High dose rate (HDR) brachytherapy involves the placement of wires into the prostate to deliver high doses of radiation directly into the prostate. Three treatments are given over a 36-hour period and are intended for patients with advanced prostate cancer.

By delivering a higher dose it is more likely to cure more aggressive cancers than conventional radiotherapy. The technique was pioneered here at St Vincent's and in the past 15 years I have performed over 1,00 cases.

 

The accuracy of the treatment protects the bowel from being damaged by the radiation and there is a five-fold decrease in damage to the rectum compared to conventional radiotherapy doses.

Combination radiotherapy, HDR is always given in association with around four weeks of external beam radiotherapy. The external beam radiotherapy is generally given two weeks after the completion of the high dose rate brachytherapy.

Major side effects have been uncommon with only a 1% chance of major bowel damage. This treatment serves as an excellent option in locally advanced cancers, which have not spread, to other organs.

International data for this combination treatment resulted in 10-year disease-free survival rates of 80% to 90% — even in men with cancers of an intermediate grade. In more aggressive tumours that may not be amenable to surgery, combination therapy or newer forms of conformal radiotherapy may become the standard of care.

About Phillip

Phillip is the Chairman of the Department of Urology, St Vincent's Private Hospital and Clinic since 2003, and a Director of the St Vincent's Prostate Cancer Centre.

The Australian Prostate Cancer Research Centre in New South Wales recently appointed him as clinical director. He is also a member of the National Prostate Cancer Research Centre

Philip is currently the highest volume robotic surgeon in Australasia

He is perhaps best known for his work developing nerve sparing techniques to help patients maximise potency