When a patient undergoes therapy for prostate cancer, there is a good chance he will suffer from side effects such as rectal bleeding and diarrhea.

These side effects have essentially been eliminated through a therapy technique now being used at the Prostate Cancer Institute of New Jersey at Hackensack University Medical Center. The Institute is one of only a few facilities in the United States using the technique in large numbers, according to Glen Gejerman M.D., clinical director of the Department of Radiation Oncology at Hackensack University Medical Center.

The therapy is appropriate for men with cancer that is confined to the prostate or has spread no further than a nearby organ called the seminal vesicles. The best chance of a cure lies in early detection.

Prostate cancer is the second most common cause of cancer death among American men. Every year, about 180,000 new cases of prostate cancer will be diagnosed. In the year 2000 approximately 31,900 men will die of this disease in the United States. African-Americans have the world's highest rate of prostate cancer and are widely considered the greatest at-risk group. In the U.S. African-Americans have a 50 percent greater chance of getting prostate cancer than Caucasians.

At the Prostate Cancer Institute, doctors are using a technique called intensity modulated radiation therapy, or IMRT, in combination with brachytherapy, also known as seed implantation to eliminate the suffering and side effects from prostate cancer treatment.

"We have found that this therapy when compared to standard radiation treatment delivers a higher dose to the prostate target while delivering a lower dose to the bladder and to the rectum with fewer side effects," said Dr. Gejerman, who heads a team of specialists studying the effects of IMRT. These findings were presented in April at the American Radium Society meeting in London.

"Dose escalation has been shown to increase disease free survival in prostate cancer," he said. "Before any man with prostate cancer agrees to have radiation treatment he should consider the many options available and the unique advantages of IMRT."

"What we are doing is giving the patient the confidence to know that he can receive aggressive cancer treatment and not have to worry that he won't be able to cope with the toxicity," Dr. Gejerman said.

"That is the overwhelming concern for patients when they are faced with cancer. The first thing they worry about is whether they can be cured. Once they feel confident of that, the next step is how it is going to impact their lifestyles."

"They ask, 'Am I going to have to constantly run to the bathroom to urinate? Will I have diarrhea? Can I do my job? Will I have to limit what appointments I can keep? What kind of hobbies can I continue with? Am I going to be embarrassed?'"

Hackensack University Medical Center started using IMRT in 1998 and has treated over 200 patients, including many from not only the New York metropolitan area but from as far away as Honolulu.

Now the medical center is combining IMRT with radiation seed implantation, resulting in less risk of lasting side effects such as diarrhea and rectal bleeding.

A radiation oncologist and urologist implants tiny rice-sized Theraseed palladium radioactive seeds directly into the prostate to deliver a continuous dose of radiation to the prostate. The physician uses special implant needles guided by ultrasound to place the radioactive seeds. Once inside, the seeds target and destroy cancerous cells, while minimizing exposure to surrounding tissue and organs.

The palladium seed releases radiation more quickly than the more commonly used iodine seed (about two to three times faster), which results in a shorter duration of side effects and treatment which may occur during the period in which radiation is delivered.

"Normal tissue and organs can only tolerate so much radiation, so if you can exclude normal tissue, you decrease toxicity and side effects," Dr. Gejerman said. "By decreasing toxicity, you can also increase the dose to the tumors." The radiation is administered five days a week for eight weeks. Each session takes about 20 minutes.

More information about The Prostate Cancer Institute of New Jersey at Hackensack University Medical Center can be found on the Institute's website at www.prostatecancernj.org or call the Institute at 201-996-2034.

Glen Gejerman, MD

Hackensack University Medical Center

201-996-2034

Anne Marie Campbell

Director of Public Relations

Hackensack University Medical Center

201-996-3763

Bruce Fabricant

Public Relations
914-328-0226