What Types Of Radiotherapy Are There
There are different types of external beam radiotherapy used to treat prostate cancer. Ask your doctor, nurse or therapeutic radiographer which type of radiotherapy you are being offered, and for how long.
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 of your prostate and the organs near it to work out the precise radiation dose and create a plan for your radiotherapy treatment.
The radiotherapy machine gives out beams of radiation that match the shape of the area to be treated as closely as possible. This helps to avoid damaging the healthy tissue around it, reducing the risk of side effects. It also allows the treatment area to get the right doses of radiotherapy to get rid of the cancer. Most radiotherapy centres use a type of IMRT technique called VMAT . It is also sometimes called RapidArc.
Stereotactic radiotherapy
Stereotactic radiotherapy, also known as stereotactic ablative radiotherapy , is another type of external beam radiotherapy that is offered in some hospitals. SABR gives a much higher dose of radiation to the treatment area at each treatment session compared to IMRT, but a lower dose overall. You will have fewer treatment sessions with this technique. It is a very precise treatment that can be delivered on a standard Linac machine.
Proton beam therapy
Types Of Prostate Radiation
The most common types of radiation for prostate cancer are external beam radiation and brachytherapy .
1. This type of radiation uses beams of radiation, which are focused on the prostate gland from a machine outside the body. Its very helpful in the early stage of prostate cancer or in cases when it is needed to relieve pain symptoms . Such treatment is usually done 5 days a week for several weeks, depending on the condition of the patient. External beam radiation for treatment of prostate cancer has different categories of treatment, such as:
- Three-dimensional conformal radiation therapy
- Intensity-modulated radiation therapy
- Stereotactic body radiation therapy
- Proton beam radiation therapy.
2. Brachytherapy for prostate cancer also called seed radiation for prostate cancer uses very small balls or pellets, which are placed into the patients prostate. Seed radiation differs in the dosage rate of the radioactive material: permanent and temporary .
Who Should Consider Taking Radiopharmaceuticals
Radiopharmaceuticals are given through a vein to men with metastatic prostate cancer that has spread widely to the bone. Strontium89 and Samarium-153 are radiopharmaceuticals given to reduce the pain caused by the bone cancer. Radium-223, or Xofigo®, is a radiopharmaceutical given to prolong life.
The side effects associated with radiopharmaceuticals are mainly the suppression, or lowering, of white blood cell and platelet levels in the blood. Your doctor will be able to assess whether your body can handle this side effect before you are given the treatment and will monitor your levels after you receive it. Your doctor, specialist nurse, or nuclear medicine practitioner will be able to give you more information about the treatment and possible side effects.
If your doctor has told you that your bone metastases have spread, you may be a candidate for a radiopharmaceutical. Speak with your oncology team to see if one of these treatments may be right for you.
Read Also: What Are The Symptoms Of Prostate Cancer Menâs Health
Read Also: How Can I Check My Own Prostate
Which Approach Is Better: Active Surveillance Surgery Or Radiotherapy
The 10 year outcomes of the Prostate Testing for Cancer and Treatment trial from the United Kingdom has provided valuable insights into the management of localized PCa.4 The trial recruited 1643 men 50 to 69 years old. Of these 545 men underwent active surveillance, 553 surgery, and 545 radiotherapy. For the participants, the median follow-up was 10 years, the median age was 62 years, the median PSA was 4.6 , 77% were Gleason 6 and 21% were Gleason 7, and 76 % were T1c and the remaining T2. There were 17 prostate-cancerspecific deaths overall: 8 in the active surveillance group, 5 in the surgery group, and 4 in the radiotherapy group. The difference was not statistically significant among groups.
Metastases developed in more men in the active-monitoring group than in the surgery group or the radiotherapy group . Higher rates of disease progression were seen in the active-monitoring group than in the surgery group or the radiotherapy group . In summary, at a median of 10 years, prostate-cancerspecific mortality was low irrespective of the treatment assigned, with no significant difference among treatments. Surgery and radiotherapy were associated with lower incidences of disease progression and metastases than was active monitoring, while 44% of the patients who were assigned to active monitoring did not receive radical treatment and avoided side effects.5
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.
Read Also: How To Milk Your Prostate
Does Msk Offer Proton Therapy For Prostate Cancer
Some men with prostate cancer may choose to receive another form of external-beam radiation therapy called proton therapy. Proton therapy can deliver a high radiation dose to the prostate while lowering the radiation dose to normal surrounding tissue. It is unclear if there is any advantage to proton therapy compared with IMRT. We are now studying how these approaches compare in terms of side effects and outcomes at the New York Proton Center. These efforts are being led by radiation oncologist Daniel Gorovets.
