How Does Radiotherapy Work
Radiotherapy aims to destroy prostate cancer cells without causing too much damage to healthy cells. External beam radiotherapy uses high-energy X-ray beams targeted at the prostate from outside the body. These X-ray beams damage the cancer cells and stop them from growing and spreading to other parts of the body . Radiotherapy permanently damages and kills the cancer cells, but healthy cells can repair themselves and recover more easily.
You may have radiotherapy to a wider area, including the nearby lymph nodes and bones, if there is a risk that the cancer has spread there. Lymph nodes are part of your immune system and are found throughout your body. The lymph nodes in your pelvic area are a common place for prostate cancer to spread to. But if you do have radiotherapy to a larger area, you will be more likely to get side effects.
How To Cope With Digestive Issues
Chemotherapy and radiation therapy can both cause nausea, vomiting and diarrhea. There are several medications, however, that can prevent and alleviate these digestive concerns. Additionally, making certain dietary changes can help ensure that you get the nutrients you need when dealing with digestive issues.
Urinary And Bowel Changes
Radiation therapy can cause permanent urinary and bowel changes. Many people dont notice any changes or have any symptoms. However, some people have late side effects.
Late side effects may be similar to the ones you had during treatment. Theres a very small chance you may develop other side effects. For example:
- The opening of your bladder may become narrower.
- You may lose your ability to control your bladder.
- You may have blood in your urine.
- You may have bleeding from your rectum.
- Your rectum may be injured.
These side effects are rare. They may come and go over time or be persistent and chronic. Your healthcare team will help you manage them.
Even if you dont develop any late side effects, remember that the tissues in your bladder and rectum were affected by your radiation therapy. Call your radiation oncologist if you:
- Have any new urinary, bladder, or bowel symptoms.
- Need to have a colonoscopy. Avoid having a colonoscopy for the first year after radiation therapy.
- Need any type of urological or rectal procedure.
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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.
What Are The Side Effects Of External Beam Radiotherapy
Like all treatments for prostate cancer, radiotherapy can cause side effects. These will affect each man differently, and you might not get all the possible side effects. Side effects happen when the healthy tissue near the prostate is damaged by radiotherapy. Most healthy cells recover so side effects may only last a few weeks or months.
Some side effects can start months or years after treatment. These can sometimes become long-term problems. Sometimes long-term or late side effects after radiotherapy treatment are called pelvic radiation disease.
Before you start treatment, talk to your doctor, nurse or therapeutic radiographer about the side effects. Knowing what to expect can help you deal with them.
If you have hormone therapy as well as radiotherapy, you may also get side effects from the hormone therapy. Read more about the side effects of hormone therapy and how you can manage them.
If youre having radiotherapy as a second treatment, and you still have side effects from your first treatment, then radiotherapy can make those side effects worse or last longer. It may also cause other side effects. The most common side effects of radiotherapy are described here.
Short-term side effects of radiotherapy
- needing to urinate often, including at night
- a sudden urge to empty your bladder
- a burning feeling when you urinate
- difficulty urinating
- blood in your urine.
Tiredness and fatigue
Skin irritation and hair loss
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What Is Prostate Radiation
Radiation for prostate cancer is a special treatment of the cancer cells with the help of high-energy rays or particles. Radiation has the power to make small breaks through our DNA cells. This breakage stop the growth and spread of cancer further. Depending on the stage of prostate cancer, radiation treatment can be used in the following situations:
- To cure or shrink early-stage cancer.
- To stop cancer from coming back somewhere else.
- To treat symptoms caused by advanced cancer.
- To treat cancer that has returned .
How Long Does External Radiation Treatment Take
In most cases the total dose of radiation needed to kill a tumor cant be given all at once. This is because a large dose given one time can cause more damage to nearby normal tissues. This can cause more side effects than giving the same dose over spread out over days or weeks into many treatments.
The total dose of external radiation therapy is usually divided into smaller doses called fractions. Most patients get radiation treatments daily, 5 days a week for 5 to 8 weeks. Weekend rest breaks allow time for normal cells to recover. The total dose of radiation and the number of treatments is based on:
- The size and location of the cancer
- The type of cancer
- The reason for the treatment
- Your general health
- Any other treatments youre getting
Other radiation schedules might be used in certain cases. For instance, radiation therapy might last only a few weeks when its used to relieve symptoms, because the overall dose of radiation needed is lower. In some cases, radiation might be given as 2 or more treatments each day. Or you might have several weeks off in the middle of treatments so your body can recover while the cancer shrinks. Your doctor will talk to you about the best plan in your case.
