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Proton Radiation Therapy Side Effects

What Types Of Prostate Cancer Can Be Treated With Proton Therapy

Proton therapy side effects in head and neck cancer patients

Almost anyone with prostate cancer may be a candidate for proton therapy, which can treat prostate tumors with complex shapes and prostate cancer in all stages when radiation treatment is indicated, even if the cancer has spread.

Types of prostate cancer treated by proton therapy include:

  • Early-stage prostate cancer
  • Prostate cancer that has spread to adjacent organs or tissues
  • Prostate cancer that has spread to the lymph nodes
  • Prostate cancer that returned after surgical removal and is detected through the prostate-specific antigen test, indicating biochemical recurrence

In some situations, another treatment or another type of radiation may offer better or faster results than proton therapy. These situations include:

  • Aggressive prostate cancer that causes symptoms: Proton therapy treatments take longer to plan than traditional radiation. Doctors may recommend traditional radiation therapy for aggressive prostate cancers so treatment can be started sooner.
  • Early-stage prostate cancer: Some early-stage prostate cancers require careful monitoring, not treatment. Others may need surgery to remove the tumor and not require radiation therapy.
  • Hip replacement implants, especially if they are in both hips, can affect the accuracy of CT imaging. Without clear images, it is difficult to plan precise proton beam delivery.
  • Pacemakers: Proton therapy can increase the risk of a pacemaker device failure.

What The Research Shows About Radiation Vs Surgery

The ProtecT trial was a 10-year, randomized clinical study designed to compare radical prostatectomy, external-beam radiotherapy and active surveillance for the treatment of localized prostate cancer.

The results, published in 2016, showed that the rate of disease progression among men assigned to radiotherapy or radical prostatectomy was less than half the rate among men assigned to active monitoring. However, there was no significant difference in survival at the median 10-year follow-up for radiation therapy, surgery or active surveillance.

If youre interested in directly comparing treatment outcomes by treatment method and risk group , the Prostate Cancer Free Foundation provides an interactive graph on its website with information from data obtained from over 129,000 prostate cancer patients over a 15-year period.

As discussed earlier in the sections on the side effects of radiation therapy and surgery, the researchers conducting the ProtecT trial also looked at side effects and quality-of-life issues and found that the three major side effects of these two treatment options that affect quality of life after prostate cancer treatment are urinary incontinence, sexual dysfunction and bowel health.

The trial found that urinary leakage and erectile dysfunction were more common after surgery than after radiation therapy. Gastrointestinal bowel problems were more common after radiation therapy.

Sex After Prostate Biopsy

To confirm a diagnosis of prostate cancer, you need to have a biopsy. During this test, your healthcare provider collects a sample of prostate tissue to look for cancer. They can do this in one of two ways:

  • Transrectal biopsy: This biopsy occurs by inserting an ultrasound probe into your rectum and then using a needle to pass through that probe to get the sample cells from your prostate.
  • Transperineal biopsy: This biopsy is taken by inserting a needle into the skin of your perineum to remove sample tissue cells from your prostate.

For the vast majority of men undergoing an uncomplicated biopsy , long-term sexual function should not be affected, reassures Dr. Bole.

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What Are The Side Effects

The side effects depend on which part of your body is being treated.

In general, you may feel tired during treatment and for a short while afterwards. You might lose your hair in the treatment area and your skin might become sore and red.

Your doctor will go through the possible side effects with you before you start treatment. They will explain how long they might last and how they can help treat them.

As with any radiotherapy there may be some long term effects. Your doctor will go through these with you. The risk of these side effects may be less than with other external radiotherapy.

Research continues to look at how well proton beam therapy works and the possible side effects.

What Are The Results Of Using Proton Therapy In Patients

About proton beam therapy

For patients facing prostate cancer, treatments and side effects present unique challenges in choosing a therapy. Proton radiation for prostate cancer treats the disease with successful outcomes and a low risk of side effects.

For thousands with cancer of the prostate, proton therapy has offered an effective, virtually painless option for prostate cancer treatment. Since the University of Florida Health Proton Therapy Institute opened in 2006, thousands have undergone proton therapy for prostate cancer, and prostate cancer patients at the UF Health Proton Therapy Institute enjoy a close-knit community of fellow patients, caregivers and spouses. Today, prostate cancer is one of many types of cancer treated at the Institute.

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What Are The Benefits Of Proton Therapy Compared To Traditional Rt

Because of its molecular properties, we can use proton therapy to deliver an extremely high dose of radiation to a very localised site with significant benefits and fewer side effects compared to traditional RT. These include:

  • Minimal radiation to healthy tissue
  • Reduced risk of secondary cancers
  • Safe dose escalation associated with higher overall survival
  • Reduced risk of radiation-induced malignancy in young patients
  • Significantly lower risk of adverse side effects and toxicity

In the case of brain tumours, the increased accuracy and precision of proton therapy can potentially reduce side effects such as IQ loss. In the case of paediatric patients, proton therapy can address the impact of long-term side effects of RT, which include concerns about reduced fertility, growth disturbances, second cancer, and endocrine dysfunction.

