What Is Proton Beam Radiation Therapy
This type of therapy treats tumors with protons instead of X-ray radiation. It may be able to deliver more radiation specifically to a prostate cancer tumor with less damage to normal tissue.
Proton beam therapy might be a safe treatment option when a doctor decides that using X-rays could be risky for a patient. But so far, research hasnât shown that it works better than traditional radiation therapy against solid cancers in adults.
The side effects of proton beam therapy are similar to the ones that other types of radiation treatment bring on. But since proton therapy may be less damaging to normal tissue, the side effects might be milder.
After treatment, you may gradually have ones like:
- Fatigue or low energy
- Sore, reddened skin around the area where you got treated
- Hair loss around the treatment spot
One of the disadvantages of proton therapy is that it might not be covered by all insurance companies. Youâd need to check with your health plan to find out.
Proton therapy also isnât widely available. You can get it only at certain centers in the U.S.
Radiation Therapy In Advanced Disease:
Some forms of radiation therapy, like external radiation therapy and radiopharmaceuticals, can help with advanced prostate cancer. One type of external radiation therapy is used along with hormone therapy to treat cancer that has spread outside the prostate to nearby tissue. In addition, radiopharmaceuticals are used to manage pain and symptoms of bone metastases. Scroll down to learn more about radiopharmaceuticals.
There Are Three Ways That Cancer Spreads In The Body
Cancer can spread through tissue, the lymph system, and the blood:
- Tissue. The cancer spreads from where it began by growing into nearby areas.
- Lymph system. The cancer spreads from where it began by getting into the lymph system. The cancer travels through the lymph vessels to other parts of the body.
- Blood. The cancer spreads from where it began by getting into the blood. The cancer travels through the blood vessels to other parts of the body.
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Cyberknife Vs Other Types Of Radiation For Prostate Cancer
by Prostate Cancer Center | Jan 18, 2022 | CyberKnife Center of Miami, CyberKnife For Prostate Cancer, CyberKnife Treats Prostate Cancer
Radiation is a powerful tool in the fight against prostate cancer with a proven track record of safety as well as an excellent cure rate.
However, when doctors talk about radiation for prostate cancer, you should know there are different radiation treatments available. They fall into two main categories, according to the American Cancer Society: internal radiation and external beam radiation.
Internal Radiation or Brachytherapy: With internal radiation doctors place small radioactive pellets or seeds into the prostate. This treatment is used for men with early-stage, slow-growing cancers. It can also be combined with external radiation for men with a greater risk of the cancer spreading.
External Beam Radiation Therapy : This radiation is focused on the prostate gland from outside the body. EBRT is often used for earlier staged cancers or to help relieve symptoms like bone pain if the cancer has spread. There are several types of external radiation used for prostate cancer.
Will Radiation Therapy Make Me Tired
Everyone has their own energy level, so radiation treatment will affect each person differently.
People often feel fatigue after several weeks of treatment. For most, this fatigue is mild. But some people lose a lot of energy and need to change their daily routine.
If your doctor thinks you should limit how active you are, theyâll discuss it with you.
To minimize fatigue while youâre receiving radiation treatment:
- Get enough rest.
- Pace yourself, and plan rest breaks throughout your day.
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Short Term Side Effects
Patients who receive any type of radiation therapy to treat their prostate cancer can have side effects. Short term side effects are ones that start during or shortly after your radiation treatment. Below is a list of possible short term side effects. Treatments can affect each patient differently, and you may not have these particular side effects. Talk with your care team about what you can expect from your treatment
What Happens On Treatment Days
If you get external radiation therapy, youâll need to get regular sessions during a period of about 5 to 8 weeks.
For each treatment, the radiation therapist will help you onto the treatment table and into the correct position. Once the therapist is sure youâre positioned well, theyâll leave the room and start the radiation treatment.
Theyâll watch you closely during the treatment. Cameras and an intercom are in the treatment room, so the therapist can always see and hear you. Try to stay still and relaxed during treatment. Let the therapist know if you have any problems or you feel uncomfortable.
Theyâll be in and out of the room to reposition the machine and change your position. The treatment machine wonât touch you, and youâll feel nothing during the treatment. Once the treatment is done, the therapist will help you off the treatment table.
The radiation therapist will take a port film, also known as an X-ray, on the first day of treatment and about every week thereafter. Port films verify that youâre being positioned accurately during your treatments.
Port films donât provide diagnostic information, so radiation therapists canât learn about your progress from them. But these films do help the therapists make sure theyâre delivering radiation to the precise area that needs treatment.
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Good Prostate Cancer Care
Your MDT will be able to recommend what they feel are the best treatment options, but ultimately the decision is yours.
You should be able to talk with a named specialist nurse about treatment options and possible side effects to help you make a decision.
You should also be told about any clinical trials you may be eligible for.
If you have side effects from treatment, you should be referred to specialist services to help stop or ease these side effects.
