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Salvage Radiation Therapy Side Effects

Does Radiation Have More Or Fewer Side Effects Than Chemotherapy

Side Effects: Salvage Radiation, and Hormone Therapy | Mark Scholz, MD | PCRI

Many of the side effects of chemotherapy and radiation are similar. Both treatments work to kill cancer cells. Both also damage healthy cells in the process.

Radiation can be a more targeted therapy. In some cases, there are fewer side effects than chemotherapy.

The type and severity of side effects from either treatment will also depend on the:

  • area of the body undergoing treatment

For many people, both radiation and chemotherapy may be part of the treatment plan.

What Do I Need To Know About Side Effects Of Radiation Therapy

The side effects of radiation therapy depend on the area of the body that receives radiation. Early side effects happen shortly after you receive radiation therapy. Late side effects can happen months to years after you receive radiation therapy. Late side effects of radiation therapy may be permanent.

When To Talk To Your Doctor

In many cases, men can effectively manage the side effects they experience due to radiation therapy from home. Sometimes, however, the side effects can become more severe.

In such a scenario, it is important for the patient to talk to their doctor. There are treatment options available to help a man cope with the side effects they are experiencing.

It is advisable to contact a doctor if the symptoms become a significant interference in your daily life. For example, if there is a consistent leakage of urine or at the rectum.

A visit to the doctor is also a good idea when the urinary symptoms are severe, and the man experiences a significant level of pain.

In cases where the side effects are not as severe, cancer patients can still talk to the treatment team, such as the radiation oncology nurse, for advice.

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If Treatment Does Not Work

Recovery from cancer is not always possible. If the cancer cannot be cured or controlled, the disease may be called advanced or terminal.

This diagnosis is stressful, and for some people, advanced cancer may be difficult to discuss. However, it is important to have open and honest conversations with your health care team to express your feelings, preferences, and concerns. The health care team has special skills, experience, and knowledge to support patients and their families and is there to help. Making sure a person is physically comfortable, free from pain, and emotionally supported is extremely important.

People who have advanced cancer and who are expected to live less than 6 months may want to consider hospice care. Hospice care is designed to provide the best possible quality of life for people who are near the end of life. You and your family are encouraged to talk with the health care team about hospice care options, which include hospice care at home, a special hospice center, or other health care locations. Nursing care and special equipment, including a hospital bed, can make staying at home a workable option for many families. Learn more about advanced cancer care planning.

After the death of a loved one, many people need support to help them cope with the loss. Learn more about grief and loss.

What Can I Expect During Salvage Therapy

Salvage Radiation Therapy

Salvage therapy can take many different forms. The salvage therapy you receive will depend on you, your condition, and your overall health.

For example, salvage therapy for an 80-year-old person with lymphoma and heart disease will look different than salvage therapy for a 25-year-old person with lymphoma and no other health conditions. A doctor will walk you through what salvage therapy will look like for you.

You might take new medications, or receive additional rounds of chemotherapy or radiation. Salvage therapy for cancer might even include surgery to remove a tumor that has spread or come back.

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Treatment Areas And Possible Side Effects

Part of the body being treated Possible side effects

Healthy cells that are damaged during radiation treatment usually recover within a few months after treatment is over. But sometimes people may have side effects that do not improve. Other side effects may show up months or years after radiation therapy is over. These are called late effects. Whether you might have late effects, and what they might be, depends on the part of your body that was treated, other cancer treatments you’ve had, genetics, and other factors, such as smoking.Ask your doctor or nurse which late effects you should watch for. See the section on Late Effects to learn more.

  • Reviewed:January 11, 2022

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Patient And Treatment Characteristics

The median age at SRT was 69 years. The median time between RP and SRT was 17 months. Regarding the year of SRT, 80 , 184 , and 157 patients underwent SRT in 20052009, 20102014, and 20152017, respectively. The patient and treatment characteristics are presented in Table . Mean doses of SRT in 20052009, 20102014, and 20152017 were 61.7, 65.4, and 67.4Gy, respectively . The proportions of IMRT in 20052009, 20102014, and 20152017 were 14%, 46%, and 82%, respectively , and those of IGRT were 43%, 71%, and 100%, respectively . The mean prescribed dose in patients treated using 3DCRT vs IMRT was 62.8 vs 67.8 Gy, respectively . The mean prescribed dose in patients treated using non-IGRT vs IGRT was 64.3 vs 65.8 Gy, respectively .

Table 1 Patient and treatment characteristics.

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Management Of Erectile Dysfunction

About 75% of men who undergo nerve-sparing prostatectomy or more precise forms of radiation therapy have reported successfully achieving erections after using these drugs. However, they are not for everyone, including men who take medications for angina or other heart problems and men who take alpha-blockers.

What To Expect After Radiation Treatment For Prostate Cancer

Salvage Radiation, Lutetium-177, 3 4=7, & What is Cribriform? | Mark Scholz, MD | PCRI

What to Expect After Radiation Treatment for Prostate Cancer? Many patients wonder what to expect after receiving radiation treatment for prostate cancer. It is the most widely used method of treatment regardless of the cancers stage. Radiation therapy can be followed by a radical prostatectomy, which removes the prostate gland and nearby lymph nodes.

