Prostate brachytherapy for localized prostate cancer

Opinion statement

After skin cancer, prostate cancer (CaP) is the most common cancer diagnosed in men. As a result of screening with prostate-specific antigen, CaP is being caught earlier than it was in the past. This has led to an increase in cure rates across all treatment modalities. There are no firm, reproducible data that demonstrate the superiority of one modality over another. The expectations for cure should be approximately 90% for low-risk patients and approximately 80% for intermediate-risk patients, regardless of treatment modality. The toxicity of available treatment modalities discriminates among them. All modalities have acute toxicity of similar severity; however, prostate brachytherapy (PI) has the least amount of long-term toxicity when compared with external beam radiotherapy and radical prostatectomy. Therefore, a patient who is confronted with the diagnosis of CaP is counseled to choose among the modalities based on the toxicity rather than the efficacy of the treatment options available. Adopting this evidence-based algorithm has led to the increased application of PI.