Bowel And Bladder Problems
Radiation therapy for prostate cancer can irritate the bowel, the bladder, or both.
A person can develop:
Radiation proctitis: Symptoms include diarrhea and blood in the stool.
Radiation cystitis: Symptoms include a need to urinate more often, a burning sensation when urinating, and blood in the urine.
Bladder problems may improve after treatment, but they may not go away completely.
How Does Radiotherapy Treatment Work
Radiation therapy works by use of high doses of radiation to kill or slow down its growth rate. In prostate cancer treatment it is used to kill the cancerous cells or slow the growth rate. It also kills the nearby healthy cells as it kills the cancerous cells.
Where curing the cancer is impossible, radiotherapy is used to reduce the symptoms such as pain caused by cancer tumor. It can also be used to prevent the problems that result from cancer tumor such as loss of bowel and bladder control, blindness etc.
*All individuals are unique. Your results can and will vary.
Here are different types of radiations and how they work:
Low Dose Rate Brachytherapy Implants
The most common form of brachytherapy for prostate cancer, LDR involves surgically placing small radioactive pellets, about the size of a grain of rice, within the prostate. Once put in place, they remain there for life, but the radiation weakens over weeks or months, until it almost completely goes away.
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Who Is A Candidate For Think Five Radiation Therapy
Our team of prostate cancer experts will help you understand your disease risk. We will discuss with you whether you are a good candidate for this faster approach.
Think Five is recommended for patients with:
- Localized prostate cancer, meaning the cancer has not spread to other parts of the body
- Low, intermediate, and selected patients with high disease risk, which is determined using a number of clinical factors, including the aggressiveness of the cancer
- Selected patients with limited disease outside of the prostate
Heres What You Should Know About This Treatment Option
Men who get diagnosed with prostate cancer have several options to choose from for their next step. Many men with slow-growing, low-risk cancer follow active surveillance, a wait-and-see approach that monitors the cancer for changes.
But if the cancer shows higher risk or has already begun to spread, other treatments are recommended. There are two options: surgery to remove the prostate or radiation to destroy the cancer cells.
Studies comparing these two approaches demonstrate no advantage of one over the other with respect to cancer control. Your path will depend on factors like your current health, the specifics of your cancer, and personal preference. Yet for many men, radiation can be the better option.
âIts much more precise than the traditional radiation used for other kinds of cancer, and research also has found that long-term quality of life is often better, with fewer adverse health effects compared to surgery,â says Dr. Anthony DAmico, a radiation oncologist with Harvard-affiliated Dana-Farber Cancer Institute and Brigham and Womens Hospital.
There are two main ways to deliver radiation to the prostate: external beam radiation and brachytherapy.
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Do We Know Which Treatment Is Best For Prostate Cancer Brachytherapy Or External Beam Radiation
Its not a question of which type of radiation therapy is best in general, but rather which therapy is best for the patients specific disease and quality-of-life concerns. We want to use the most tailored, pinpointed radiation to treat the prostate tumor effectively while minimizing side effects. This can depend on the tumors size and stage as well as other patient characteristics and even a patients individual preferences.
Why People With Cancer Receive Radiation Therapy
Radiation therapy is used to treat cancer and ease cancer symptoms.
When used to treat cancer, radiation therapy can cure cancer, prevent it from returning, or stop or slow its growth.
When treatments are used to ease symptoms, they are known as palliative treatments. External beam radiation may shrink tumors to treat pain and other problems caused by the tumor, such as trouble breathing or loss of bowel and bladder control. Pain from cancer that has spread to the bone can be treated with systemic radiation therapy drugs called radiopharmaceuticals.
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How Will I Know That My Hormone Therapy Is Working
Doctors cannot predict how long hormone therapy will be effective in suppressing the growth of any individual mans prostate cancer. Therefore, men who take hormone therapy for more than a few months are regularly tested to determine the level of PSA in their blood. An increase in PSA level may indicate that a mans cancer has started growing again. A PSA level that continues to increase while hormone therapy is successfully keeping androgen levels extremely low is an indicator that a mans prostate cancer has become resistant to the hormone therapy that is currently being used.
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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.
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What Is Radiation Therapy
Radiation therapy is a form of cancer therapy that employs high-intensity wave energy to destroy cancer cells. Over 50% of cancer patients receive radiation therapy as part of their treatment protocol. X-rays are the most common type of energy used during treatment, but gamma rays, protons, or electron beams can also be utilized. Radiation therapy refers typically to external beam radiation, meaning the source of energy comes from a device outside the patients body, targeting the beams at a specific location on the body.