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Urinary And Sexual Function
Perhaps the 2 most feared complications of RP from a patient’s perspective are urinary complications and impotence. One difficulty in assessing these complications is that there are no precise definitions of incontinence or impotence in the literature. Furthermore, centers have obtained their outcomes data by widely divergent methods, including questionnaires, telephone interviews, or surgeon assessment. Lastly, continence and potency rates are improved when the patient population is highly selected .
Urinary incontinence can be a devastating complication following prostatectomy. Given the difficulty in measuring this clinical outcome, however, continence results in the literature vary widely. Most centers with a high-volume experience in this procedure report continence rates between 80% and 95% .
Long Term Side Effects Of Prostate Cancer Radiotherapy
Most side effects of radiotherapy gradually go away in the weeks or months after treatment. But long term side effects can continue. Or you might notice that some side effects begin months or years later.
Everyone is different and the side effects vary from person to person. You may not have all of the effects mentioned. Tell your doctor or nurse if you have any of these problems. They can help you to find ways of controlling the effects.
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Radiopharmaceuticals That Target Psma
Prostate-specific membrane antigen is a protein that is often found in large amounts on prostate cancer cells.
Lutetium Lu 177 vipivotide tetraxetan is a radiopharmaceutical that attaches to PSMA, bringing radiation directly to the prostate cancer cells.
This drug can be used to treat prostate cancer that has spread and that has already been treated with hormone therapy and chemotherapy. The cancer cells must also have the PSMA protein. Your doctor will order a PSMA PET scan before you get this drug to make sure the cancer cells have PSMA.
This drug is given as an injection or infusion into a vein , typically once every 6 weeks for up to 6 doses.
Possible side effects
Some of the more common side effects of this drug include:
This drug can lower blood cell counts:
- A low red blood cell count can cause tiredness, weakness, pale skin, or shortness of breath.
- A low blood platelet count can lead to bleeding or bruising more easily than normal, or bleeding that is hard to stop.
- A low white blood cell count can lead to an increased risk of infections, which might show as a fever, chills, sore throat, or mouth sores.
This drug might damage the kidneys. Your doctor or nurse will likely advise you to drink plenty of fluids and to urinate often before and after getting this drug, to help protect the kidneys. Tell your doctor or nurse if you start to pass less urine than is normal for you.
Gel Reduces Side Effects Of Radiation Therapy For Prostate Cancer
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For the thousands of men treated with radiation therapy for prostate cancer each year, a new procedure is providing a lot of relief.
, medical director of radiation oncology at Miami Cancer Institute, is the first certified physician in South Florida to use a soft gel-like material, called SpaceOAR, to lessen the side effects some prostate cancer patients experience because of radiation.
Because the prostate and the rectum are in close proximity, there is a risk that the rectum could be damaged by radiation, said Dr. Fagundes. When we protect the rectum by moving it away from the prostate, we can more safely deliver a high radiation doses to the prostate to kill the cancer cells. The procedure is 99 percent effective in creating space between the prostate and the rectum, thus eliminating the risk of any significant radiation-induced injury to the rectum, such as the development of blood in the stool.
The procedure also reduces discomfort some prostate cancer patients experience during radiation treatment. According to Dr. Fagundes, more than 10 percent of men who receive radiation therapy without prostate-rectal spacing develop rectal pain during treatment. When treated with the gel, the risk of pain decreases to 2.7 percent, he says.
In addition, patients who undergo radiation therapy with prostate-rectal spacing are much more likely to maintain normal bowel function during and after treatment, adds Dr. Fagundes.
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Active Surveillance And Watchful Waiting
If prostate cancer is in an early stage, is growing slowly, and treating the cancer would cause more problems than the disease itself, a doctor may recommend active surveillance or watchful waiting.
Active surveillance. Prostate cancer treatments may seriously affect a personÃ¢s quality of life. These treatments can cause side effects, such as erectile dysfunction, which is when someone is unable to get and maintain an erection, and incontinence, which is when a person cannot control their urine flow or bowel function. In addition, many prostate cancers grow slowly and cause no symptoms or problems. For this reason, many people may consider delaying cancer treatment rather than starting treatment right away. This is called active surveillance. During active surveillance, the cancer is closely monitored for signs that it is worsening. If the cancer is found to be worsening, treatment will begin.
