Active retiree Larry Fenster is a problem-solver. So when he was diagnosed with prostate cancer, he searched for solutions. Mr. Fenster, 80, soon found out that he was a prime candidate for brachytherapy (radioactive seed therapy). The treatment would allow him to avoid surgery and traditional radiation therapy.
For several years, the Manhasset resident — an avid golfer who enjoys traveling with his wife — watched his concentration of PSA (prostate-specific antigen) rise from a “normal” score below 4.0 nanograms per milliliter all the way up to 10.
A prior biopsy did not show cancer, but his urologist, Robert Waldbaum, MD, of Northwell Health’s Smith Institute for Urology, ordered parametric magnetic resonance imaging (MRI).
The scan revealed a mass in Mr. Fenster’s prostate, and a directed re-biopsy confirmed that he had Stage II cancer. Dr. Waldbaum referred him to Louis Potters, MD, Northwell’s chair of radiation medicine and deputy physician-in-chief of radiation medicine for the health system’s Cancer Institute.
Dr. Potters determined the best course of treatment by assessing Mr. Fenster’s risk — informed by a physical exam, his PSA level and an evaluation of the prostate tissue using what doctors call the Gleason score.
Most frequently, older men and those with low-risk disease can elect active surveillance rather than initial treatment. But Dr. Potters determined that Mr. Fenster’s risk of disease, coupled with his active lifestyle, meant intervention was the best approach.
He recommended a radioactive seed implant rather than more traditional surgery or radiation therapy. Prostate cancer experts at Northwell Health, Dr. Potters noted, are among the most experienced in seed implants in the US, having performed more than 10,000 such procedures.
“This procedure has a long track record,” said Dr. Potters. “In a recent randomized controlled study, it was shown to beat traditional external radiation therapy in curing the disease.” Recent medical journals confirm the success of seed implant therapy compared to other radiation options and surgery — meaning the studies showed patients receiving this therapy had less prostate cancer-related mortality and lower incidence of metastasis, plus fewer side effects and faster recovery times.
Seed therapy has been around for 25 years, and is undergoing a resurgence. Side effects include more frequent and bothersome urination, sometimes with a mild burning sensation that usually resolves in six to 12 weeks. But each man’s experience is different, and Mr. Fenster reported few side effects.
“I was on the golf course the next day,” Mr. Fenster said. Two days later, he traveled to Michigan to visit his grandson and attend a football game. What’s more, after 52 years of marriage, he said he and his wife enjoy a healthy sex life, even after the procedure. “Talk about a blessing!”
Prior to the procedure, Mr. Fenster said he was getting out of bed three or four times a night to use the bathroom. Now, he says, he hardly ever needs to get up, and his PSA level is nearly undetectable at .02 ng/mL.
“I live a normal life,” he said, citing his faith in God — and the expertise of his doctors at Northwell Health — for returning him to cancer-free health.
Brachytherapy offers numerous benefits as a prostate cancer treatment.
During the 50-minute outpatient procedure, a physician implants seeds individually into the gland. Ultrasound and advanced real-time technology help to target the exact placement.
Most men return to normal activities the day after brachytherapy. That contrasts with external beam radiation therapy, which can take up to nine weeks to complete, or surgery, which can take up to one month or longer of recovery time. For men who qualify, the procedure is becoming an increasingly preferred option.
Brachytherapy requires a high degree of expertise that Northwell Health’s radiation oncologists can provide, Dr. Potters said.