Brachytherapy

When his close friend suffered a mild stroke in fall 2022, he asked John when the last time was that he had a physical. It had been years.

John Ryder, 58, finally scheduled a wellness exam. His doctor ordered routine bloodwork as part of a physical. The results showed that John’s prostate-specific antigen (PSA) level was a worrisome 6.78 mg/mL — an indicator of possible prostate cancer.

A biopsy confirmed he had cancer, and John began researching treatment options and cancer specialists. His search ultimately led him to UPMC Hillman Cancer Center at UPMC Horizon–Shenango Valley in Farrell, Pa.

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Prostate Cancer Screening

PSA is a protein produced by the prostate gland. When there’s a problem with the prostate, PSA levels can rise above normal levels. Elevated PSA levels can be a sign of an enlarged prostate, inflammation, or prostate cancer.

According to the American Cancer Society, men with a PSA level between 4 and 10 mg/mL have a one in four chance of having prostate cancer. Additional testing is usually done to determine what’s going on.

In John’s case, after his initial PSA rise in mid-2022, a biopsy was performed and came back negative. His PSA continued to be monitored, and he had a prostate MRI, which also came back negative. John’s PSA began to rise again in mid-2023, which prompted a prostate core needle biopsy performed in the summer of 2023. The result: It was positive for cancer.

With a diagnosis, John’s next step was deciding what treatment to pursue. He initially met with William Eric Spielvogle, MD, a medical oncologist and hematologist at UPMC Hillman Cancer Center at UPMC Horizon–Shenango Valley.

Dr. Spielvogle confirmed that the cancer hadn’t spread beyond the prostate. After speaking with John, Dr. Spielvogle referred him to Uzoma Iheagwara MD, PhD, a radiation oncologist and clinical director, radiation oncology, UPMC Hillman Cancer Center at UPMC Horizon–Shenango Valley. Dr. Iheagwara reviewed all of John’s treatment options, including:

  • Active surveillance (closer monitoring over time).
  • Surgery (to remove his prostate).
  • Radiation therapy (external beam, stereotactic body radiation therapy, or brachytherapy).

“I knew I didn’t want to waste any time,” John says. “I could have chosen active surveillance. But I figured if I have something, I might as well do something now.”

Prostate Seed Implantation

John decided against surgery, but he still wanted to be proactive with treatment. He elected to have low-dose rate brachytherapy, given the convenience of the one-time, same-day procedure.

With brachytherapy (a form of internal radiation therapy), doctors place tiny radioactive seeds inside the prostate. The seeds emit radiation that destroys the cancer cells, sparing surrounding healthy tissue and organs.

Dr. Iheagwara referred John to Peter Daloni, MD, a urologist at UPMC Horizon.

Both doctors were at John’s side when he had the brachytherapy procedure at UPMC Horizon in January 2024. During the three-hour procedure, 94 radioactive seeds were placed inside his prostate.

A follow-up test done a month later showed his PSA level dropped to 2.57 mg/mL, which is in the normal range.

“When I got those results, I called my wife right away,” says John. “My PSA level was never that low.”

John says he appreciated having doctors who listened to his concerns and took time to explain treatment options. He also praised his doctors and the staff at UPMC Horizon for the care he received. The nurses in the radiation oncology department were “especially helpful and exceptionally nice,” he added.

“I had confidence in them. I knew from my research that the doctors at UPMC Hillman Cancer Center and UPMC Horizon were top-notch,” John says. “Everything went smoothly. The care I received was excellent.”

About UPMC Hillman Cancer Center

When you are facing cancer, you need the best care possible. UPMC Hillman Cancer Center provides world-class cancer care, from diagnosis to treatment, to help you in your cancer battle. We are the only comprehensive cancer center in our region, as designated by the National Cancer Institute. We have more than 70 locations throughout Pennsylvania, Ohio, and New York, with more than 200 oncologists – making it easier for you to find world-class care close to home. Our internationally renowned research team is striving to find new advances in prevention, detection, and treatment. Most of all, we are here for you. Our patient-first approach aims to provide you and your loved ones the care and support you need. To find a provider near you, visit our website.