However, radiation therapy can also be administered in other ways. Internal radiation therapy, known as brachytherapy, refers to the placement of a radioactive implant inside the body near the tumor location. The implant capsule can carry a higher dose of radiation to treat a smaller area than would be possible with external beam radiation.
Another form of radiation treatment, known as systemic radiation therapy, uses radioactive materials administered orally or through a vein. Although the radiation does pass through the body, the vast majority will be released at the tumor site, posing minimal risk to the rest of the body.
Detecting And Treating At Once
A previous City Stories article detailed what Yeh calls the next big thing: detecting and eradicating prostate cancer at the same time using the PSMA system. A specially modified positron emission tomography scan detects areas displaying a prostate-specific membrane antigen. A radioactive isotope can then immediately deliver a cancer-killing attack to those targeted cells. Yeh is also watching the progress of another PET scan detection method, this one using Axumin, an advanced diagnostic imaging agent, or radiotracer, which may pick up cancer cells missed by other methods.
Yehs enthusiasm for all of this progress is personal. Several of his relatives have succumbed to cancer. He entered radiation oncology to find nonsurgical ways to make a difference.
Every patient, he says, is like a family member to me.
It certainly felt that way to Oakley who, after a course of radiation treatments, went into remission and has remained cancer free. Along the way, hes also made changes to his diet and exercise regimens. Hes dropped some 140 pounds, enabling him to bring renewed energy and passion to the production company he runs with his wife, Melanie Grunder.
If youre lucky enough to get to City of Hope, you are truly lucky, he said. They are the reason Im alive. Dr. Yeh took a guy not destined to be around and made him a person with purpose.
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Are There Side Effects Of The Combination Approach To Prostate Cancer Radiation Therapy
When it comes to early stages of disease, patients very frequently do well with either brachytherapy or external beam radiation. Success rates of around 90% or higher can be achieved with either approach. When the disease is somewhat more advanced based on the PSA level, Gleason score, extent of visible disease on magnetic resonance imaging we have learned over the years that higher doses of radiation are critical to achieving better results. Some evidence, including a large trial, suggests that for patients with intermediate- or high-risk prostate cancer, a combined approach using brachytherapy along with external beam radiation may be best compared to standard dose external beam radiation therapy alone.
What Are The Dangers Of Radiotherapy Prostate Cancer Treatment
Radiotherapy is considered effective for treatment of cancer with a success rate of above 90%. But is it safe for prostate cancer treatment? Does it cause any side effects? And if yes, are radiation therapy side effects reversible?
Well, radio frequency is pain-free and considered safe for prostate cancer treatment. To help you understand the safety of this procedure we shall look at both the short and long-term side effects resulting from this treatment.
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Radiation Therapy For Prostate Cancer
Radiation therapy uses high-energy rays or particles to kill cancer cells. Depending on the stage of the prostate cancer and other factors, radiation therapy might be used:
- As the first treatment for cancer that is still just in the prostate gland and is low grade. Cure rates for men with these types of cancers are about the same as those for men treated with radical prostatectomy.
- As part of the first treatment for cancers that have grown outside the prostate gland and into nearby tissues.
- If the cancer is not removed completely or comes back in the area of the prostate after surgery.
- If the cancer is advanced, to help keep the cancer under control for as long as possible and to help prevent or relieve symptoms.
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What Is A Radiation Oncologist
If a patient is undergoing radiation, the cancer treatment plan may be managed by a radiation oncologist who carefully monitors the persons overall health and well-being through the process.
With advanced cancer, a patient may also be referred to a medical oncologist. This specialized doctor uses medicines such as chemotherapy and hormone therapy to treat cancers. Its common for several medical specialists to work together on a treatment plantheyre known as a cancer care team.
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What Is Radiation Therapy Used For
Radiation therapy is used to treat an array of cancers, either alone or in conjunction with other cancer treatments such as surgery or chemotherapy. A radiation oncologist will use radiation therapy to treat or cure early-stage cancer and to prevent cancer from returning to another area of the body. Radiation therapy may be used for palliative care, with the goal to alleviate the symptoms and suffering caused by advanced-stage cancer.Dr. Lee notes that depending on the type of cancer and the treatment plan involved, the time and regularity of radiation therapy may vary. A palliative track, a short course to improve symptoms, or a definitive treatment to cure the cancer may all have differing time lengths and visit frequencies, he says.