Does Proton Therapy Shorten Your Life

All issued resolved within six months. This study provides some prospective evidence that the higher daily radiation dose delivered in hypofractionated proton therapy does not negatively impact patient quality of life, said senior author Neha Vapiwala, MD, an associate professor of Radiation Oncology.

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Proton Therapy Versus Carbon Ion Therapy

Carbon ion radiotherapy is similar to proton therapy, except it uses carbon ions instead of protons. Carbon ions are heavier than protons, so they can deliver more radiation to the tumor and cause more damage to cancer cells. International research shows promising results in cancer survival rates with carbon ion therapy. However, there are presently no centers in the U.S. that offer CIRT.

Spaceoar Hydrogel: Reducing Radiation Exposure

Proton therapy minimizes radiation side-effects in breast cancer patients – New Day Northwest

The prostate and rectum are located very close to each other and are separated only by a small space. When undergoing proton therapy for prostate cancer, your doctor will determine if you are eligible for placement of a special hydrogel between the prostate and rectum . The SpaceOAR hydrogel creates additional space between the prostate and the rectum to further reduce radiation exposure to the rectum, thereby minimizing unwanted side effects and potential injury to the rectum during treatment. More than 50,000 patients worldwide have been successfully treated with SpaceOAR Hydrogel.

The placement of the hydrogel is a minimally invasive procedure done within our center and the hydrogel remains inside the body throughout treatment. The material that the SpaceOAR Hydrogel is made from has been used in other implants such as surgical sealants used in the eye, brain and spine. The biodegradable material naturally dissolves after a few months and is cleared in your urine.

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Possible Side Effects Of Ebrt

Some of the side effects from EBRT are the same as those from surgery, while others are different.

Bowel problems: Radiation can irritate the rectum and cause a condition called radiation proctitis. This can lead to diarrhea, sometimes with blood in the stool, and rectal leakage. Most of these problems go away over time, but in rare cases normal bowel function does not return. To help lessen bowel problems, you may be told to follow a special diet during radiation therapy to help limit bowel movement during treatment. Sometimes a balloon-like device or gel is put between the rectum and the prostate before treatment to act like a spacer to lessen the amount of radiation that reaches the rectum.

Urinary problems: Radiation can irritate the bladder and lead to a condition called radiation cystitis. You might need to urinate more often, have a burning sensation while you urinate, and/or find blood in your urine. Urinary problems usually improve over time, but in some men they never go away.

Some men develop urinary incontinence after treatment, which means they cant control their urine or have leakage or dribbling. As described in the surgery section, there are different levels and types of incontinence. Overall, this side effect occurs less often with radiation therapy than after surgery. The risk is low at first, but it goes up each year for several years after treatment.

What Should We Expect From Proton Therapy

Proton therapy treatment usually takes about 68 weeks, with daily weekday visits that last about 3045 minutes. Most of the time is spent getting the child into the right position for the treatment.

Proton therapy treatment is painless, and doesn’t require a hospital stay. Children under 6 years old might need to get general anesthesia to keep them completely still during the treatment.

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Proton Therapy Vs Other Treatments

Which treatment you should have is not as simple as comparing proton therapy to chemotherapy, surgery, or hormone treatments. Each serves a specific purpose.

Your treatment will depend, in large part, on how aggressive the cancer is and its stage at diagnosis. Other things to consider are:

  • previous treatments
  • other health conditions that might interfere with certain treatments

Proton therapy is more expensive and not widely available. Your doctor will look at the total picture when recommending treatment.

Questions To Ask Your Doctor Radiographer Or Nurse

Heavily promoted therapy for prostate cancer looks risky
  • Will I have a planning session at a different time to the treatment, or immediately before?
  • Will I have external beam radiotherapy or hormone therapy as well?
  • What side effects might I get?
  • How will we know if the treatment has worked?
  • What should my PSA level be after treatment and how often will you test it?
  • If my PSA continues to rise, what other treatments are available?

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Whos A Good Candidate For This Procedure

Anyone who can have radiation therapy can have proton therapy. Proton therapy can be used as primary treatment for early stage prostate cancer or as part of a total treatment plan for prostate cancer. Its also an effective treatment for people who require pelvic radiation therapy after undergoing previous therapies.

Will Radiation Therapy Make Me Tired

Everyone have their own energy level, so radiation treatment will affect each person differently. Patients often feel fatigue after several weeks of treatment. For most patients, this fatigue is mild. However, a loss of energy may require some patients to change their daily routine.

If your doctor thinks you should limit your activity, they will discuss it with you.

To minimize fatigue while you are receiving radiation treatment:

  • Be sure to get enough rest.
  • Eat well-balanced, nutritious meals.

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The Success Rate Of Prostate Surgery

Survival rates can tell you how many people with the same type and stage of cancer are still alive 5 years after being diagnosed. For example, if you have stage 3 colon cancer, there is a 66% chance that 5 years later, you will be alive. But the rates cannot tell you how long you will live. However, they may help give you an idea of how likely your treatment will be successful.

Survival rates are estimates. They are based on data from many people who have had cancer before. These numbers might be confusing because they dont tell you what will happen, but they can help doctors decide treatments. Talk with your doctor to see if these statistics apply to you because they know about your situation.

