Why are younger men told that they should have radical surgery and not seeding since there are no long term reports on seeding?
The argument that there is insufficient long-term follow-up of brachytherapy series is no longer valid. In fact, numerous series including our own and the Seattle group have mean and medium long-term follow-up that surpasses surgical series published in the PSA era. The answer has to do with the ability of an older person to withstand surgery. It is the same with any kind of surgical procedure. The older one is, the more difficult it is to tolerate anesthesia and the trauma of invasive procedures. Older people heal more slowly and are more apt to develop infections and other complications. In our practice, we commonly treat men in their early 40’s (as well as patients in their 50’s, 60’s and older). Younger men, after all, have the most to lose – being impotent and wearing diapers for decades.