What Do Other Men Say
Listen to men talk about their experiences being diagnosed with prostate cancer, making treatment decisions and facing the changes which occurred after treatment.
Diagnosed in 2000 at 49 years, Alan was on active surveillance for 10 years before having surgery to remove his prostate, and he talks about how this was not an easy decision to arrive at. He was recently married at the time and keeping his partner involved in his decisions was important so they could support each other and work together on intimacy and relationship issues. Support groups were also an important part of Alanâs recovery, helping him feel less alone.
Paul was 49 years old when he was diagnosed back in 2018 due to an elevated PSA level. Six months later, he was treated with brachytherapy, a form of radiation treatment. He talks about his journey through diagnosis, treatment and coping with the physical, mental and emotional changes brought about by treatment, as well as the impact on his partner. Paul highlights the importance of having regular PSA tests, and keeping physically and mentally fit after treatment.
Diagnosed with prostate cancer at 67 years, due to difficulties with urinating and erection, Andy had a radical prostatectomy. He describes his recovery after surgery and the importance of pelvic floor exercises for controlling urine leaks. He also talks about the impact of treatment on sexual wellbeing and intimacy with his partner.
Read Also: Prostate Cancer Family History Risk
What Are The Advantages
- The main advantage of radiotherapy is that it may help to control the growth of the cancer.
- For a small number of people with borderline resectable cancer and locally advanced pancreatic cancer, radiotherapy may help to make surgery possible.
- Each treatment session will take about 30 minutes, or longer for SABR. You wont usually need to stay in hospital.
- You may be able to carry on with your daily life, such as going to work, if you feel up to it.
- If you have advanced cancer, radiotherapy can help control symptoms and relieve pain.
Permissions And Ethical Aspects
The Ministry of Social Affairs and Health in Finland provided permission to obtain the Finnish Cancer Registry patient data. Experts in health psychology revised the questionnaire, and it was mailed to the patients from the National Public Health Institute . The Ethics Committee of Helsinki University Hospital approved the research protocol.
You May Like: How Do I Know I Have Prostate Cancer
How To Decide Between Radiation And Surgery For Localized Prostate Cancer
This page adheres to our medical and editorial policy and guidelines.
If youre like most men whove been diagnosed with prostate cancer, youve been told you have early-stage, localized prostate cancer, meaning the disease hasnt spread beyond the prostate. You may have also been told that you have choices about what you want to do next.
Unless your cancer is aggressive, youve probably been presented with three treatment options:
- Active surveillance: Oncologists use this method for less aggressive prostate cancer. Your care team will runs test periodically to evaluate whether the cancer has progressed. If so, they may recommend additional treatment.
- Radiation therapy: This treatment uses targeted radioactive energy to reduce tumor size, destroy cancer cells and alleviate some cancer-related symptoms.
- Surgery: Typically, this involves a procedure called a prostatectomy, which removes the prostate and surrounding cancer cells.
If you arent comfortable with active surveillance , or if your oncologist says it isnt the right option for you, you may have to decide between radiation therapy and surgery to treat your cancer.
Many men want to know whats the best treatment for their localized prostate cancer. But its a misconception that you have only one better or safer choice. In most cases, either radiation therapy or surgery is an equally good choice when we look at long-term survival.
To help you through the process of making this decision, this article covers:
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
Don’t Miss: How To Effectively Stimulate Prostate
How Does Brachytherapy Work
Brachytherapy involves implanting small, permanent radioactive seeds or temporary needles into the cancerous prostate.
After you are identified as a good candidate for brachytherapy, an ultrasound is used to guide the placement of needles into the prostate. Depending on whether you and your doctor have chosen permanent/low-dose brachytherapy or temporary/high-dose brachytherapy, these needles are then used to either put in permanent seeds or temporary radiation sources.
Placement of seeds is a minimally invasive procedure and does not require incisions. Men undergoing the procedure can return to full activity in less than a week. This is done as an outpatient procedure before you begin treatment.
Radiation Therapy For Advanced Prostate Cancer
When prostate cancer spreads, it tends to travel first to the bones. This may be diagnosed using imaging tests such as computed tomography scans. Cancer in the bones may cause pain and discomfort, so radiation is one tool that doctors may recommend to help manage the disease. Other commonly used treatments for advanced prostate cancer include chemotherapy, hormone therapy or immunotherapy.
External radiation therapy may be used to help reduce bone pain by targeting specific tumors, especially on the spine.
