How to cite: Crawford ED; Pohlman GD; Decker D; Kurtzman SM. LDR Brachytherapy in Community Practice: Expanding Access Through Collaborative Care. Grand Rounds in Urology. October 2026. Accessed Oct 2026. https://grandroundsinurology.com/ldr-brachytherapy-in-community-practice-expanding-access-through-collaborative-care/
Summary
E. David Crawford, MD, Editor-in-Chief of Grand Rounds in Urology and Professor of Urology at the University of California, San Diego, San Diego, California, moderates a panel with Garrett D. Pohlman, MD, Urologist, Kearney Urology Center, PC, Kearney, Nebraska, Daniel Decker, MD, Urologist, Vitality Plus Urology, Mountain Home, Arkansas, and Steven M. Kurtzman, MD, Radiation Oncologist, Western Radiation Oncology, Mountain View, California. The group examines how low-dose-rate (LDR) brachytherapy can be integrated into community and rural urology practices through collaboration between urologists and radiation oncologists.
Dr. Decker describes limited access to cancer care in rural communities, where patients may otherwise travel to urban centers for treatment. He discusses incorporating LDR brachytherapy into a rural practice to expand local treatment options for patients who may have difficulty completing repeated visits for external beam radiation therapy. Dr. Pohlman similarly emphasizes treatment burden, including travel, transportation, lodging, time away from work, and the repeated visits associated with longer treatment courses. He describes LDR brachytherapy as a single-procedure option, with patients generally leaving the surgery center the same day.
Dr. Kurtzman explains the development of a model in which an experienced radiation oncology team works directly with community urologists. The model includes patient selection, referral, telemedicine consultation, treatment recommendations, procedural planning, dosimetry, and follow-up. The panel emphasizes that treatment recommendations are individualized according to clinical stage, risk group, and urinary function.
The faculty discusses operational implementation in ambulatory surgery centers. Drs. Decker and Pohlman describe procedures lasting approximately 20 minutes in their experience, with multiple cases performed during a designated procedure day. Telemedicine further supports access to radiation oncology consultation for geographically dispersed patients.
The panel emphasized multidisciplinary collaboration, appropriate patient selection, and the role of LDR brachytherapy across prostate cancer risk groups. The faculty position community-based programs as a way to broaden access to definitive prostate cancer treatment while reducing travel and treatment burden for selected patients.
ABOUT THE AUTHOR
Researcher-physician E. David Crawford, MD, has devoted his medical career to educating the public about men's health issues and finding effective techniques and procedures to address prostate cancer, the most common malignancy affecting men in the United States. He is currently a Professor of Urology and Jack A. Vickers Director of Prostate Research at the University of California, San Diego. Dr. Crawford earned his MD from the University of Cincinnati and his postgraduate training, which included an internship and residency in Urology, at the Good Samaritan Hospital in Cincinnati, Ohio. He subsequently completed a fellowship in Genitourinary Cancer at the University of California, Los Angeles. Dr. Crawford is an internationally-recognized expert in benign prostate hypertrophy, urologic cancers, and, in particular, prostate cancer. He has conducted research in the treatment of advanced bladder cancer, metastatic adenocarcinoma of the prostate, hormone-refractory prostate cancer, and other areas of urological infections and malignancies.
Garrett D. Pohlman, MD, is a urologist with Kearney Urology Center, P.C., in Kearney, Nebraska. He received his undergraduate degree from the University of Nebraska, Lincoln, and his medical degree from the University of Nebraska College of Medicine in Omaha. He then went on to complete his internship and residency at the University of Colorado School of Medicine in Denver. Dr. Pohlman specializes in urinary incontinence, bladder diseases, and other urinary disorders. Dr. Pohlman is also the host of the Prostate Health Podcast. On it, he conducts weekly interviews with experts, innovators, and leaders regarding prostate conditions. With the podcast, he is educating the general public regarding prostate health, the conditions that affect the prostate, and the latest technology used to manage these conditions. The podcast can be found at www.prostatehealthpodcast.com.
Daniel Decker, MD is a Board-Certified Urologist with a Bachelor of Science degree in Biology from Baylor University and a Medical degree from Wake Forest University School of Medicine. He completed his general surgery internship and Urology residency at the University of Texas Southwestern Medical Center, where he was a chief resident from 2010 to 2011.
Steven M. Kurtzman, MD, received a Bachelor of Arts from Cornell University, Ithaca, New York, and his medical degree from Case Western Reserve University School of Medicine in Cleveland, Ohio. He completed his residency at the University of Pennsylvania, Philadelphia, Pennsylvania, and joined WRO in 1998. Dr. Kurtzman is nationally renowned for his expertise in ‘real-time’ intraoperatively planned prostate brachytherapy. He has presented at multiple national meetings and has taught physicians on this advanced technique from around the globe.
He is notable for performing implants throughout the United States and has treated over 6,000 patients over the past 20 years. He also serves on the medical advisory board of several medical device companies, helping to inform the development of new treatment techniques. He is the Director of Prostate Brachytherapy for Western Radiation Oncology.
