Interstitial brachytherapy is basically hand-to-hand combat, instead of missiles launched from far away. The idea here is that the farther energy gets from its source—the more tissue a radiation beam has to pass through to reach its target-—the less effective it will be in killing cancer. And that implanting tiny sources of radiation directly in the cancerous tissue (brachy comes from the Greek word meaning “short,” as in “a short distance away from the malignancy”) will really blast the tumor—and, as an added bonus, minimize the risk of harming innocent civilians, the cancer-free cells nearby.

In the past, interstitial brachytherapy has not been as successful in controlling prostate cancer as external-beam radiation therapy. However, the development of advanced guidance ultrasound systems, three-dimensional treatment planning and templates to ensure an even distribution of radiation throughout the prostate may improve this technique’s results.

Recently, cryotherapy—killing prostate cells by freezing them— has become increasingly popular as a less-invasive form of treatment for localized prostate cancer. Although it appears to be well tolerated, and involves only a short hospital stay, it remains to be determined whether it will be as effective as external-beam radiation or radical prostatectomy in curing prostate cancer.

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