ASCO encourages the following testing schedule for active surveillance:
A PSA test every 3 to 6 months
A DRE at least once every year
Another prostate biopsy within 6 to 12 months, then a biopsy at least every 2 to 5 years
Treatment should begin if the results of the tests done during active surveillance show signs of the cancer becoming more aggressive or spreading, if the cancer causes pain, or if the cancer blocks the urinary tract.
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Radiation Therapy Side Effects
Radiation not only kills or slows the growth of cancer cells, it can also affect nearby healthy cells. Damage to healthy cells can cause side effects.
Many people who get radiation therapy have fatigue. Fatigue is feeling exhausted and worn out. It can happen all at once or come on slowly. People feel fatigue in different ways and you may feel more or less fatigue than someone else who is getting the same amount of radiation therapy to the same part of the body.
Other radiation therapy side effects you may have depend on the part of the body that is treated. To see which side effects you might expect, find the part of your body being treated in the following chart. Many of the side effects in the list link to more information in the Side Effects section. Discuss this chart with your doctor or nurse. Ask them about your chances of getting each side effect.
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Advantages And Disadvantages Of External Beam Radiotherapy
- You dont need a general anaesthetic and you dont need to stay overnight in hospital.
- You may be able to work and carry on normal activities during the treatment.
- You are not radioactive during or after the treatment so you can be in close contact with others.
- Each treatment is relatively short. It usually takes about 15 minutes, although you may be in the radiotherapy department for up to an hour.
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Ideas For Future Studies Of Proton Therapy
Despite the studys limitations, these intriguing findings raise questions that should inform future prospective phase 3 trials, Dr. Buchsbaum said, although there are barriers to large studies of proton therapy.
For instance, it is particularly encouraging that proton therapy appeared to be safer in a group of older and sicker patients who typically experience more side effects, Dr. Baumann noted.
Dr. Buchsbaum agreed that proton therapy may be especially helpful for older and sicker patients, but he noted that ongoing phase 3 trials were not designed to analyze this group of patients.
And because proton therapy may cause fewer side effects, future trials could also explore whether combining proton therapy with chemotherapy might be more tolerable for patients, the authors wrote.
For example, both chemotherapy and traditional radiation for lung cancer can irritate the esophagus, making it painful and difficult for patients to eat. But proton therapy might limit damage to the esophagus, making it easier for a patient to tolerate the combination, Dr. Baumann explained.
Future studies could also explore whether combining proton therapy with higher doses of chemotherapy might increase cures without causing more side effects, he added.
Dr. Buchsbaum agreed, saying that it would be worthwhile to explore this possibility. Just asking the question: Is more effective? might not be giving it a fair opportunity to demonstrate its benefit to society, he said.
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Vitamins And Dietary Supplements
Its OK to take a multivitamin during your radiation therapy, but dont take more than the recommended daily allowance of any vitamin or mineral.
Dont take any other dietary supplements without talking with a member of your radiation therapy team. This includes vitamins, minerals, and herbal or botanical remedies.
If I Choose Radiation Therapy Will Surgical Treatment Still Be An Option
Your doctor may use radiation therapy as your primary treatment. It is important to note that the cure rates for surgery and radiation are similar. Therefore, you have the same risk of cancer recurring if surgery is performed.
If it is not successful, your doctor will likely not consider surgery or repeat radiation therapy due to the risk of serious complications. If your doctor recommends surgery after radiation or additional radiation, the doctor performing the re-treatment or surgery should have a significant level of experience. There are experimental clinical studies being evaluated for use of very localized re-irradiation for this group of patients. Some patients for whom radiation is not effective are treated with systemic therapy or closely monitored. Additional treatment will depend on the PSA level and rate of rise of the PSA.
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Prostate Treatment Possible Side Effects
During the radiation treatments, you may or may not experience some of the following symptoms. Below is a list of possible side effects of radiation to the pelvic area as well as tips on how to manage. IF you experience any of these side effects please notify one of the therapists or nurses so that they may be able to assess the situation accordingly.
- IF you are experiencing FATIGUE:
- Fatigue may occur around the third week of radiation treatment as a result of the radiation interacting with the body.
- Exercising will help give you more energy.
- Take a short nap if needed to help restore energy.
Hormone Therapy Side Effects
Testosterone is the primary male hormone, and plays an important role in establishing and maintaining typical male characteristics, such as body hair growth, muscle mass, sexual desire, and erectile function, and contributes to a host of other normal physiologic processes in the body. The primary systemic
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