External Beam Radiation Therapy For Prostate Cancer
External radiation therapy uses a machine outside the body to send high-energy beams toward the area of the body with cancer. Treatment is typically administered five days a week for a period of 6-8 weeks. Many men receive 3-dimensional conformal radiation therapy, which uses a computer to shape the radiation beams to fit the tumor. This makes it possible to target the cancer more closely while lessening the damage to healthy tissue near the prostate.
You will lie down under the linear accelerator for just a few moments at each visit and placed precisely in the same place each time. The actual radiation therapy treatments take only a few minutes. A radiation therapy visit is often only 15-20 minutes in length.
Faq: Radiation Therapy For Prostate Cancer
Why would I choose radiation therapy?
Radiation therapy, including external beam radiation therapy and brachytherapy, is an alternative form of treatment for prostate cancer. EBRT may be used after other treatments, such as surgery, to manage cancer that has recurred or is at high risk of recurrence. Radiation therapy has an excellent record of success, providing long-term disease control and survival rates equivalent to other treatments, including surgery.
How should I expect to feel during radiation therapy?
Undergoing external beam radiation therapy is similar to having a routine X-ray. Radiation cannot be seen, smelled or felt. Generally, side effects don’t appear until the second or third week of treatment. Because radiation therapy is a local treatment, only the areas of the body where it is directed will experience side effects. Most patients will experience some or all of the following:
- Increase in the frequency of urination
- Urinary urgency
- Softer and smaller volume bowel movements
- Increased frequency of bowel movements
- Worsening of hemorrhoids or rectal irritation with occasional scant blood and fatigue
Many questions may arise during radiation therapy treatment. Your doctors will be available to answer questions throughout your treatment.
How should I expect to feel after radiation therapy?
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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What Are The Side Effects Of Brachytherapy
- Frequent urination or urinary retention or burning with urination
- Erectile dysfunction
- Urethral stricture or narrowing of the urethra
- Diarrhea or blood in the stool
- Secondary cancers
For the short time that the seeds are giving off larger amounts of radiation, you should avoid close proximity to children or pregnant women. Make sure to talk with your radiation oncologist or oncology nurse for instruction about radiation safety and exposure for family members or pets.
If you are traveling through an airport following brachytherapy treatment, there is a chance that radiation detectors will be set off. Talk to your radiation oncologist and ask for a note to indicate youve just had radiation treatment.
Possible Side Effects Of Radiation Treatment For Prostate Cancer
The radiation used to destroy cancer cells can also hurt normal cells in the nearby area. Side effects from radiation treatment are related to the area of the body being treated. Patients start to have side effects a few weeks into their treatment. While side effects may be unpleasant, there are treatments to help deal with them. Most side effects are temporary and slowly start to go away once treatment is done.
You will be seen by your radiation oncology providers often during treatment. These visits are a chance to ask questions and to talk about any side effects and how to best manage them. You can also call your providers to speak about any side effects.
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Diarrhea Flatulence Or Painful Defecation
These symptoms usually occur after the second or third week of treatment. Symptoms will resolve after the treatment ends. During radiation, dietary modification usually helps reduce the frequency and severity of diarrhea. Try to avoid or reduce fried foods, greasy foods and highly spiced foods. Reduce foods with insoluble fiber, such as lettuce and cauliflower, and increase low-fiber and soluable-fiber foods, such as bananas, mashed potatoes, applesauce, white rice, canned or cooked fruits and vegetables.
Maintain your intake of lean proteins, such as turkey, chicken and fish, and increase your fluid intake to avoid dehydration. Using moist toilet paper, baby wipes or sitz baths may help relieve rectal irritation. Your doctor may recommend anti-diarrheal medications. Contact your doctor if you see blood in your stool, if the diarrhea worsens or if you become light-headed or dizzy.
Staging Of Prostate Cancer
Doctors will use the results of your prostate examination, biopsy and scans to identify the stage of your prostate cancer .
The stage of the cancer will determine which types of treatments will be necessary.
If prostate cancer is diagnosed at an early stage, the chances of survival are generally good.
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Brachytherapy Or Internal Radiation Therapy
Internal radiation therapy , also known as brachytherapy, involves placing radioactive seeds on the prostate gland inside the body. The seeds are around the size of a grain of rice.
The implant may be temporary or permanent:
- Temporary: The doctor inserts the seeds into a small tube and leaves them there for between 5-15 minutes . A person may need 1-4 sessions, typically over the course of 2 days.