When Is Brachytherapy Alone The Right Choice
For some patients with disease that is confined to the prostate and not too aggressive , brachytherapy alone is a good option. It is also convenient for the patient as it is done in an outpatient setting and most people can get back to work within a few days.
But brachytherapy is not right for everyone. For some patients with less-aggressive disease, a watch-and-wait approach would be preferred. At MSK, our philosophy is that when the disease is caught very early, it is very appropriate to do active surveillance and hold off on treatment.
This philosophy applies to patients with a low PSA level, or nonaggressive disease as reflected by a Gleason score of 6 with evidence of cancer in only a few of the biopsy samples and no evidence from the MRI of a significant amount of disease. There are also very select patients with Gleason 7 disease who may be candidates for active surveillance.
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What Is Intermittent Adt
Researchers have investigated whether a technique called intermittent androgen deprivation can delay the development of hormone resistance. With intermittent androgen deprivation, hormone therapy is given in cycles with breaks between drug administrations, rather than continuously. An additional potential benefit of this approach is that the temporary break from the side effects of hormone therapy may improve a mans quality of life.
Randomized clinical trials have shown similar overall survival with continuous ADT or intermittent ADT among men with metastatic or recurrent prostate cancer, with a reduction in some side effects for intermittent ADT .
Treatment Options For Men With Urinary Symptoms After Radiation For Prostate Cancer
Many men benefit from medical treatment to help them with urinary symptoms during IMRT, CyberKnife, proton beam, or brachytherapy. These medications include alpha-blockers such as Flomax, alpha-reductase inhibitors such as finasteride or Proscar, and anticholinergic medications such as Detrol, or Vesicare.
When medical treatment does not provide sufficient benefit or of the symptoms persist, other treatment options offered at New York Urology Specialists include Urolift procedure, Rezum procedure, iTind for prostate, Greenlight laser of the prostate, Botox injections in the bladder, and TURP.
It should be noted that men with urinary symptoms after radiation therapy for prostate cancer should have a cystoscopy at a minimum to exclude urethral stricture disease and bladder tumors. Some men may also benefit from a urodynamic evaluation.
Did you know?Dr. Shteynshlyuger has performed over 1,000 surgeries and procedures for enlarged prostate, including Rezum, Urolift, prostate enucleation, laser ablation of the prostate, and TURP. He performs over 100 prostate procedures a year.
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Possible Side Effects Of Ebrt
Some of the side effects from EBRT are the same as those from surgery, while others are different.
Bowel problems: Radiation can irritate the rectum and cause a condition called radiation proctitis. This can lead to diarrhea, sometimes with blood in the stool, and rectal leakage. Most of these problems go away over time, but in rare cases normal bowel function does not return. To help lessen bowel problems, you may be told to follow a special diet during radiation therapy to help limit bowel movement during treatment. Sometimes a balloon-like device or gel is put between the rectum and the prostate before treatment to act like a spacer to lessen the amount of radiation that reaches the rectum.
Urinary problems: Radiation can irritate the bladder and lead to a condition called radiation cystitis. You might need to urinate more often, have a burning sensation while you urinate, and/or find blood in your urine. Urinary problems usually improve over time, but in some men they never go away.
Some men develop urinary incontinence after treatment, which means they cant control their urine or have leakage or dribbling. As described in the surgery section, there are different levels and types of incontinence. Overall, this side effect occurs less often with radiation therapy than after surgery. The risk is low at first, but it goes up each year for several years after treatment.
How Can I Reduce Skin Reactions
- Gently cleanse the treated area using lukewarm water and a mild soap such as Ivory, Dove, Neutrogena, Basis, Castile, or Aveeno Oatmeal Soap. Donât rub. Pat your skin dry with a soft towel or use a hair dryer on a cool setting.
- Try not to scratch or rub the treated area.
- Donât put any ointment, cream, lotion, or powder on the treated area unless your radiation oncologist or nurse has prescribed it.
- Donât wear tight-fitting clothing or clothes made from harsh fabrics like wool or corduroy. These fabrics can irritate the skin. Instead, choose clothes made from natural fibers like cotton.
- Donât apply medical tape or bandages to the treated area.
- Donât expose the treated area to extreme heat or cold. Avoid using an electric heating pad, hot water bottle, or ice pack.
- Donât expose the treated area to direct sunlight. That could intensify your skin reaction and lead to a severe sunburn. Choose a sunscreen of SPF 30 or higher. Protect the treated area from direct sunlight even after your course of treatment is over.
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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: