About Cesium-131 / FAQs
Frequently Asked Questions
If you have recently been diagnosed with prostate cancer, effective treatment options exist. It is important that all of your questions be answered and all of your treatment options be fully explained. Here are some common questions and answers which may be helpful in your treatment decision. Be sure to talk to your doctor about your specific diagnosis and all treatment options.
How common is prostate cancer?
How treatable is prostate cancer?
What is the most popular choice for prostate cancer treatment?
What is brachytherapy?
When is brachytherapy recommended as a treatment for prostate cancer?
I’ve heard surgery is more effective than brachytherapy. Is that true?
Is brachytherapy a new form of treatment?
What is Cesium-131?
What is the difference between Cesium-131 and other brachytherapy isotopes (Iodine-125 and Palladium-103)?
Is Cesium-131 an approved treatment in the United States?
Does Medicare pay for Cesium-131?
Who makes Cesium-131?
How common is prostate cancer?
The American Cancer Society estimates that 232,090 new cases of prostate cancer will be diagnosed in the United States in 2005. A man has about a 1-in-5 chance of developing prostate cancer in his lifetime, but only 1-in-33 men will die of the disease. Prostate cancer accounts for about 10% of cancer deaths in men. African-American are twice as likely to be diagnosed with prostate cancer as other American men.
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How treatable is prostate cancer?
A recent clinical study of over 1700 patients followed for 12 years showed a survival rate of 99% at 10 years for low risk prostate cancer patients receiving seed brachytherapy. Sixty percent of all prostate cancers are found when they appear to be confined to the prostate gland. The 5-year relative survival rate for men diagnosed when prostate cancer is in the local and regional stages (local means it is still confined to the prostate; regional means it has spread from the prostate to nearby areas, but not to distant sites such as bone) is nearly 100%. Of the men whose prostate cancers have already spread to distant parts of the body at the time of diagnosis, about 34% will survive at least 5 years.
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What is the most popular choice for prostate cancer treatment?
According to the National Cancer Institute, in the early 1990s, roughly 30 percent of prostate cancer patients in the United States were treated by surgery, 30 percent by radiation, and 20 percent by watchful waiting, while most of the rest were treated with a combination of therapies. However, since about 1993, the rate of prostatectomies has been dropping. Some recent market surveys indicate the rate of seed brachytherapy procedures is now greater than prostatectomy.
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What is brachytherapy?
Brachytherapy, often referred to as "seed brachytherapy or simply "seed therapy" is a form of internal low dose radiation treatment in which tiny "seeds," about the size of a grain of rice and made of laser-welded titanium, are inserted into the body and permanently implanted in cancerous tissue. A radioactive isotope contained in the seed begins immediately to release energy to attack cells located within a small range around the seed. Because of the precision of seed placement made possible today by ultrasound and digital imagery, doctors are able to effectively target and destroy localized cancer. Over time, the isotope's energy is completely depleted. Speed of depletion is measured by an isotope's "half-life," which is the time it takes to deplete half of its energy.
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When is brachytherapy recommended as a treatment for prostate cancer?
There are several factors that contribute to treatment choice, including age, overall health and most importantly, the stage of your cancer. Talk to your doctor about your specific treatment options. Generally speaking, brachytherapy is recommended for Stage I and Stage 2 (T1, T2), when the cancer remains confined to the prostate gland. A recent clinical study by urologist, Dr Jerrold Sharkey, has shown seed brachytherapy success rates to be better than or equal to prostatectomy in low, intermediate and high risk patients.
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I’ve heard surgery is more effective than brachytherapy. Is that true?
No. Despite a perception that radical prostatectomy "cuts the cancer out," studies have shown that seed brachytherapy success rates are better than or equal to prostatectomy and seed brachytherapy is a less invasive procedure with low rates of complications. Recent clinical studies have shown a cancer re-occurrence rate of 25-30% in some prostatectomy patients. Market surveys indicate surgery, while traditionally more popular than other therapies, is on the decline as a choice for prostate cancer treatment.
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Is brachytherapy a new form of treatment?
No. Brachytherapy was developed in the 1960's and a patient was first treated with the therapy in 1967. For years, brachytherapy was limited by a doctor's ability to see inside the patient's body in order to accurately position the seeds. Over the past decade or so, advancements in ultrasound and digital imagery have practically done away with these limitations and made brachytherapy an extremely effective form of prostate cancer treatment in its early stages.
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What is Cesium-131?
Cesium-131™ is the most significant technology advancement in seed brachytherapy in over 18 years and has been cleared by the FDA for market in the United States. Cesium-131 was originally considered for seed brachytherapy more than 40 years ago when seed brachytherapy was in its infancy. Pioneers in the field of seed brachytherapy believed the physical characteristics of Cesium-131 could potentially provide superior clinical benefits over other radioisotopes in the treatment of prostate cancer.
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What is the difference between Cesium-131 and other brachytherapy isotopes (Iodine-125 and Palladium-103)?
Cesium-131 provides the clinical benefits associated with a high energy, short half-life radioisotope. It has a half-life of 9.7 days, compared with 60 days for Iodine-125 and 17 days for Palladium-103. The radiation from long half-life isotopes remain in the body for much longer periods of time, up to 600 days in the case of Iodine-125. Most clinicians agree that, after 150 - 180 days, the radiation from Iodine-125 provides little or no useful therapy. Using conventional radiation detection equipment, Cesium-131 is non-detectable in the body after approximately 97 days. Cesium-131 also has a higher energy level, allowing the radiation to more aggressively attack the cancer cells. Using Cesium-131 also allows the physician to use up to 30% less total radiation to treat your prostate cancer.
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Is Cesium-131 a cleared treatment in the United States?
Yes. Cesium-131 received FDA clearance for market in March 2003 for the treatment of prostate, breast, liver, head, and neck cancers, as well as other malignant diseases.
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Does Medicare pay for Cesium-131?
Yes. The Centers for Medicare and Medicaid have established a specific reimbursement code for Cesium-131. Most insurance companies also cover seed brachytherapy treatment.
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Who makes Cesium-131?
IsoRay Medical, Inc. of Richland, Washington is the only company in the world manufacturing and distributing the Cesium-131 seed. Corporate headquarters are located in Richland, Washington.
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