Does Radiation Treatment For Prostate Cancer Make You Sick

How Fertility Might Be Affected

How Radiation Affects The Prostate | Mark Scholz, MD

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.

Will Radiation Therapy Cause My Hair To Fall Out

Only people who get radiation to the scalp or the brain may have hair loss. Others won’t. If it does happen, itâs usually sudden and comes out in clumps. In most cases, your hair will grow back after therapy stops, but it may be thinner or have a different texture.

Some people choose to cut their hair short before treatment begins to make less weight on the hair shaft. If you lose hair on top of your head, be sure to wear a hat or a scarf to protect your scalp from the sun when you go outside. If you decide to buy a wig, ask the doctor to write a prescription for one and check to see if it’s covered by your insurance or is a tax-deductible expense.

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.

Intensity-modulated radiotherapy

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

Recommended Reading: Stage 4 Prostate Cancer In Bones

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 Are Other Possible Early Side Effects From Radiation Therapy

Other early side effects you might have usually depend on where you get the radiation.

Eating Problems

Radiation therapy to the head, neck, or parts of the digestive system can make you lose your appetite. But it’s important to keep eating a healthy diet while youâre having treatment to keep your body strong.

Try eating five or six small meals spread out through the day instead of three large ones.
Try new recipes or foods.
Keep healthy snacks on hand. It will help you eat when you’re hungry rather than waiting for mealtimes and maybe losing your appetite.

Mouth Problems

Before you start radiation to your head or neck, see your dentist for a thorough exam. Radiation can cause problems in your mouth that include:

Trouble swallowing

Tell your cancer team about any of these problems so they can help you feel better. To help manage these side effects:

Avoid spicy and acidic foods.
Don’t smoke, chew tobacco, or drink alcohol.
Brush your teeth often with fluoride toothpaste and a soft brush.

Hearing Problems

Radiation therapy to the head can sometimes cause hearing problems. One reason might be that it hardens the wax in your ears. Let your doctor know if you have trouble hearing.

Nausea

Radiation to the head, neck, and any part of the digestive tract can cause nausea and vomiting. Let your doctor know if that happens. They can give you medicine to control it. Also, you might be able to learn relaxation techniques and biofeedback to help control and reduce feelings of nausea.

Don’t Miss: Where Is The Prostate Located In A Man

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.

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.

Are There Side Effects Of The Combination Approach

There is a slightly higher chance that patients who receive the combined therapy will have rectal irritation or urinary side effects. This is common with prostate cancer radiation therapy because the radiation can damage cells in the tissues surrounding the prostate. But at MSK, we routinely use sophisticated computer-based planning techniques that help us reduce the dose given to normal tissues such as the rectum, bladder, and urethra, lessening the chances of side effects and complications. We have also found that, when treating with the combined approach, using the high-dose-rate brachytherapy compared to low-dose-rate brachytherapy may have less in the way of side effects.

In addition, at MSK, we routinely use a rectal spacer gel, which we inject between the prostate and the rectum while the patient is under mild anesthesia, to create a buffer between these two tissues. By creating this space, we can further reduce the dose of radiation the rectum is exposed to. This leads to fewer side effects for the patient. The rectal spacer gel is biodegradable and dissolves on its own within the body after a few months.

Stiff Joints And Muscles

Which is Better – Surgery vs. Radiation for Prostate Cancer?

Radiotherapy can sometimes make your joints and muscles in the area being treated feel stiff, swollen and uncomfortable.

Exercising and stretching regularly can help to prevent stiffness.

Tell your care team if joint or muscle stiffness a problem. They may refer you to a physiotherapist, who can recommend exercises for you to try.

Don’t Miss: Permanent Cure For Prostate Enlargement

What Does External Beam Radiotherapy Involve

You will have your treatment at a hospital radiotherapy department. Youll see a specialist doctor who treats cancer with radiotherapy, known as a clinical oncologist. You may also see a specialist nurse and a specialist radiographer. Theyll talk to you about your treatment plan and ways to manage any side effects.

Before your radiotherapy treatment

Radiotherapy planning session

A week or two before your treatment, youll have a planning session. This is to make sure the radiographers know the exact position, size and shape of your prostate. It will help them make sure the radiotherapy is aimed at your prostate and that the surrounding areas get as little radiation as possible.

During your radiotherapy treatment

You will have one treatment at the hospital five days a week, with a rest over the weekend. You can go home after each treatment.

