Back in 2014, Henry Ham was advised to surgically remove his prostate when the walnut-size gland began to show small signs of cancer. Since the 73-year-old felt the suggestion was a little aggressive, he sought a variety of second opinions.
Though there isn’t anything very unusual about removing a prostate, Dr. David Marshall, a radiation oncologist at the Medical University of South Carolina's Hollings Cancer Center, said it’s not always the only option and it isn’t always necessary. If the cancer levels are low enough and seem to be slow-growing, then most patients can walk away as long as they get their prostate routinely monitored.
That's what Ham was advised to do when he got that second opinion.
But when it was discovered last May that his prostate cancer had become more aggressive, this wait-and-see approach was no longer an option.
Undergoing a process called brachytherapy, which recently evolved thanks to a new system, Ham had a series of linked, rice-size radioactive seeds implanted into and around his prostate. Blu Build Brachytherapy has been found to increase the accuracy and intensity of the radioactive seeds hitting cancerous portions of a prostate, while also reducing the longevity of symptoms following treatment.
Last year, Ham and at least 12 others at the Hollings Cancer Center became some of the first patients in the country to benefit from the new technology.
“I would recommend it,” Ham said. “It was fairly easy.”
According to the Centers for Disease Control and Prevention, nearly 200,000 cases of prostate cancer were reported in 2015 and more than 30,000 deaths were linked to the disease.
The American Cancer Society cites prostate cancer as the second leading cause of cancer death among men in the U.S., trailing only lung cancer deaths. At least one in 41 men will eventually die from prostate cancer, according to the group.
Standard treatment for the disease varies for prostate cancer patients and includes brachytherapy, surgical removal of the prostate and external radiation. Because prostate cancer often progresses more slowly than other types of cancer, many patients are often advised to simply monitor the disease's growth.
"Most men, if we live long enough, we're going to get prostate cancer," said Dr. Rex Morgan, an internal medicine physician with East Cooper Medical Group. "But that doesn't mean we're going to die from prostate cancer."
Brachytherapy, itself, isn't new. Its origins actually date back to 1917, according to a paper published in Seminars of Surgical Oncology, when a scientist discovered a way to insert radium needles into the prostate.
Eventually, the procedure evolved and, historically, iodine and palladium seeds have been used to deliver radiation to the prostate gland. Though effective, those seeds are often associated with side effects, such as bladder issues and nausea, that can last six to 12 months after the procedure. The newer Blu Build Brachytherapy system uses seeds made from cesium and recovery is reduced to three to six months.
“The advantages of seed implant with cesium is that the side-effect profile seems to come and go faster,” said Marshall, the Hollings Cancer Center doctor.
Marshall also explained that the cesium seeds deliver a stronger concentrated dose of radiation to the prostate. Thirty days after the procedure, 90 percent of the radiation dose has been delivered with cesium seeds. By 100 days, there is essentially no trace of radiation left.
Then the seeds are capable of sitting in the patient forever without harm and because the seeds are linked, they are less likely to float away from the prostate and impact other organs.
“It sits there like a filling in your tooth,” Marshall said. “It doesn’t cause any problems, it just sits there.”
Though Hollings is one of the first institutions to use the system, Marshall’s hope is that word gets around and more doctors are able to offer brachytherapy since it is a cost-effective way to treat prostate cancer and, apart from the cesium seeds, the procedure isn't all that new. Most patients, he said, can have the procedure done in the morning and return home by noon the same day.
Ham, who had the procedure in December, still has a few days left before the radiation from the seeds are gone. After that, he will eventually start external radiation to finalize his cancer treatment.
With prostate cancer being so prevalent, he encouraged men to consistently be tested.
"I think it's something that needs to be out there," he said. "They need to keep on getting tested."