KRMC's cancer program measures up

Kalispell Regional Medical Center's internal radiation therapy for prostate cancer was judged equal to national averages for treatment results in a recent evaluation.

Radiation Physicist Mark Skwarchuk said the cancer center requested the study as part of its quality control program for patient procedures.

He said an expert in the field evaluated the center's brachytherapy seeding used to treat early-stage, prostate cancers in 119 patients over the last five years at the medical center.

Skwarchuk called the results "absolutely comparable to national averages." Patients treated with iodine-125 radioactive seed dose at the center were identical to patients treated at other centers using the therapy.

An outpatient procedure, brachytherapy uses needles to insert radioactive "seeds" in the prostate very close to the tumor. It delivers radiation to destroy the cancerous cells while reducing damage to nearby healthy tissue.

"We implant individuals when we feel confident the disease is in the prostate only," Dr. Gordon Stille, radiation oncologist, said.

According to Stille, accurate seed placement plays a crucial role in treatment success. He said physicians work with extremely small tolerances when placing the seeds.

Performed by ProSeed Inc., the evaluation confirmed that the medical center's placements compared favorably with those performed in brachytherapy centers around the nation.

Damage to the urethra, a common side effect, was lower than national averages in patients treated at Kalispell Regional Medical Center.

Stille said that men contemplating the range of prostate cancer treatments cite incontinence as the side effect most feared. Brachytherapy offers a lower risk of incontinence than other treatments such as removal of the prostate.

Men also must consider the risk of sexual dysfunction. According to Stille, brachytherapy offers the best odds of any treatments of maintaining sexual potency.

Statistics from the American Cancer Society reveal that one in six men will face the challenge of defeating prostate cancer. Stille said the risk of the disease increases with age, approaching 100 percent if a man lives to 100.

More than 70 percent of prostate cancer occur in men over 65.

The cancer center at Kalispell Regional Medical Center offers a support group for prostate cancer survivors and newly diagnosed patients. They offer first-hand experience and support to patients weighing therapy choices.

Treatment options include watching and waiting, hormones, external radiation, internal radiation, removal - called prostatectomy - and combinations of those options.

"Radical prostatectomy was always felt to be the gold standard," Stille said.

But with about 17 years of implant therapy successes, the number of men choosing seeding now approaches 50 percent. The procedure offers the advantages of minimally invasive surgery with rapid recovery and reduced, postoperative pain.

"It's amazing how few guys complain of pain,"Stille said.

He said some farmers have had the two-hour procedure and jumped back on their tractors the next day. Most men get back on their feet within 24 hours.

Although radioactive seeding has been around for decades, Stille said the technique made a huge leap forward with the invention of the trans-rectal ultrasound. The equipment guides the physicians as they insert needles loaded with seeds.

"You can see in real time where the seeds are going," Stille said.

The radiation oncologist works in a team with Dr. John Andenoro, staff urologist, to place between 55 and 145 seeds in increments throughout the prostate, where the seeds remain but radioactivity drops off over time.

A month after receiving the procedure, patients return for a CT scan that reveals the location of the seeds. The scans then go to ProSeed to produce a post-implant computer plan.

"It shows how the dose is distributed throughout the prostate," Stille said. "You have a good idea of how well you did."

Skwarchuk said ProSeed used this information to compare Kalispell Regional Medical Center's results with the information from several thousand other centers around the nation in its database.

Stille called the results of the evaluation good news for patients who elect to have radioactive seeds implanted at the medical center.

"It tells them we're doing good implants here," he said.

Reporter Candace Chase may be reached at 758-4436 or by e-mail at cchase@dailyinterlake.com