Using Brachytherapy as a salvage procedure for failed surgery

There is certainly some short term positive results with this but I see possible issues with it. Brachytherapy is a local therapy and not a regional therapy and cannot replace the role of EBRT post RP. For one, if there are high risks that lymph node invasion has occurred such as G7 and above, then these patients should be asking about Iliac/Inguinal node invasion and the ability to include them in post RP cases for salvage therapy. If it makes any sense at all that it's possible, at least for me, then there is very little reason to consider interstitial therapy and the use of external beam makes better sense. The same argument applies to HIFU in a salvage role to RP. We already know data for HIFU isn't great in that use. But if the relapses are in the prostate bed it may work well. The problem is that we won't ever know without the passage of time. And if there is relapse after salvage seeds then what? still go for the EBRT to the nodes? That seems redundant but I think it's possible. The question is whether it's reasonable to subject a patient to RP, Seeds, and EBRT where RP/and EBRT work quite well together.

Interesting considerations...

Tony

Tony,
I agree with you. The only way I would consider it is that if a biopsy or a scan showed the cancer to be identified and contained in the prostate.