Which Treatment Is Best For You
The exact type of treatment that is best for you can depend upon many factors, such as the stage of the cancer, where in the prostate the cancer is located, and individual factors. These are all taken into account by the treating healthcare team when creating a personalized treatment plan.
When you meet with your healthcare provider, they will give you the options that will be the most effective in treating your case of prostate cancer.
For stage 1 prostate cancer, treatment may include:
- Watchful waiting or active surveillance
- Hormone therapy
- Radical prostatectomy with pelvic lymphadenectomy
- Radiation after surgery
- Transurethral resection of the prostate
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Prostate Cancer: Radiation Therapy
Radiation therapy, also called X-ray therapy, uses high levels of radiation to kill prostate cancer cells or keep them from growing and dividing while minimizing damage to healthy cells.
Radiation can be given from a machine outside the body and directed at the prostate . Or a surgeon can place radioactive materials into the tumor . These radioactive materials can be temporary or permanent.
What Are The Different Types Of Internal Radiation Therapy
Brachytherapy and radiopharmaceuticals are both considered internal radiation therapies because they both work after being inserted inside the body, rather than being directed from outside. However, the similarities mostly end there. Brachytherapy works by implanting radioactive material into the prostate and is used for localized prostate cancer. Radiopharmaceuticals are injected into the bloodstream and are used for advanced, metastatic prostate cancer. Read on to find the details of each.
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Considering Complementary And Alternative Methods
You may hear about alternative or complementary methods that your doctor hasnt mentioned to treat your cancer or relieve symptoms. These methods can include vitamins, herbs, and special diets, or other methods such as acupuncture or massage, to name a few.
Complementary methods refer to treatments that are used along with your regular medical care. Alternative treatments are used instead of a doctors medical treatment. Although some of these methods might be helpful in relieving symptoms or helping you feel better, many have not been proven to work. Some might even be harmful.
Be sure to talk to your cancer care team about any method you are thinking about using. They can help you learn what is known about the method, which can help you make an informed decision.
How Do I Choose Which Radiation Therapy Is Right For Me
Localized prostate cancer means it has not spread outside the prostate. Radiation therapy for early-stage, localized prostate cancer includes:
- Low dose rate or high dose rate brachytherapy.
- Hypofractionated radiation therapy .
Your radiation treatments will depend on the type of prostate cancer you have. Your radiation oncologist can help you decide which radiation treatments are best for you.
When the disease has spread outside the prostate gland, there are 2 common treatment options.:
- IG-IMRT combined with hormone therapy. Treatments last about 5 weeks.
- High-dose-rate brachytherapy combined with a short course of daily IG-IMRT with or without hormone therapy. Treatments may be as few as 5 or as many as 25.
With advanced or aggressive cancer, theres risk of the tumor spreading into areas outside the prostate. In such cases, we may combine radiation therapy with hormone therapy.
Hormone therapy slows or blocks the growth of prostate cancer cells. Testosterone is a male sex hormone that can cause prostate cancer cells to grow. Hormone therapy lowers the amount of testosterone your testicles make.
We start your hormone therapy before you have radiation therapy. This is because radiation therapy works better when hormone therapy continues throughout treatment. Sometimes hormone therapy also is given after radiation therapy treatment is over. Our doctors will talk with you about whether hormone therapy is right for you.
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Managing Side Effects Of Radiation Therapy
Radiation therapy at MSK is very precise, so there is less risk of complications. MSK doctors are working on new ways to accurately target a tumor so there are even fewer side effects. MSK was one of the first cancer centers to use an MR linear accelerator to treat people with prostate cancer. This machine lets doctors use magnetic resonance imaging to deliver radiation therapy.
However, radiation can cause short-term side effects and long-term side effects. Side effects depend on the area that was treated and whether organs were in the path of the radiations beam.
Radiation causes inflammation in tissue that was touched by the radiation beam. This swelling can affect activity in your bowel and your bladder. Your bowel is your small and large intestines. Your bladder stores urine until you need to urinate.
- Need to urinate more often than usual.
- Need to urinate at night more often than usual.
- Have sudden urges to urinate.
- Have loose stool .
Treatment By Stage Of Prostate Cancer
Different treatments may be recommended for each stage of prostate cancer. Your doctor will work with you to develop a specific treatment plan based on the cancers stage and other factors. Detailed descriptions of each type of treatment are provided earlier on this same page. Clinical trials may also be a treatment option for each stage.
Early-stage prostate cancer
Early-stage prostate cancer usually grows very slowly and may take years to cause any symptoms or other health problems, if it ever does at all. As a result, active surveillance or watchful waiting may be recommended. Radiation therapy or surgery may also be suggested, as well as treatment in clinical trials. For those with a higher Gleason score, the cancer may be faster growing, so radical prostatectomy and radiation therapy are often recommended. Your doctor will consider your age and general health before recommending a treatment plan.
