Steven J. Frank

As part of a special course on brachytherapy for prostate cancer from the American Brachytherapy Society and Grand Rounds in Urology, Steven J. Frank, MD, Professor of Radiation Oncology at the University of Texas MD Anderson Cancer Center, Medical Director of the Proton Therapy Center at MD Anderson, and leader of both the Proton Therapy Program for Head and Neck Cancer and the Prostate Brachytherapy Program, introduces the many myths about brachytherapy and dispels them with data, revealing the truth of brachytherapy and its effects. He shows data asserting that patients under 60 and obese patients are great candidates for brachytherapy. Dr. Frank then discusses how radiation exposure to a patient’s family is less than what a flight from New York City to San Francisco would cause, and that brachytherapy has great curative ability based on a PSA of .2 ng/ml at 4 years being curative. He describes how long-term data and outcomes for brachytherapy are in the treatment’s favor, showing that it is an excellent option for low-, intermediate-, and high-risk cancer. Dr. Frank states that patient satisfaction is greater with brachytherapy than other treatments due to low rates of urinary incontinence and reduction in sexual function, and no penile shortening or treatment regret. He summarizes how salvage therapy and salvage brachytherapy following radiation have been found to be effective but require skilled and experienced teams. Dr. Frank also discusses asymptomatic seed migration 3 years after implantation, the lack of data on hair loss, the safety of cremation, and how MRI-assisted radiosurgery is an innovation in brachytherapy. He concludes that brachytherapy has been found to be the most innovative, cost-effective, satisfying, and curative prostate cancer treatment.