Mira Keyes, MD, FRCPC, FABS, presented “Brachytherapy for Prostate Cancer” as part of a course on Prostate Brachytherapy released in 2021 and created by the American Brachytherapy Society in partnership with Grand Rounds in Urology.
How to cite: Keyes, Mira. “Brachytherapy for Prostate Cancer.” September 2021. Accessed Jan 2025. https://grandroundsinurology.com/brachytherapy-for-prostate-cancer/
Brachytherapy for Prostate Cancer – Summary
As part of a special course on brachytherapy for prostate cancer from the American Brachytherapy Society and Grand Rounds in Urology, Mira Keyes, MD, FRCPC, FABS, Clinical Professor at the University of British Columbia (UBC) and a radiation oncologist at the Vancouver Centre of the British Columbia Cancer Agency (BCCA), gives an overview of brachytherapy for prostate cancer (PCa), making a case against its declining use based on its efficacy. She begins by introducing the American Brachytherapy society, which was founded in 1978 to provide insight, rationale, and research into the use of brachytherapy in the treatment of both malignant and benign conditions. Dr. Keyes then describes how brachytherapy was performed with radium tubes when it was invented in 1901, and was then subsequently done with needles beginning in 1915. She concludes her short history by marking 1983 as the beginning of the modern era of prostate brachytherapy, thanks to advances in imaging capabilities. Dr. Keyes discusses data showing that brachytherapy is associated with better survival in patients with local to advanced cervical cancer. She then goes over the processes for high dose rate and low dose rate brachytherapy for PCa, focusing on the quick recovery, high cure rates, and minimal to no incontinence or sexual dysfunction as benefits for both treatments. Dr. Keyes shows data on brachytherapy utilization for PCa depicting its decline since 2003 due to robotic prostatectomy use, PSA screening changes, active surveillance low-risk treatment recommendation changes, and higher reimbursement for IMRT and robotic surgery. She also discusses data showing that 10% of US cancer care spending is on prostate cancer, with the highest procedure cost per patient going to robotic surgery. Dr. Keyes compares the use of brachytherapy in the US to that of Canada, stating that Canada’s increasing use is due to a reimbursement system that incentivizes brachytherapy, and the education of the public, residents, general practitioners, and urologists. She concludes that the benefits of brachytherapy support its use for localized PCa in the US.
For more on brachytherapy, check out the first module of the free Prostate Brachytherapy course from GRU and the American Brachytherapy Society.
ABOUT THE AUTHOR
Mira Keyes, MD, FACS, is a Clinical Professor at the University of British Columbia (UBC) and a radiation oncologist at the Vancouver Centre of the British Columbia Cancer Agency (BCCA). Dr. Keyes has a wide range of research interests, including Prostate Brachytherapy, Genito-Urinary Oncology, Breast Cancer, Postgraduate Medical Education, and Patient Communication.
Dr. Keyes received her MD at the University of Novi Sad in Yugoslavia, Serbia. Dr. Keyes then received her FRCPC Radiation Oncology from the Royal College of Physicians of Canada. Dr. Keyes completed her fellowship at the Royal College of Physicians of Canada for Radiation Oncology, in the Vancouver Cancer Center.
Dr. Mira Keyes is one of the founders of theBritish Columbia Cancer Agency (BCCA)Provincial Prostate Brachytherapy Program (1998), past program Quality Assurance Head, and since 2006, a Provincial Program Head. Dr. Keyes is a former Residency Training Program Director in Radiation Oncology at UBC, and past Royal College examiner in Radiation Oncology. She is vice chair of the group developing Brachytherapy Diploma Certification with Royal College of Physicians and Surgeon of Canada, for the purpose of credentialing brachytherapy training process at a national level.
She is an elected board member for ABS (American Brachytherapy Society) and member of the editorial board for Brachytherapy Journal. She is a member of CARO (Canadian Association for Radiation Oncology), CBG (Canadian Brachytherapy Group) ASTRO and ESTRO. Dr. Keyes has been an invited speaker at many national and international conferences; she is an author of over fifty peer reviewed articles and recipient of many peer review grants. She has a large GU and Head and neck practice.
She is a recipient of several UBC awards: Mentorship Award (2018), Teaching Award (2017), CanMeds of Excellence Award (2014) and AD McKenzie UBC Department of Surgery Clinical Teaching Award 2017, in 2019, nominated for Royal College of Physicians and Surgeons of Canada Mentorship Award. She is a CARO and BC Cancer wellness committee chair.