- Permanent: The doctor will place around 1000 radioactive seeds that release radiation for several weeks to months. Often, they leave the seeds in place when not active since they likely will not cause discomfort.
Before inserting the seeds, the doctor will give the patient either a general or local anesthetic. They may use imaging technology to help ensure they position the seeds accurately.
What To Expect After Traditional External Radiation Treatment For Prostate Cancer
According to WebMD, traditional radiation treatments for prostate cancer are done five days a week for a period of five to eight weeks.
After treatment, according to the Prostate Cancer Foundation, patients may experience short-term symptoms including frequent urination and urgency issues. They may also experience problems with their bowels, like loose stool. Medications can help ease symptoms. And a patients doctor may recommend a low-fiber diet.
The risk of long-term symptoms from radiation treatment for prostate cancer is low less than 5%. However, those risks can include urinary and bowel issues.
Radiation has less impact on erectile function in the first five to ten years after treatment when compared to surgery, the Prostate Cancer Foundation says. However, there could be a delayed effect. Within 15 years after treatment with radiation, erectile dysfunction rates are similar to those who chose surgery.
Aside from cancer, these long-term side effects are the biggest fear for many prostate cancer patients. Thats why CyberKnife may be a better option for you.
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What Is Brachytherapy
This is a type of internal radiation. For this treatment, a surgeon places radioactive pellets about the size of a grain of rice directly into your prostate. They use imaging tests to help them place the pellets correctly, and computer programs to figure out the exact dose of radiation you need.
In general, getting brachytherapy alone is only an option for some people with early-stage prostate cancer thatâs growing relatively slow. Brachytherapy plus external radiation might be an option if your cancer is more likely to grow outside your prostate gland.
You get brachytherapy in a hospital operating room. Before the procedure, youâll get anesthesia to either numb your body or help you sleep. You may need to stay in the hospital overnight.
The two types of brachytherapy for prostate cancer are:
Permanent brachytherapy. Your doctor may also call this âlow dose rateâ brachytherapy. The pellets give off low doses of radiation for weeks or months. Theyâre very small and rarely cause pain, so doctors usually leave them in your prostate after they stop giving off radiation.
Temporary brachytherapy. Your doctor may also call this âhigh dose rateâ brachytherapy. Doctors donât use it as often as the permanent type. Temporary brachytherapy gives off higher doses of radiation for a short time. In general, you need up to four quick treatments over 2 days, and your treatment team removes the radioactive material each time.
Some possible side effects of brachytherapy are:
What Are The Risks
As with any medical treatment, there are some risks involved with the use of SpaceOAR Hydrogel. Potential complications associated with SpaceOAR Hydrogel include, but are not limited to: pain associated with SpaceOAR hydrogel injection pain or discomfort associated with SpaceOAR Hydrogel needle penetration of the bladder, prostate, rectal wall, rectum, or urethra injection of SpaceOAR Hydrogel into the bladder, prostate, rectal wall, rectum, or urethra local inflammatory reactions infection injection of air, fluid or SpaceOAR Hydrogel intravascularly urinary retention rectal mucosal damage, ulcers, necrosis bleeding constipation and rectal urgency.
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Swelling Bruising Or Tenderness Of The Scrotum
Symptoms generally resolve on their own within three to five days. Oral anti-inflammatory medications such as ibuprofen are usually sufficient for pain relief, if necessary. You should avoid hot tubs and Jacuzzis for at least two to three days after the procedure. Postpone bike riding until the tenderness is gone.
The Side Effects Of Radiation Therapy For Prostate Cancer
There are a few side effects of radiation therapy for prostate cancer, like diarrhea and passing urine regularly.
These side effects often occur after one or two weeks of starting RT. The symptoms can worsen during treatment and after the treatment ends. But you can feel relief after two weeks of treatment.
The side effects that occur in one person may not come in another person. They can vary from person to person. The possible side effects of radiation therapy for prostate cancer are as follows:
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What To Expect After Treatment
Most side effects lessen significantly in the first 3-4 weeks but you may experience urinary and bowel side effects for several weeks after you complete your EBRT treatment. Full recovery however takes three to six months and some patients may never recover to their baseline urinary and bowel function and may need to continue taking medications prescribed during treatment. Rare patients report continued but lessening fatigue for several weeks or months after treatment ends. The better the urinary and bowel functions are prior to radiation, the more likely full recovery occurs.
