private group of urologists in Seattle has the largest series of patients, about 300, and reports "very encouraging" results, the UM specialists said. The fourth program is based in Atlanta.
The American Cancer Society estimates that 122,000 cases of prostate cancer will be diagnosed in the country this year, with 32,000 deaths. In Maryland, 2,100 new cases are expected this year, with 550 deaths.
Prostate cancer strikes one in every 11 men and if a man lives to be 90 he will have prostate cancer, Jacobs said. It is the second leading cause of cancer death in men after lung cancer. The cancer society says 70 percent of men properly treated for prostate cancer survive more than five years.
In the past, radioactive seeds were implanted during a surgical procedure that required a 6 to 8 inch incision and a hospital stay of about four days.