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Dr. D’Amico compares EBRT and brachytherapy in prostate cancer

Anthony V. D’Amico, MD, PhD, discusses the choice between external beam radiation therapy and brachytherapy in patients with prostate cancer.

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      In this video, Anthony V. D’Amico, MD, PhD, a professor and chair of genitourinary radiation oncology at Brigham and Women’s Hospital and Dana-Farber Cancer Institute, explains the factors involved in choosing between external beam radiation therapy and brachytherapy, a type of internal radiation therapy in patients with prostate cancer.

      Transcript

      Essentially, these treatments are felt to be equivalent. And so we don't have a strong preference as to one or the other, it's really a matter of patient choice. Brachytherapy has more lower urinary tract symptoms in the short term compared to external beam, but it's done more quickly, in a single visit or two, and as a result, it may be more convenient with the short-term cost of more lower urinary tract symptoms. Not everybody is eligible for brachytherapy; they have to have a prostate below a certain size, typically 60 cubic centimeters, and they can't have significant lower urinary tract symptoms to begin with, as well. More commonly, brachytherapy is used as a boost after external beam in people with unfavorable intermediate- or high-risk disease, because it’s been shown to have a halving of progression or a reduction in relapse with this combined approach, as opposed to external beam radiation therapy alone.

      Transcript has been edited for clarity.

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