How ProstRcision Works

ProstRcision is a cutting-edge prostate cancer treatment that proves to be a successful option for patients. Here are the reasons that patients and providers choose ProstRcision:

  1. Two kinds of radiation – Utilizing both seed implants and conformal beam irradiation means ProstRcision attacks prostate cancer from every angle.

  2. Standards and procedures – Strict adherence to procedures ensure that the most efficient process is carried out every time.

  3. A world-class information database – We have tracked progress on every patient we have ever treated and can leverage this information to tailor a man’s treatment.

Steps of the ProstRcision Treatment Process

It’s important for patients to understand that ProstRcision involves a two-step treatment process, specifically targeting cancer cells within the prostate while minimizing potential side effects. These two treatment steps overlap, which produces the dose intensification required to kill the cancer.

Step 1: Radioactive Seed Placement

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The actual size of an I-125 seed (right), used to radiate the cancer, and the gold seed (left) is used as a target.

Step 2: External Beam Radiation Therapy

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Our therapist prepping a prostate cancer patient for treatment

ProstRcision Process Explained

The ProstRcision procedure begins when a physician implants tiny radioactive seeds into the prostate. Since the seeds are only 1/5 of an inch in length and as thin as a pencil lead, physicians can position them directly in the tumor and away from important muscles and nerves. These seeds emit most of their radiation over the course of a few months but will continue to release radiation for up to one year. When we say ProstRcision can attack the cancer with pinpoint accuracy, it’s because the area surrounding the seeds is hit with a tremendous amount of radiation, but a few millimeters away, the radiation level drops off rapidly.

Placing the Radioactive Seeds

Since the prostate does not show up on an X-ray, the precisely placed radioactive seeds not only release radiation to kill the cancer, but they serve to map out the prostate so it can be seen on X-ray as well. In addition to these small silver seeds, physicians inject several slightly larger and thicker gold seeds into the prostate. These gold seeds also help to outline the prostate on X-rays, so the doctor can plan the second step of the ProstRcision process – the delivery of targeted irradiation.

Limitations of Seed Implants for Prostate Cancer

Seed implants are an excellent way to destroy cancer within the prostate, but they do have limitations. They don’t effectively kill any cancer that may have leaked outside the prostate (called microscopic capsule penetration). Further, because of the amount of close-range radiation these seeds give off, they cannot be placed right next to the urethra without damaging it. Importantly, studies show that over 41% of men with prostate cancer have cancer on or near the urethra. This is why we follow the seed implant with another type of radiation called linear accelerator irradiation. The additional radiation delivered by an accelerator ensures that all the cells are killed within the prostate, because leaving even one cell, healthy or cancerous, could allow the cancer to come back over time.

External Radiation Therapy After Seed Implants

One or two methods are used to deliver linear accelerator irradiation – either conformal beam (where the beam of radiation is shaped into an exact outline of each patient’s prostate) or the Intensity Modulated Radiotherapy Technique (IMRT). IMRT allows for better control over the dose of radiation and can potentially keep the nearby organs from being over-exposed while focusing the radiation on the prostate.

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Are Hormones a Part of the ProstRcision Treatment?

Patients rarely receive hormones with ProstRcision treatments. However, we have seen a large number of men who received hormones before they came to RCOG for ProstRcision. We compared the cure rates of these men with those men treated only with ProstRcision and no hormones. Cure rates were not increased with the use of hormone therapy before starting ProstRcision. This is some of the information we store in the database to be able to make decisions about ways to improve the treatment over time. Hormones didn’t produce an improved outcome.