Experts in the Prostate Cancer Radiation Oncology Service, part of the Lank Center for Genitourinary Oncology at Dana-Farber/Brigham and Women’s Cancer Center, have pioneered unique treatment approaches and novel assessment techniques resulting in better cancer control and quality-of-life for patients with prostate cancer. Caring for approximately 750 patients per year, the Service’s team of radiation oncologists, medical oncologists, urologic surgeons, physicists, radiologists, specialized nursing staff, dietitians, and other specialists deliver advanced assessment and leading, innovative treatment options for patients with newly diagnosed or recurrent prostate cancer.
State-of-the-art treatment modalities at the Prostate Cancer Radiation Oncology Service include:
- Intraoperative MRI-Guided Prostate Brachytherapy (seed therapy) for patients with newly
diagnosed or locally recurrent prostate cancer;
- High-dose 3D Conformal External Beam Radiation Therapy using a unique prostate
localization and immobilization device;
- Leading clinical trials.
World-Class Genitourinary Cancer Care
The Lank Center for Genitourinary Oncology at Dana-Farber/Brigham and Women’s Cancer Center brings together radiation oncologists and medical oncologists with urologic surgeons, radiologists, and other specialists to treat patients as one medical team. The Lank Center for Genitourinary Oncology is one of 11 specialized treatment centers at Dana-Farber/ Brigham and Women’s Cancer Center, one of the most comprehensive and advanced centers for adult cancer care and research available.
Brigham and Women’s Hospital and Dana-Farber Cancer Institute continue to be world-class leaders in cancer treatment and research. U.S. News & World Report® repeatedly includes Brigham and Women’s Hospital on its Honor Roll of “America’s Best Hospitals” and Dana-Farber Cancer Institute among the top cancer centers in the nation.
Pioneering Innovative Treatment
Intraoperative MRI-Guided Prostate Brachytherapy Program
In 1997, experts in the Prostate Cancer Radiation Oncology Service developed MRI-guided prostate brachytherapy, deploying seed placement using MRI guidance in the treatment of select patients with newly-diagnosed prostate cancer. Utilizing a three-dimensional imaging approach, this technique enables more precise placement of high-dose radioactive seeds into the known cancer bearing area and areas at risk for prostate cancer, while sparing surrounding tissues and organs. MRI-guided prostate brachytherapy has resulted in the near complete prevention of urinary incontinence and marked reductions in urinary symptoms compared to other seed programs.
The only program of its kind in New England and one of only four in the world, the Prostate Cancer Radiation Oncology Service’s Intraoperative MRI-Guided Brachytherapy Program offers benefits for both patients with newly diagnosed prostate cancer and those with recurrent prostate cancer and is uniquely able to deliver repeat radiation treatment, while preserving quality-of-life in the vast majority of cases. To date, physicians in the Intraoperative MRI Guided Brachytherapy Program have completed more than 500 procedures using this technique. Experts in the Program are also looking at fusing MRI with ultrasound as a means to approximate three-dimensional imaging in order to expand this capability more broadly to the public.
High-dose 3D Conformal External Beam Radiation Therapy
Designed for patients with more advanced prostate cancer, this approach is often used in conjunction with injectable and oral hormonal therapy to accentuate the effect of the radiation treatment. External beam radiation is a lifesaving treatment, and the combinational approach using hormonal therapy and external beam radiation is considered the standard of care for patients with advanced prostate cancer. Experts at Dana-Farber/Brigham and Women’s Cancer Center in conjunction with Medrad, Inc. have developed a specialized device to immobilize and localize the prostate in order to deliver precise, high-dose radiation therapy, which has been shown to lead to increased effectiveness in cancer treatment delivery. Physicians in the Center have studied nearly 100 cases using the intra-rectal balloon and will soon begin studying this device with intensity modulated radiation therapy (IMRT), a more targeted form of 3D Conformal External Beam Radiation Therapy.
Precise Delivery of Prostate Cancer Treatment
The intra-rectal balloon has enabled our radiation oncologists to:
- Immobilize the prostate for the delivery of precise, high-dose conformal external beam radiation therapy;
- Localize the prostate to ensure that the radiation is delivered to the prostate cancer with minimal exposure to surrounding tissues, including the rectum and bladder.