If you have localised prostate cancer, the course of radiotherapy usually involves 20 treatment sessions over four weeks. You might hear this called hypo-fractionated radiotherapy.

At some hospitals, youll have 37 sessions over seven or eight weeks instead. If you have 37 sessions, youll receive a slightly larger overall dose of radiotherapy but the dose you receive at each session will be lower than if you have 20 sessions.

Its safe for you to be around other people, including children and pregnant women, during your course of radiotherapy. The radiation doesnt stay in your body so you wont give off any radiation.

Are There Side Effects With Imrt

Yes, there can be side effects or unwanted changes in your body when you have IMRT. Side effects are different from person to person. Some people have no or very mild side effects. Some have bothersome side effects that may last for only a short period of time. Other men may have side effects that last for a longer period of time or forever. Some side effects occur within days or weeks of your treatment and others may not happen for six or more months after your treatment.

The side effects that you have depend on:

The radiation dose you get during your prostate cancer treatment, and
Your general health

Before beginning your treatment, your doctor and health care team will talk with you about the side effects you might have, how long they might last, and what you can do to help make them better.

The good news is that most side effects will go away in time. When you do have side effects, there are ways to make you feel better. If you have a side effect that is really bad, your doctor may stop your radiation therapy for a short time or change your treatment in some way. Be sure to tell your doctor or health care team about any side effects that you have. They can help you treat the problems and tell you how to lower the chances that the side effects will come back.

Intensity Modulated Radiation Therapy

IMRT, an advanced form of 3D-CRT therapy, is the most common type of external beam radiation therapy for prostate cancer. It uses a computer-driven machine that moves around the patient as it delivers radiation. Along with shaping the beams and aiming them at the prostate from several angles, the intensity of the beams can be adjusted to limit the doses of radiation reaching nearby normal tissues. This lets doctors deliver an even higher radiation dose to the cancer.

Some newer radiation machines have imaging scanners built into them. This advance, known as image guided radiation therapy , lets the doctor take pictures of the prostate just before giving the radiation to make minor adjustments in aiming. This appears to help deliver the radiation even more precisely and results in fewer side effects.

A variation of IMRT is called volumetric modulated arc therapy . It uses a machine that delivers radiation quickly as it rotates once around the body. This allows each treatment to be given over just a few minutes. Although this can be more convenient for the patient, it hasnt yet been shown to be more effective than regular IMRT.

Radioprotective Drugs For Reducing Side Effects

One way to reduce side effects is by using radioprotective drugs, but these are only used for certain types of radiation given to certain parts of the body. These drugs are given before radiation treatment to protect certain normal tissues in the treatment area. The one most commonly used today is amifostine. This drug may be used in people with head and neck cancer to reduce the mouth problems caused by radiation therapy.

Not all doctors agree on how these drugs should be used in radiation therapy. These drugs have their own side effects, too, so be sure you understand what to look for.

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.

Also Check: What Is Sbrt For Prostate Cancer

How Does The Team Confirm Delivery Of The Correct Dose

The UC Davis team performs thorough quality assurance for every single plan and every single patient before treatment. For patients receiving Intensity Modulated Radiation Therapy , the team radiates a phantom with radiation detectors inside to confirm that the radiation dose delivered is correct. This procedure is done before the first treatment is delivered.

What Have I Learned By Reading This

Radiation vs. Surgery for Prostate Cancer | Ask a Prostate Expert, Mark Scholz, MD

You learned about:

How to get ready for this treatment
What you can expect to happen before, during and after your radiation therapy
Possible side effects of IMRT
What things you can do to take care of yourself

If you have any questions, please talk to your doctor or health care team. It is important that you understand what is going on with your treatment. This knowledge will help you take better care of yourself and feel more in control so that you can get the most from your treatment.

Recommended Reading: Prostate What Does It Do

Side Effects Of Radiation Therapy

When discussing radiation therapy with a patient, Im often asked, What side effects should I expect?

There are three things to keep in mind about radiation therapy side effects:

Radiation is like sunlight. Its made up of photons, just like sunlight, except radiation photons have higher energy so they can penetrate beyond the skin to reach cancer inside your body.

Radiation is a form of local treatment that only affects whats within the area being treated.

No two people will have the same degree of side effects, and theres no way to know how youll do until you start.

There are two main categories of side effects, the EARLY and the LATE.