ASCO, the American Urological Association, American Society of Radiation Oncology, and the Society of Urologic Oncology recommend that patients with high-risk early-stage prostate cancer that has not spread to other areas of the body should receive radical prostatectomy or radiation therapy with hormonal therapy as standard treatment options.
Locally advanced prostate cancer
Watchful waiting may be considered for older adults who are not expected to live for a long time and whose cancer is not causing symptoms or for those who have another, more serious illness.
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What Types Of Radiotherapy Are There
There are two common types of external beam radiotherapy:
- intensity-modulated radiotherapy
- 3-dimensional conformal radiotherapy .
You may also hear about image guided radiotherapy . This is part of all radiotherapy treatments. Taking images of the prostate before each treatment allows your radiographer to make small changes to the area that is going to be treated, in case the prostate has moved slightly since your last treatment session. This makes sure the surrounding healthy tissue gets as little radiation as possible. It also makes sure the whole prostate is treated.
This is the most common type of external beam radiotherapy in the UK. A computer uses the scans from your radiotherapy planning session to map the location, size and shape of your prostate. The radiotherapy machine gives beams of radiation that match the shape of the prostate as closely as possible. This helps to avoid damaging the healthy tissue around it, reducing the risk of side effects.
The strength of the radiation can be controlled so that different areas get a different dose. This means a higher dose of radiation can be given to the prostate without causing too much damage to surrounding tissue.
3D conformal radiotherapy
As with IMRT, the radiation beams are mapped to the size, shape and position of the prostate. But the strength of the radiation cant be controlled in 3D-CRT, so all areas are treated with the same dose.
Other types of radiotherapy
Proton beam therapy
Remission And The Chance Of Recurrence
A remission is when cancer cannot be detected in the body and there are no symptoms. This may also be called having no evidence of disease or NED.
A remission can be temporary or permanent. This uncertainty causes many people to worry that the cancer will come back. Although there are treatments to help prevent a recurrence, such as hormonal therapy and radiation therapy, it is important to talk with your doctor about the possibility of the cancer returning. There are tools your doctor can use, called nomograms, to estimate someone’s risk of recurrence. Understanding your risk of recurrence and the treatment options may help you feel more prepared if the cancer does return. Learn more about coping with the fear of recurrence.
In general, following surgery or radiation therapy, the PSA level in the blood usually drops. If the PSA level starts to rise again, it may be a sign that the cancer has come back. If the cancer returns after the original treatment, it is called recurrent cancer.
When this occurs, a new cycle of testing will begin again to learn as much as possible about the recurrence, including where the recurrence is located. The cancer may come back in the prostate , in the tissues or lymph nodes near the prostate , or in another part of the body, such as the bones, lungs, or liver . Sometimes the doctor cannot find a tumor even though the PSA level has increased. This is known as a PSA recurrence or biochemical recurrence.
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Eight Types Of Standard Treatment Are Used:
Watchful waiting or active surveillance
Watchful waiting and active surveillance are treatments used for older men who do not have signs or symptoms or have other medical conditions and for men whose prostate cancer is found during a screening test.
Watchful waiting is closely monitoring a patients condition without giving any treatment until signs or symptoms appear or change. Treatment is given to relieve symptoms and improve quality of life.
Active surveillance is closely following a patient’s condition without giving any treatment unless there are changes in test results. It is used to find early signs that the condition is getting worse. In active surveillance, patients are given certain exams and tests, including digital rectal exam, PSA test, transrectal ultrasound, and transrectal needle biopsy, to check if the cancer is growing. When the cancer begins to grow, treatment is given to cure the cancer.
Other terms that are used to describe not giving treatment to cure prostate cancer right after diagnosis are observation, watch and wait, and expectant management.
Patients in good health whose tumor is in the prostategland only may be treated with surgery to remove the tumor. The following types of surgery are used:
Are You A Candidate
Whether your doctor recommends radiation depends on various factors, including your age, health, and personal preferences. The type of radiation is often dictated by your risk group and whether the cancer is localized or has spread.
Sometimes hormone therapy is given before radiation or along with it. ADT reduces levels of male hormones, called androgens, which can slow or even stop the cancers growth. Studies have found this one-two punch leads to higher survival rates than radiation alone among men with localized prostate cancer and a Gleason score of 7 or higher.
If you opt for surgery, your doctor may suggest radiation afterward, called adjuvant radiation therapy. “You have surgery to remove cancer, and then radiation to eliminate any remaining tumor deposits to keep cancer from returning,” says Dr. Anthony DAmico, a radiation oncologist with Harvards Dana-Farber Cancer Institute. Cancer that has grown beyond the prostate also may require post-surgery radiation.
After youve had radiation, youll have a prostate-specific antigen test every three to six months for five years and then annually after that to check for recurrence of the cancer. “If your PSA ever rises above 2, then imaging tests are done, and if needed, additional radiation or other appropriate treatment is given,” says Dr. DAmico.
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