Leading the Way in Prostate Cancer Research
Researchers at Dana-Farber/Brigham and Women’s Cancer Center have pioneered new approaches in the assessment and treatment of prostate cancer, leading to better outcomes and quality-of-life for patients with this disease.
Uncovering the Value of PSA
Anthony V. D’Amico, MD, PhD, Chief, Prostate Cancer Radiation Oncology Service, has led several sentinel, multi-institutional studies that have enabled specialists to better understand how to use prostate-specific antigen (PSA) tests at diagnosis and following failure of primary treatment or salvage hormonal therapy to guide decisions regarding treatment. This research has shown:
- The change in PSA in the year prior to diagnosis is the most important factor in delineating between patients who can be cured using therapy directed solely at the prostate, such as prostate brachytherapy or surgery, versus those patients who need more comprehensive therapy using external beam radiation combined with hormonal therapy for potential cure. (N Engl J Med 2004; 351);
- Evidence to support the use of PSA to predict who is most likely to survive prostate cancer when it recurs following treatment. This research study shows that PSA may be used as a method to determine who is in most need of chemotherapy following hormonal therapy failure versus those patients who do not require chemotherapy in order to prolong survival. (J Natl Cancer Inst 2004; 96:509-15);
- The duration of time for PSA levels to double following surgery or radiation is an indicator of patients who need immediate hormonal therapy versus patients who can delay hormonal therapy. (J Natl Cancer Inst 2003; 95:1376-83).
- In addition, the findings from these studies provide the link between PSA response and subsequent prostate cancer death, enabling clinical trials to be designed based on the intermediate end-point of PSA response in lieu of death. This will enable researchers to shorten the duration of clinical trials, decrease the number of subjects needed to achieve meaningful results, and substantially expedite the discovery of new therapies for patients with relapse deemed life threatening.
Uniting Scientists and Clinicians in Prostate Cancer Research
Dana-Farber/Brigham and Women’s Cancer Center has also been selected as a site for the Specialized Program of Research Excellence (SPORE) in Prostate Cancer, a five-year, multi-center translational research initiative funded by the National Cancer Institute, designed to lead to the development of new scientific approaches in early detection, diagnosis, treatment, and prognosis of prostate cancer. Bringing together leading scientists and clinicians in prostate cancer, current endeavors of the SPORE in Prostate Cancer at Dana-Farber/Brigham and Women’s Cancer Center include:
- Discovery of novel mechanisms for prostate cancer treatment;
- Identification of genetic and serologic determinants of prostate cancer risk and progression;
- Study of the molecular basis of prostate cancer.
Prostate Cancer Clinical Trials
The Prostate Cancer Radiation Oncology Service is offering the following clinical trials:
- Salvage Magnetic Resonance Image-Guided Prostate Brachytherapy – A pilot study to determine the effects of MRI-guided prostate brachytherapy on prostate cancer in patients with recurrent prostate cancer following radiation therapy. This study will also evaluate the feasibility of this type of therapy.
- The Impact of a Delay in Initiating Radiation Therapy on PSA Outcome for Patients with Clinically-Localized Prostate Cancer – A study to determine whether delays in initiating radiation therapy are associated with PSA outcome for patients with clinically-localized prostate cancer.
- A Phase II Study of Late Rectal Toxicity Following 3D Conformal External Beam Radiation Therapy Performed Using a Prostate Immobilization Device – A study to determine whether placement of an intra-rectal balloon in the rectum during radiation planning and in the first 15 radiation treatment sessions will decrease the risk of long-term rectal bleeding.
Patient Education and Support Services
Our annual “Symposium on Prostate Cancer” brings together nationally prominent experts from Dana-Farber/Brigham and Women’s Cancer Center and patients for presentations and question and answer sessions. The goal of the symposium is to educate patients so that they can make more informed decisions regarding their prostate health. Offered to our patients free of charge, the symposium covers the latest information on the detection, staging, outcome assessment, and eventual prevention of prostate cancer.
Dana-Farber/Brigham and Women’s Cancer Center provides a wide array of support services for patients with prostate cancer, including counseling and support groups, services for international patients, interpreter services, hospitality, and housing.
Your Connection to the Prostate Cancer Radiation Oncology Service
For more information, or to refer a patient, please contact our referral coordinator at
(617) 732-7936.
Prostate Cancer Radiation Oncology Service Faculty:
