Session Item

In this presentation we will focus on the socioeconomic factors impacting brachytherapy in the United States. We will explore trends in prostate cancer treatment and discuss potential corrective strategies to reverse the declining utilization of prostate brachytherapy. In doing so we will focus on factors negatively impacting the utilization of brachytherapy in the United States, particularly regarding reimbursement. To frame this discussion, we will also explore the impact of PSA screening, active surveillance, radical prostatectomy, competing forms of radiotherapy and other factors affecting utilization of brachytherapy in a fee for service health care environment. In addition, we will explore decreasing brachytherapy utilization in academic centers in the United States. These considerations are timely as both academic and nonacademic radiation oncology practices have demonstrated a significant reduction in the use of prostate brachytherapy in the past fifteen years. With the case volume continuing to decline, it is unclear whether we are prepared to train the next generation of residents in this critical modality. Furthermore, we will suggest strategies to combat these trends to train the next generation of residents, to potentially include simulation-based training, the creation of centers of excellent, national brachytherapy organization training opportunities as well as worldwide educational opportunities. Finally, we will discuss where brachytherapy fits into current treatment recommendations and how we as brachytherapists can capitalize on such recommendations to expand the utilization of brachytherapy worldwide.