Radiation/Prostate/ LUNGS

Radiation implants for prostate can move to lungs

By Amy Norton

NEW YORK, Apr 09 (Reuters Health)

Radioactive seeds implanted to fight prostate cancer can eventually break away and find their way to the lungs, but there are no apparent short-term consequences, new study findings suggest.

The study of 58 prostate cancer patients who had chest x-rays within 90 days of seed implantation found that in 36%, a small number of seeds had migrated to the lungs. But lung-function tests showed no evidence of short-term harm, according to findings published in the April issue of the journal Urology.

The implantation of radioactive seeds, known as brachytherapy, is becoming more and more common in the treatment of prostate cancer. This isn't the first study to show that so-called radioactive seed migration can occur shortly after treatment. In fact, brachytherapy experts recommend that patients be told of the possibility before treatment and that they have a chest x-ray shortly after the seeds are implanted.

But patients--and many of the urologists in charge of their follow-up care--are unaware of the migration potential, study author Dr. Robert E. Weiss of Robert Wood Johnson University Hospital in New Brunswick, New Jersey, explained in an interview.

The good news, he told Reuters Health, is that "at least in the short term, there are no deleterious effects."

And, Weiss said, it appears that only a small amount of radiation makes it to the lungs, suggesting it "shouldn't have a bad effect" in the long run either. In his team's study, 12 men had a single seed move to the lungs, while the 9 others had no more than four seeds migrate.

Still, long-range follow-up of patients with radioactive seed migration is needed, according to Weiss and his colleagues. So far, they note, no cases of lung cancer secondary to seed migration have been reported.

For now, Weiss said, prostate cancer patients should be told about the possibility for seed migration before getting brachytherapy. Men who have already had the procedure, he noted, should be reassured by the lack of short-term effects in this study.

SOURCE: Urology 2002;59:555-559.

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