Prostatecancer is the most diagnosed solid tumor type among men. In the early stages ofprostate cancer, indolent cases without major symptoms will receive activesurveillance and watchful waiting to observe how the disease progresses. If thecancer spreads outside of the prostate gland, other treatment options areconsidered, the first of which being radiation.

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What Is Stereotactic Body Radiation Therapy And What Advantages Does It Offer

Stereotactic body radiation therapy, or SBRT, involves the use of sophisticated image guidance that pinpoints the exact three-dimensional location of a tumor so the radiation can be more precisely delivered to cancer cells. Traditionally, external beam radiation has been delivered in anywhere from 45-48 sessions over multiple weeks. But large, randomized studies have shown that shorter courses of radiation are just as safe and effective. Therefore, at MSK, we have shortened all our radiation courses.

There is increasing interest in giving this radiation in very short courses of treatment using intense radiation doses, called hypofractionated radiation therapy. Many of the people we care for have a type of radiation therapy called MSK PreciseTM. This is a hypofractionated form of SBRT that can be given in five sessions. MSK has been doing this for the past 20 years, and the results in the several hundred people whove been treated have been excellent so far. The treatment is very well tolerated and quite effective

Because of its superior precision, MSK Precise can have fewer side effects than more conventional radiation techniques, with extremely low rates of incontinence and rectal problems. The sexual side effects are low, similar to what is experienced with more extended external radiation techniques. And of course, its much more convenient for patients.

What Is 3d Conformal Radiation Therapy

Itâs a procedure that uses a computer to make a three-dimensional picture of your tumor. It helps your treatment team deliver the highest possible dose of radiation to the tumor while minimizing the damage to normal tissue.

3D conformal radiation therapy uses CT-based treatment combined with three-dimensional images of a prostate tumor. CT is short for computed tomography, which uses X-rays to produce detailed pictures inside the body.

So far, this technique has worked well for localized tumors such as prostate cancer limited to the prostate gland.

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How Can I Help Myself

Urinary problems can affect your self-esteem and independence, and affect your work, social and sex life.

Making some changes to your lifestyle may help, and there are some practical steps that can make things easier.

  • Try to drink plenty of fluids, but cut down on fizzy drinks, alcohol, tea and coffee as these may irritate the bladder
  • Do regular pelvic floor muscle exercises to help strengthen the muscles that control when you urinate.
  • Try to stay a healthy weight. Being overweight can put pressure on your bladder and pelvic floor muscles.
  • If you smoke, try to stop. Smoking can cause coughing which puts pressure on your pelvic floor muscles. NHS Choices has more information about stopping smoking
  • Plan ahead when you go out. For example, find out where there are public toilets before leaving home.
  • Pack a bag with extra pads, underwear and wet wipes. Some men also find it useful to carry a screw-top container in case they cant find a toilet.
  • Get our Urgent toilet card to help make it easier to ask for urgent access to a toilet.
  • Disability Rights UK runs a National Key Scheme for anyone who needs access to locked public toilets across the UK because of a disability or health condition.
  • If you often need to use the toilet at night, leave a light on in case youre in a hurry, or keep a container near your bed.

Questions To Ask Your Doctor Nurse Or Radiographer

Radiotherapy in the treatment of prostate cancer: Accuracy and ...

You may find it helpful to keep a note of any questions you have to take to your next appointment.

  • What type of radiotherapy will I have?
  • How many sessions will I need?
  • What other treatment options do I have?
  • What are the possible side effects and how long will they last?
  • What treatments are available to manage the possible side effects from radiotherapy?
  • Will I have hormone therapy and will this carry on after radiotherapy?
  • How and when will I know if radiotherapy has worked?
  • If the radiotherapy doesnt work, which other treatments can I have?
  • Who should I contact if I have any questions?
  • What support is there to help manage long-term side effects?

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If Youre Getting Radiation Therapy To The Abdomen

If you are getting radiation to your stomach or some part of the abdomen , you may have side effects such as:

Eating or avoiding certain foods can help with some of these problems, so diet planning is an important part of radiation treatment of the stomach or abdomen. Ask your cancer care team about what you can expect, and what medicines you should take to help relieve these problems. Check with your cancer care team about any home remedies or over-the-counter drugs youre thinking about using.

These problems should get better when treatment is over.

Managing nausea

Some people feel queasy for a few hours right after radiation therapy. If you have this problem, try not eating for a couple of hours before and after your treatment. You may handle the treatment better on an empty stomach. If the problem doesnt go away, ask your cancer care team about medicines to help prevent and treat nausea. Be sure to take the medicine exactly as you are told to do.

If you notice nausea before your treatment, try eating a bland snack, like toast or crackers, and try to relax as much as possible. See Nausea and Vomiting to get tips to help an upset stomach and learn more about how to manage these side effects.

