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Cleveland Clinic Analysis Provides First Comparative Long-Term Look at Least Toxic Prostate Cancer Treatments

Investigation Examined Toxicity for Three Treatments over 16-Year Period

January 31, 2012

Cleveland Clinic researchers today released a comprehensive analysis of more than 100,000 prostate cancer patients over a 16-year period that shows brachytherapy or prostatectomy are the least toxic among the three most commonly used methods to treat prostate cancer. The analysis indicates that patients who had brachytherapy or prostatectomy had lower long-term toxicities and treatment-related costs than external beam radiation therapy (EBRT).

“Typically, investigations of prostate cancer toxicity don’t go beyond five years. These results provide valuable insight that may influence future decision-making regarding the use of these treatment options,” said Jay Ciezki, MD, a radiation oncologist in the Taussig Cancer Institute at Cleveland Clinic.

Prostate cancer is the most common cancer in men, and the second leading cause of cancer death among men in the U.S. Advancements in the treatment of prostate cancer have increased survival rates, but the toxicity of those treatments has not been well studied beyond five years from treatment.
Dr. Ciezki examined the Surveillance, Epidemiology, and End Results (SEER)-Medicare linked database to determine which of the three common prostate cancer treatments – brachytherapy, prostatectomy and external beam radiation – had higher long-term toxicities and treatment-related costs. Brachytherapy is the use of a radioactive source placed in the prostate itself, giving a high radiation dose to the tumor while reducing the radiation exposure in the surrounding healthy tissue. Prostatectomy is the surgical removal of the prostate gland.

A total of 137,427 patients who were 65 years or older at the time of a prostate cancer diagnosis and who had prostate cancer as their only cancer diagnosis were retrieved from the SEER-Medicare database. Because the SEER-Medicare database provides information on cancer diagnoses and outcomes, along with individual patient costs, it allowed the investigators to obtain Medicare reimbursement data for both the initial treatment and any subsequent treatments related to the toxicities. Dr. Ciezki and his team of researchers then calculated the total cost per patient-year for each of the three therapies over time. 

Dr. Ciezki will present his findings on Feb. 2 at the 2012 Genitourinary Cancer Symposium in San Francisco.

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