Besides non-melanoma skin cancer, prostate cancer is the most commonly diagnosed cancer, among men, in the United States. For many men, the work-up of prostate cancer starts with a routine PSA blood test at their primary care physician’s office. From there, many men with an elevated PSA get referred to a urologist for a biopsy of their prostate and/or imaging, such as an MRI. Men diagnosed with prostate cancer living in the San Francisco Bay Area have many options when choosing a specialist for their prostate cancer. Physicians specializing in prostate cancer will often discuss multiple potential treatment options, depending on the stage of the prostate cancer. Viable treatment options often include active surveillance, prostatectomy, brachytherapy, external beam radiation therapy, stereotactic body radiation therapy, proton therapy, TULSA, androgen deprivation therapy, and/or a combination of these therapies. Understanding the pros and cons of all of these treatment options is important before choosing any single treatment pathway.

At Western Radiation Oncology (WRO), our team of experienced physicians specialize in the treatment of prostate cancer. Our commitment to providing quality, personalized care has allowed us to grow our presence throughout the Bay Area and beyond. We are happy to provide patients with second opinions on the management of their prostate cancer. 

Our physicians, Dr. Steve Kurtzman and Dr. Ankit Agarwal, are both Board Certified radiation oncologists and perform more Low Dose Rate brachytherapy cases each year than any other physician practice in the world. Both Dr. Kurtzman and Dr. Agarwal specialize in real-time intraoperatively planned LDFR brachytherapy. Patients in the San Francisco Bay Area can trust that they are receiving the best possible care for their prostate cancer at WRO. 


What is our goal?


The goal of WRO is to make the process of treatment as easy and stress-free as possible. We possess numerous locations throughout the Bay Area to make it convenient for our patients. 

Our physical offices in Northern California are located in Mountain View, Danville, Salinas, and San Mateo. 

We also operate at surgery centers and hospitals throughout the Bay Area, including Oakland, Walnut Creek, Fremont, San Mateo, Los Gatos, Salinas, Gilroy, San Ramon, and Tracy. 


What is Low Dose Rate (LDR) brachytherapy?


Low Dose Rate (LDR) brachytherapy is a type of cancer treatment that involves the placement of radioactive seeds directly into the prostate. The radioactive seeds emit low levels of radiation over a period of several days to weeks, delivering a low dose of radiation to the affected area. This type of brachytherapy is commonly used to treat prostate cancer. For men with earlier stages of prostate cancer, brachytherapy alone can often be used and is a highly effective form of treatment. For men with more advanced stages of prostate cancer, a combination of external beam radiation therapy and brachytherapy can be used to increase the chance of cure as compared to using either treatment modality used alone.

In LDR brachytherapy, the radioactive seeds get inserted directly into the affected area, allowing for a higher concentration of radiation to reach the cancerous cells. This targeted approach reduces the risk of side effects compared to external radiation therapy since the surrounding tissues do not receive much of the radiation.

At WRO, our healthcare providers perform LDR brachytherapy as an outpatient procedure. It is usually well tolerated and can be extremely effective in the treatment of prostate cancer. Patients typically return to their normal activities soon after the procedure.


Ethos Adaptive Radiation therapy


Aside from prostate brachytherapy, WRO physicians offer Ethos Adaptive Radiation therapy at El Camino Hospital in Mountain View, CA. El Camino Hospital was the first hospital on the West Coast to utilize Ethos Adaptive Radiation therapy technology, and we are proud to offer adaptive stereotactic body radiation therapy (SBRT) using the Ethos system to appropriate patients. 

SBRT is an external beam radiation technique that allows us to deliver radiation therapy to the prostate in four or five treatments. At El Camino Hospital, we can deliver escalated doses of radiation therapy that could increase the long term control of prostate cancer, while minimizing long term side effects, using the advanced Ethos system. At El Camino Hospital, we utilize rectal spacing through products such as SpaceOAR and urethral sparing radiation to minimize any bowel or urinary side effects.

The Ethos system allows us to adapt to patient’s unique anatomy on each day of treatment, thus shrinking our treatment margins and reducing the radiation dose to normal surroundings organs. This approach takes advantage of cutting-edge imaging, artificial intelligence-based image segmentation, and automated radiation planning techniques to guide the delivery of radiation. 


Compared to traditional radiation therapy, both Ethos Adaptive Radiation therapy and brachytherapy offer several advantages for prostate cancer patients, including:


Increased precision

The ability to target cancer cells and adjust the radiation delivery in real-time using either intraoperatively real-time planned brachytherapy or the Ethos system increases the precision of the treatment and can reduce the risk of side effects.

Reduced treatment time

Patients can receive their entire brachytherapy treatment in a single session, which lasts under an hour. Ethos Adaptive Radiation therapy, using SBRT, can potentially reduce the overall treatment time, as it allows for more efficient delivery of radiation. We can typically deliver an entire course of SBRT radiation therapy over 4-5 total sessions.

Improved outcomes

The combination of brachytherapy in combination with external beam radiation therapy has shown to have higher long term progression free survival rates than external beam radiation therapy alone for patients with high-risk prostate cancer. In addition, by dose escalating the dose delivered with SBRT radiation using the Ethos system, we can achieve a higher tumoricidal dose to the prostate. 

Improved quality of life

By minimizing the exposure of healthy tissue to radiation, both Ethos Adaptive Radiation therapy and brachytherapy can help achieve a great quality of life after completion of treatment. 


The advantage of a multidisciplinary approach in the San Francisco Bay Area


A multidisciplinary approach in San Francisco Bay Area involves a team of specialists working together to develop a comprehensive treatment plan for each patient. We work with urologists and medical oncologists throughout the Bay Area to deliver the best care to our patients. 

This approach has several advantages, including:

Access to a Wide Range of Treatment Options

By combining the expertise of different specialists, a multidisciplinary approach allows patients to hear about all of their potential treatment options and allows us to deliver the high-quality care.  

Personalized care

Each patient is unique and may have different health needs and concerns. Different specialists working together helps in the development of a personalized treatment plan that takes into account your individual needs.

Improved coordination of care

Our clinic ensures that all aspects of a patient’s care are coordinated and integrated, reducing the risk of miscommunication and duplicated efforts. We care about creating a seamless patient care experience. 

If you’re in California and would like to consult with one of Western Radiation Oncology’s physicians, please contact us here.