Since 2005, prostrate brachytherapy has been conducted at SUMS to cure non-metastatic prostate cancer. This treatment is a form of internal radiotherapy, where a sealed radiation source, I-125, is permanently placed inside the area requiring treatment. Recently, patients from all over Japan (from Hokkaido to Okinawa or oversea country) come to SUMS to seek this treatment.

Thus, the center has earned high trust among all patients and their families all over the country. Also, a lot of doctors and medical staff have come to study our method. For this reason, in 2015 a new department specific for Brachytherapy on Prostate Cancer has been established. In cooperation with the Radiation Oncology group, it has become feasible to handle up to 130 cases per year as a top-ranking center for prostrate brachytherapy in Japan.

In the United States, brachytherapy has a history of over twenty years since it was established as a radiotherapy for prostate cancer, and it is a common treatment now.

At SUMS, over 850 patients have been treated since 2005. It has been shown that brachytherapy is a safe and highly effective treatment if carried out by experienced and skilled medical staff. Furthermore, this treatment has little ill effects for the patients.

The most important message is that the initial treatment should be successful in completely eliminating prostate cancer and preventing recurrence. This is because patients with recurrence after the initial treatment often tend to end up having further recurrence even though they get more treatment. Also, we should remind that a long term hormonal therapy (ADT: androgen deprivation therapy) for recurrent prostate cancer may cause a variety of toxic effect on the body. Therefore, we have a strong mission to achieve recurrence free prostate cancer treatment.

Experience and overseas data have shown that brachytherapy alone or brachytherapy in combination with other appropriate treatment results in a high percentage of success with a very low rate of recurrence. This is true for not only low risk cases, but also for intermediate and high risk prostate cancer.

Brachytherapy is an internal radiotherapy that is carried out by the insertion of small radioactive seeds into the treated local site. Brach means short distance. The name derives from the Greek word, "short ", referring to the short distance between the therapeutic agent and the target region. In Japan, brachytherapy using radioactive particles such as radium, cesium, and gold were conducted for tongue cancer and gynecologic cancer for a long time.

In the 1970's, radiotherapy in the tissue was developed in the United States. The sealed I-125 seeds were inserted into the prostrate and irradiated. However, the method at that time was through an abdominal incision. Moreover, implanting the seeds were done manually. Inaccurate implantation made the treatment standard treatment. Later, trans-rectal echo for prostrate was developed to insert supersonic waves into the rectum, which has given a clearer echogram of the prostrate. Thus, by observing the echogram, inserting seeds into the prostate gland using needles from the perineum has become feasible. Precisely inserting seeds into the prostate gland without incision made the treatment improve dramatically.

In the 1990's, brachytherapy using I-125 has been increasing year by year. Over 50,000 patients undergo this treatment per year in the U.S. these days. Real-time planning method during operation enables irradiation to be safe and the radiation energy to be higher. Especially since 2004, real-time planning method during operation, which was developed by Prof. Stone and Prof. Stock in New York's Mt. Sinai Medical Center, has made implanting seeds highly precise.

Thanks to this method, extremely high energy of irradiation has become available and can be used safely, which led to much higher successful results. SUMS has invited Dr.Nelson Stone, a professor at Mt. Sinai Medical University, three times to learn more about the real-time planning method. Then, after further examination, a newly-developed method of our own has been applied to many patients, including difficult cases.



 

リアルタイムによる術中計画法による超音波画像と、治療後のX線フィルム