After both LDR and HDR brachytherapy, you may experience the following:
- burning with urination
- increased urination frequency
- slow or weak urinary stream
- incomplete emptying of the bladder
- a brief period of blood in urine
- perineal pain or soreness
Why Are There Marks On My Skin
Your radiation therapist will make small marks resembling freckles on your skin along the treatment area. These marks provide targets for the treatment and are a semi-permanent outline of your treatment area.
Donât try to wash these marks off or retouch them if they fade. The therapist will re-mark the treatment area when necessary.
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Radiotherapy For Prostate Cancer
Radiotherapy uses high energy waves similar to x-rays to destroy prostate cancer cells. It is a common treatment for prostate cancer.
You might have external beam radiotherapy or internal radiotherapy . External beam radiotherapy directs radiotherapy beams at the cancer from a machine. This is different to internal radiotherapy which means giving radiotherapy to the cancer from inside the body. For prostate cancer, you might have a type of internal radiotherapy called brachytherapy.
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.
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What Happens After Radiotherapy
After youve finished your radiotherapy, you will have regular check-ups to monitor your progress. This is often called follow-up. The aim is to:
- check how your cancer has responded to treatment
- help you deal with any side effects of treatment
- give you a chance to raise any concerns or ask any questions.
Your follow-up appointments will usually start two or three months after treatment. You will then have appointments every three to six months. After three years, you may have
follow-up appointments less often. Each hospital will do things slightly differently, so ask your doctor or nurse for more details about how often you will have follow-up appointments.
The PSA test is a blood test that measures the amount of a protein called prostate specific antigen in your blood. You will usually have a PSA test a week or two before each follow-up appointment, so the results are available at your check-up. This can often be done at your GP surgery. PSA tests are a very effective way of checking how well your treatment has worked.
After treatment, your PSA level should start to drop. Your PSA level wont fall to zero as your healthy prostate cells will continue to produce some PSA. But it could fall to about 1 ng/ml, although every man is different and your medical team will monitor your PSA level closely.
Treatment options after radiotherapy
Looking after yourself after radiotherapy
What Is Radiation Therapy
Radiation is the strategic use of ionizing radiation or photons to kill cancer cells. It works by damaging the cancer cells DNA .The targeted cells die without growing or replicating themselves. Radiation therapy, like surgery, is very effective at killing localized or locally advanced prostate cancer and has the same cure rate as surgery.
Just as surgical skill can play an important role in determining outcomes from prostatectomy, the technical skill of your radiation oncologist can play an important role in radiation outcomes. When choosing a radiation oncologist, look for a physicians who has broad experience with an assortment of approaches and can objectively help you decide on the best course of treatment.
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Stereotactic Body Radiation Therapy Or Stereotactic Ablative Radiation Therapy
Guided by advanced imaging techniques, SBRT delivers large doses of radiation over a short period of time to a precise area. SBRT is commonly referred to by the names of the machines used to deliver the radiation. SBRT can offer some patients with localized prostate cancer the convenience of fewer treatments while maintaining treatment effectiveness and safety. SBRT may also be used to treat metastases for some patients to reduce tumor mass and potentially enhance survival.
Brachytherapy For Prostate Cancer
Brachytherapy is a type of radiation therapy that uses radioactive metallic seeds, smaller than a grain of rice. These seeds are permanently placed inside the prostate gland to:
- Deliver a high dose of radiation directly to the prostate gland and sometimes to the seminal vesicles.
- Release radiation slowly over several months and stop releasing it within a year.
Doctors may use brachytherapy alone or with external radiation, depending on the stage of cancer. These seeds from brachytherapy treatment can remain in place for the rest of a person’s life.
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Urinary And Bladder Changes
Radiation therapy to the pelvis can cause urinary and bladder problems by irritating the healthy cells of the bladder wall and urinary tract. These changes may start 35 weeks after radiation therapy begins. Most problems go away 28 weeks after treatment is over. You may experience:
- Burning or pain when you begin to urinate or after you urinate
- Trouble starting to urinate
- Bladder spasms, which are like painful muscle cramps
Ways to manage include:
- Drink lots of fluids. Aim for 68 cups of fluids each day, or enough that your urine is clear to light yellow in color.
- Avoid coffee, black tea, alcohol, spices and all tobacco products.
- Talk with your doctor or nurse if you think you have urinary or bladder problems. You may need to provide a urine sample to check for infection.
- Talk with your doctor or nurse if you have incontinence. He/she may refer you to a physical therapist to assess your problem. The therapist may recommend exercises to help you improve your bladder control.
- Your doctor may prescribe medications to help you urinate, reduce burning or pain, and ease bladder spasms.
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