Managing diarrhea

Many people have diarrhea at some point after starting radiation therapy to the abdomen. Your cancer care team may prescribe medicines or give you special instructions to help with the problem. Diet changes may also be recommended, such as:

What Are The Advantages And Disadvantages Of External Beam Radiotherapy

What may be important for one person might not be so important for someone else. If youre offered external beam radiotherapy, speak to your doctor, nurse or radiographer before deciding whether to have it. They can tell you about any other treatment options and help you decide if radiotherapy is right for you.

Advantages of external beam radiotherapy

  • If your cancer is localised or locally advanced, radiotherapy will aim to get rid of the cancer completely.
  • Many men can carry on with many of their normal activities while having treatment, including going to work and driving.
  • Radiotherapy can be an option even if youre not fit or well enough for surgery.
  • Radiotherapy is painless .
  • The treatment itself only lasts around 10 minutes, including the time it takes to get you into position. But youll probably need to be at the hospital for up to an hour each day to prepare for your treatment. You dont need to stay in hospital overnight.

Disadvantages of external beam radiotherapy

I was able to continue working throughout my treatment, although I got tired quickly. I had some side effects but nothing I couldnt cope with. A personal experience

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Defining Patients At Risk After Radical Prostatectomy

Accurate risk characterization could result in an appropriate management of post-RP patients. However, the optimal post-operative approach to these patients is a subject of continuous debate because the risk definition after RP relies on clinical, pathological features and PSA kinetics. Furthermore, the choice of treatment should be tailored according to prognostic factors and/or risk stratification.

Up to one-third of patients treated with RP may have adverse pathologic features , defined as positive surgical margins, extra-prostatic extension, seminal vesicle invasion, and/or lymph node invasion and high Gleason score.

Only patients with at least two of the following pathologic features are at higher risk of cancer specific mortality and may significantly benefit from adjuvant treatment after RP: pathologic Gleason score 8, pT3/pT4 disease, and the presence of nodal disease .

In the study of Abdollah et al. men with low-volume nodal disease , ISUP grade 25 and pT34 or R1, as well as men with 3 to 4 positive nodes were more likely to benefit from RT after surgery, while the other subgroups did not .

However, the level of evidence for the management of pN1 patients is still low .

The most sensitive and the only validated biomarker for disease persistence and recurrence remains PSA and PSA-based parameters . Persistent PSA is defined in the majority of studies as detectable post-RP PSA of 0.1 ng/mL within 4 to 8 weeks of surgery and occurs in 520% of men after RP .

Tips For Coping With Salvage Therapy Treatment

Side Effects of Radiation Therapy for Prostate Cancer | Prostate Cancer Staging Guide

It can be overwhelming and discouraging when your condition isnt responding to treatment. Its important to take the time to care for yourself and seek support. For example, it might help to:

  • Ensure youre getting plenty of rest.
  • Follow any dietary recommendations your doctor has recommended for your condition.
  • Stock up on prepared meals or easy freezer meals so you have food on days you dont feel your best.
  • Let family, friends, and other loved ones help by preparing meals, running errands, cleaning, or providing companionship.
  • Arrange for a ride to and from treatment, especially if you feel weak, nauseous, or dizzy afterward.
  • Join an online or in-person

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Evidence For The Use Of Salvage Radiotherapy

Recent evidence from these three randomized trials suggests that early intervention with ART can lengthen biochemical disease-free, metastasis-free and overall survival in patients with pathologically advanced prostate cancer. However, a disadvantage of routine ART is treating those who would never develop biochemical recurrence after RP, and unnecessarily exposing an increased number of patients to the side effects of RT.

Frequent Urination Burning With Urination And Difficulty Urinating

These are the most common complaints. Occasionally the urinary stream will weaken. Generally these symptoms are managed with medications to help the bladder function better or eliminate burning. Rarely, your doctor may order a urine test. Symptoms will resolve after the end of treatment. Contact your doctor if you see blood in your urine or if you are unable to urinate.

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Definition Of Salvage Radiotherapy And The Distinction Between Srt And Adjuvant Rt

Generally, “salvage” radiotherapy is defined as radiation treatment given for suspected recurrent malignant disease after a period of observation after prostatectomy. In contrast, “adjuvant” radiotherapy refers to treatment directly after prostatectomy in patients potentially without residual disease and with an undetectable PSA. There are several important distinctions between SRT and ART: 1) There is a higher likelihood of local residual disease without distant metastatic disease for patients in whom ART is indicated immediately post-prostatectomy versus a patient for whom SRT is being considered 2) The burden of disease may be higher for SRT vs ART and 3) Multiple prospective randomized trials have shown a benefit to ART, whereas similar evidence is lacking for SRT .

ART is given for patients at high risk of localized recurrence, generally defined as: evidence for prostate cancer outside the capsule , positive surgical margins, or seminal vesicle invasion. In contrast, SRT patients can have recurrence years after RP, and it is often unclear whether the detected PSA represents recurrence locally within the prostate bed, seminal vesicle remnants, pelvis, or at a distant site. This is obviously important for RT planning, as delivering RT to the prostate bed is useless if no disease remains locally.

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