Seattle Prostate Institute

About Seed Implantation -

Using ultrasound, physicians could now see the seed-bearing needles inside the prostate, thereby better enabling them to deposit the seeds evenly throughout the gland so that the radiation could reach all the cancerous tissue. Equally as important, perhaps, was that open surgery was no longer necessary. By using a rigid template guiding device, the needles could be inserted into the prostate from outside of the body. (Figure 5) This transformed what had been major surgery into a 1 hour outpatient procedure with little discomfort and rapid return to normal activities. Unlike the open surgical technique, the more precise ultrasound procedure allowed physicians to achieve the even distribution of seeds that was necessary in order for the radiation to have its maximum therapeutic impact on the cancer cells throughout the prostate. (Figure 6)

Building on Dr Holm pioneering work, two Seattle physicians, Dr. John Blasko and Dr. Haakon Ragde introduced ultrasound-guided prostate implantation to the U.S. in 1985. In the years that followed, physicians from around the country and around the world came to Seattle to learn this new and promising technique. Today, hundreds of centers across the U.S. are performing more than 40,000 seed implants a year.

WHO IS A CANDIDATE FOR A SEED IMPLANT?

Like surgery and external beam radiation, the objective of seed implantation is to cure or eliminate the cancer before it can spread to other parts of the body, bringing with it the potential for serious illness and death. As with these other forms of treatment, the best candidates for seed implants are men with early stage cancer in which the tumors are small and confined to the prostate gland.

Understanding Risk

In assessing the nature of a man’s prostate cancer, physicians generally think in terms of low, intermediate, and high risk groups, where risk means the probability that the cancer had already spread beyond the prostate at the time of the initial diagnosis. Whether the treatment under consideration is seed implantation, surgery, or any other therapy, the low risk patients will have the best results in terms of disease-free survival, or DFS. This generally accepted measure of success refers to the length of time following treatment that a patient lives without the reappearance of cancer. Since prostate cancer, like most cancers, can reappear many years after treatment, neither surgeons nor radiation oncologists can really guarantee that a patient has been totally cured at the time of treatment. Disease-free survival, therefore, has become the working definition of cure.