A relative survival rate tells how likely a person is to survive a particular type of cancer. I.e., if the 5-year close survival rate for prostate cancer is 90%, it means that men who have this type of cancer are about 90% as likely as other men to live a minimum of 5 years after being diagnosed with the disease.

What Will I Feel During And After The Procedure

Proton Therapy side effects

You should not feel any pain or discomfort during the procedure. Afterward, there may be some side effects, and they will be managed by your radiation oncologist in the same way they would be for any course of radiation. Other factors that may influence how well you feel after treatment are how big a dose you are given and whether you are also getting chemotherapy at the same time. Common side effects include temporary hair loss and skin reactions in the direct path of the radiation and fatigue, especially when a large area is being treated.

Radiation treatment can cause side effects. These problems may result from the treatment itself or from radiation damage to healthy cells in the treatment area.

The number and severity of side effects will depend on the type of radiation, dose, and body part under treatment. Talk to your doctor and/or nurse so they can help manage them.

Radiation can cause early and late side effects. Early side effects happen during or right after treatment. They are typically gone within a few weeks. Common early side effects include fatigue and skin problems. Skin in the treatment area may become sensitive, red, irritated, or swollen. Other changes include dryness, itching, peeling, and blistering.

Depending on the area being treated, other early side effects may include:

  • hair loss in the treatment area
  • mouth problems and difficulty swallowing
  • eating and digestion problems

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Proton Therapy Advantages And Disadvantages

Proton radiation may represent an incremental improvement over IMRT due to the reduced exposure of surrounding normal body tissues to radiation. Therefore, in the situations outlined above where IMRT would normally be considered, men may prefer to choose proton radiation over IMRT. The purported advantages of proton radiation over IMRT remain theoretical and clinically unproven. No head to head studies comparing the IMRT and proton radiation exist.

Disadvantages associated with proton radiation are related to its high cost and the fact that not all insurance programs cover proton radiation. In addition, there are relatively few centers doing proton radiation, so geographic inconvenience can be a major factor considering that numerous visits are required over a 5 to 9-week period.

Men considering treatment for prostate cancer need to do their homework. Side effects from radiation can be irreversible. The selection of optimal radiation varies with patient circumstances. Many factors need to be considered when radiation is contemplated.

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How Fertility Might Be Affected

For women: Talk to your cancer care team about how radiation might affect your fertility . Its best to do this before starting treatment so you are aware of possible risks to your fertility.

Depending on the radiation dose, women getting radiation therapy in the pelvic area sometimes stop having menstrual periods and have other symptoms of menopause. Report these symptoms to your cancer care and ask them how to relieve these side effects.Sometimes menstrual periods will return when radiation therapy is over, but sometimes they do not.

See Fertility and Women With Cancer to learn more.

For men: Radiation therapy to an area that includes the testicles can reduce both the number of sperm and their ability to function. If you want to father a child in the future and are concerned about reduced fertility, talk to your cancer care team before starting treatment. One option may be to bank your sperm ahead of time.

See Fertility and Men With Cancer to learn more.

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Is Proton Therapy Safer Than Traditional Radiation

Traditional radiation therapy delivers radiation to the tumor and to healthy tissues around the tumor. With proton therapy , the majority of the radiation is delivered to the tumor.

A type of radiation treatment called proton beam radiation therapy may be safer and just as effective as traditional radiation therapy for adults with advanced cancer. That finding comes from a study that used existing patient data to compare the two types of radiation.

Traditional radiation delivers x-rays, or beams of photons, to the tumor and beyond it. This can damage nearby healthy tissues and can cause significant side effects.

Plus, proton therapy is more expensive than traditional radiation, and not all insurance companies cover the cost of the treatment, given the limited evidence of its benefits. Nevertheless, 31 hospitals across the country have spent millions of dollars building proton therapy centers, and many advertise the potential, but unproven, advantages of the treatment.

In the new study, patients treated with proton therapy were much less likely to experience severe side effects than patients treated with traditional radiation therapy. There was no difference in how long the patients lived, however. The results were published December 26 in JAMA Oncology.

These results support the whole rationale for proton therapy, said the studys lead investigator, Brian Baumann, M.D., of the Washington University School of Medicine in St. Louis and the University of Pennsylvania.

What Are The Disadvantages Of Proton Beam Therapy

Protective effect of transparent film dressing on proton therapy ...

Proton therapy is not the right choice for everyone. Some negatives of proton therapy include:

  • Availability: There is a small number of proton therapy centers in the U.S., which means you may need to travel for treatment that may last several weeks.
  • Longer planning time: Your radiation oncologist will need a few weeks to plan proton therapy. They may recommend traditional radiation if you need treatment sooner.
  • Insurance coverage/cost: Proton therapy costs more than photon radiation therapy because the machines and equipment for proton therapy are very complex, and they are expensive to make and operate. Some insurance providers may not approve proton therapy if there is no definitive evidence that it is a better treatment option. It is important to check with your insurance provider about coverage. Many proton therapy centers, including the center at Johns Hopkins, have insurance authorization specialists who can assist you in obtaining treatment authorization.

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