McGuire VA Medical Center is reaching out to veterans across the country who have an aggressive form of prostate cancer, with a treatment that is quick and effective. It is called brachytherapy, and veterans from Michigan, Minnesota, Indiana, Oklahoma and Puerto have come to McGuire for the treatment.
“They told me I was category six, maybe six and a half,” said Carlos Alvarez, a veteran living in Puerto Rico, who had prostate cancer and his local doctors didn’t give him many options. “I could have, you know, the prostate eliminated,” added Alvarez.
But a better solution was waiting for him at McGuire, which has treated over 1,000 veterans from all over, with a procedure called brachytherapy, during which radioactive seeds are injected into the prostate in a quick, simple operation. “They show up in the morning for the procedure, we basically put them to sleep,” said Dr. Drew Moghanaki. Dr. Moghanaki is a radiation oncologist and staff physician at McGuire. “The seeds that have to go inside the prostate. They are very small, much smaller than a grain of rice, about the diameter of a lead-tipped pencil, and between 30 to 50 cc’s. We just push them in through the skin and it is a very clean procedure. We rarely have any infections and we are done in about 20 to 30 minutes, and wake the patient up, and we are all done. It’s incredible. There is very little pain, if any. The needles are about the size of what you might use to start an IV. And the patient is recovering and on the way. They may have to go to the bathroom more often for a few months after the procedure, but we almost never see any major complications from this procedure,” said Dr. Moghanaki.
The other alternative is external beam radiation, which he says is a six week procedure and sometimes impossible for veterans who live in remote regions. “Right now we’ve got about nine million veterans and we know about 90% of our patients are still male. When you take such a heavily-male population that is older, you wind up getting about 17,000 prostate cancer cases a year. And they are spread all over the U.S. and need access to care that may not be available where they might be. Especially depending upon the type of treatment they may want” said Dr. Moghanak.
Brachytherapy is not new, but works better in the VA financial model. Dr. Moghanak added, “The U.S. health-care system is really a fee-for-service healthcare system. The more expensive procedures that can be done, the more revenue can be made. And brachytherapy just doesn’t make a lot of money for, you know, practitioners out in the real world. When you put together the convenience of a one-day procedure that is more effective and more cost effective, it really is a win, win, win.”
“I went to Virginia, got everything hooked up, they did the procedure and the following morning, I was on my way home,” said Carlos Alvarez.
For Carlos and the approximately 100 veterans treated every month at McGuire, Dr. Moghanaki says, “For a moderately aggressive cancer, you are looking at a greater than 90% success rate long term and even in the most aggressive cancers you may be in the 80%-85%, which its hard to get those numbers either with surgical removal or external beam radiation.”
Prostate cancer is the second most common cancer among American men. McGuire’s radiation/oncology program is rated among the best, and through the VA’s national referral program, veterans from around the country are coming here by the hundreds for low-dose brachytherapy, when they can’t find it at home.