Abstract

Introduction: Because its efficacy has been shown to be equivalent to other widely used modalities, brachytherapy is gaining wide popularity as an alternative treatment for early stage prostate cancer. Despite advancement in brachytherapy, a number of patients will fail treatment. Observation, hormonotherapy, radical prostatectomy, and cryotherapy have been the main options for the brachytherapy failure prostate cancer. The goal of these therapies is to improve local control and possibly impact long-term survival.

Observation is the treatment option for older patients and patients with slow prostate specific antigen doubling time. Candidates for hormonotherapy are patients with older age and rapid prostate specific antigen doubling time. Patients with early stage prostate cancer and younger age may benefit most from salvage radical prostatectomy. Salvage cryoablation is a viable alternative to radical prostatectomy especially in older patients and those with comorbidities.