Some patients with advanced cancer may qualify to be part of a clinical trial involving radiation. In clinical trials, researchers study the effect of new treatments to see whether these are as safe and comprehensive as current treatments, or better.
You May Like: Can Psa Test Detect Prostate Cancer
Uf Health Proton Therapy Cancer Experts
As a major non-profit academic medical center, the University of Florida Health Proton Therapy Institute has treated more than 10,000 patients and led the way for innovative cancer care in the Southeast U.S. since 2006. As an academic health center, our published research is setting the standards for proton therapy cancer care worldwide, with dozens of clinical trials and more than 300 published research articles in peer-reviewed journals.
When you become a patient at UF Health Proton Therapy Institute, you are assured of receiving the highest quality cancer care as measured by state and national standards. We are committed to delivering the best possible patient outcomes. Our 125+ employees are dedicated to delivering proton cancer treatment in a way that takes the entire patient into account, so you can keep living life to the fullest.
Are you a candidate for Proton Therapy?
New Study Compares Long
- By Charlie Schmidt, Editor, Harvard Medical School Annual Report on Prostate Diseases
Prostate cancer therapies are improving over time. But how do the long-term side effects from the various options available today compare? Results from a newly published study are providing some valuable insights.
Investigators at Vanderbilt University and the University of Texas MD Anderson Cancer Center spent five years tracking the sexual, bowel, urinary, and hormonal status of nearly 2,000 men after they had been treated for prostate cancer, or monitored with active surveillance . Cancers in all the men were still confined to the prostate when diagnosed.
Dr. Karen Hoffman, a radiation oncologist at MD Anderson and the studys first author, said the intent was to provide information that could help men choose from among the various therapeutic options. Surgical and radiation techniques have changed significantly in the last few decades, and at the same time, active surveillance has become an increasingly acceptable strategy, she said. We wanted to understand the adverse events associated with contemporary approaches from the patients perspective.
Roughly two-thirds of the men enrolled in the study had favorable risk cancer, which is nonaggressive and slow-growing. A quarter of these men chose active surveillance, and the rest were treated with one of three different methods:
You May Like: What Is The Treatment For Prostate Cancer That Has Spread
Recommended Reading: Metastatic Prostate Cancer Treatment Options
Having Radiotherapy For Prostate Cancer
You have external beam radiotherapy as an outpatient in the radiotherapy department. Radiotherapy is given using a machine that is like a big x-ray machine. This is called a linear accelerator .
You usually have it as a series of short, daily treatments. The treatments are given from Monday to Friday, with a rest at the weekend. Radiotherapy is not painful, but you will need to lie still while you have it.
You may have radiotherapy over either:
- 4 weeks the dose you get for each treatment session is higher.
- 7 weeks the total overall dose of radiation is higher.
Both ways are effective, and the side effects are the same. You usually have radiotherapy over 4 weeks as it is a shorter treatment.
If you have a type of radiotherapy called stereotactic ablative radiotherapy you have it over a much shorter time.
Your doctor or nurse will explain how long your course of radiotherapy will take. It is safe for you to be with other people during external radiotherapy, including children.
There are different techniques used to treat prostate cancer more effectively. They treat the cancer while protecting healthy tissue and reducing side effects.
Your cancer doctor plans your radiotherapy carefully to make sure it is as effective as possible. During the planning visit, you will have a CT scan.
If Youre Getting Radiation Therapy To The Brain
People with brain tumors often get stereotactic radiosurgery if the cancer is in only one or a few sites in the brain. Side effects depend on where the radiation is aimed. Some side effects might show up quickly, but others might not show up until 1 to 2 years after treatment. Talk with your radiation oncologist about what to watch for and when to call your doctor.
If the cancer is in many areas, sometimes the whole brain is treated with radiation. The side effects of whole brain radiation therapy may not be noticeable until a few weeks after treatment begins.
Radiation to the brain can cause these short-term side effects:
- Trouble with memory and speech
Some of these side effects can happen because radiation has caused the brain to swell. Medicines are usually given to prevent brain swelling, but its important to let your cancer care team know about headaches or any other symptoms. Treatment can affect each person differently, and you may not have these particular side effects.
Radiation to the brain can also have side effects that show up later usually from 6 months to many years after treatment ends. These delayed effects can include serious problems such as memory loss, stroke-like symptoms, and poor brain function. You may also have an increased risk of having another tumor in the area, although this is not common.
Talk with your cancer care team about what to expect from your specific treatment plan.
Also Check: Plant Based Diet For Prostate Health