John Sylvester, MD, FABS, presented “Brachytherapy” during the 27th Annual Southwest Prostate Cancer Symposium conference on October 17, 2024, in Scottsdale, Arizona.
How to cite: Sylvester, John. “Brachytherapy.” October 17, 2024. Accessed Feb 2025. https://grandroundsinurology.com/brachytherapy/
Brachytherapy – Summary
John Sylvester, MD, FABS, delves into the historical evolution, techniques, and efficacy of brachytherapy in prostate cancer management. In this 25-minute presentation, Dr. Sylvester highlights early innovations, such as intraurethral radiation by Hugh Hampton Young, and transitions to modern advances, including ultrasound-guided seed placement. Comparing brachytherapy with external beam radiation and surgery, he underscores its superior tumor control, reduced radiation exposure to healthy tissues, and low incontinence rates.
Dr. Sylvester presents compelling evidence from multi-institutional studies, such as the ASCENDE-RT trial, demonstrating the survival benefits of combining brachytherapy with external beam radiation. He asserts that modern techniques significantly reduce complications. Insights into androgen deprivation therapy reveal that shorter durations of hormone treatment achieve comparable outcomes with improved quality of life.
Data from international collaborations illustrate brachytherapy’s unparalleled efficacy in preventing biochemical recurrence and distant metastases, particularly in high-grade cancers. Dr. Sylvester emphasizes brachytherapy’s adaptability, cost-effectiveness, and its role as the gold standard for localized, high-dose radiation delivery. By bridging clinical evidence with practical insights, he advocates for wider adoption of brachytherapy, citing its profound impact on patient outcomes and its potential for broader integration in cancer care.
About the 27th Annual Southwest Prostate Cancer Symposium:
Presented by Program Chairs Nelson N. Stone, MD, Richard G. Stock, MD, and William K. Oh, MD, this conference educated attendees about advances in the management of localized and advanced prostate cancer, with a focus on imaging, technology, and training in the related devices. It included a scientific session, as well as live demonstrations of surgical techniques. You can learn more about the conference here.
ABOUT THE AUTHOR
John E. Sylvester, MD, FABS, is a radiation oncologist with GenesisCare in Bradenton, Florida. He also serves as a clinical assistant professor in the College of Medicine at Florida State University. Dr. Sylvester earned his medical degree from the University of California, Los Angeles (UCLA) and completed his residency at UCLA Department of Radiation Oncology while serving as Chief Resident.
Dr. Sylvester has performed 7,000 prostate brachytherapy procedures and developed multiple technical improvements by improving visualization of the urethra during the procedure, optimally utilizing R.A.P.I.D strand, and co-developing THINStrand. Additionally, he was a major investigator in multi-institutional research studies for stereotactic body radiation therapy (SBRT)and Immunomodulation + intensity-modulated radiation therapy (IMRT) for prostate cancer. He has published numerous articles and medical textbook chapters on prostate brachytherapy and co-authored and edited The Prostate Cancer Treatment Book. He wrote the white paper on 4-D Calypso image-guided IMRT and was the first physician in the USA to use SpaceOAR in prostate cancer IG-IMRT.
Dr. Sylvester publishes prostate cancer research papers every year and regularly lectures at the National Radiation Oncology Society Medical Conferences. He earned the "Innovation Research Award 2014" from the Manatee County Chamber of Commerce and was awarded Sarasota Magazine's Top Doctor distinction from 2012-2023.
