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.
What Are The Side Effects Of External Beam Radiation Therapy
As with most prostate cancer treatments, external beam radiation therapy can also cause side effects. The severity can depend on the type of radiation, dose size, length of treatment and area of treatments. These frequently include:
- Skin irritation
- Erectile dysfunction
- Secondary malignancy
If you are considering prostate cancer treatment with a form of EBRT, talk with your radiation oncologist to discuss options, potential side effects, and how those side effects will be managed.
Recently, the FDA approved the use of Space OAR, a hydrogel product for men choosing radiation therapy that can reduce the radiation received by the rectum during treatment. This can help decrease the chances of developing rectal complications such as the inability to control your bowels. The hydrogel is injected between the prostate and rectum where the gel solidifies and creates a space before radiation begins. To learn more about this product, visit the manufacturers site here.
Who Should Consider External Beam Radiation Therapy
In most cases, external beam radiation therapy is used for men with localized prostate cancer . The intent of EBRT in this case is to kill the tumor while sparing as much healthy tissue as possible. Sometimes it is used in more advanced cases. For example, it can be used along with hormone therapy, or used to relieve pain from bone metastases.
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Treating Advanced Prostate Cancer
If the cancer has reached an advanced stage, it’s no longer possible to cure it. But it may be possible to slow its progression, prolong your life and relieve symptoms.
Treatment options include:
- hormone treatment
If the cancer has spread to your bones, medicines called bisphosphonates may be used. Bisphosphonates help reduce bone pain and bone loss.
Gathering Information To Inform Your Decisions
Although Dunn said cost shouldnt be a factor in determining the best course of treatment and what medications to take to treat the cancer, it does often play a role in a persons decisions.
According to Dunn, this may lead people to skip their treatment altogether or opt for a suboptimal treatment regimen that they feel they can afford. Dunn explains that HealthWell Foundations mission is to make sure that patients dont have to choose between their medication and paying for food or for rent or for anything else vital.
You will need to consider several pieces of information when making treatment decisions, including:
- what stage your cancer is in
- your age and life expectancy
- other health conditions you have
- your doctors opinion about the urgency of treatment
- odds that treatment will help or cure you
- potential side effects of treatment
With major medical decisions, its a good idea to get a second opinion from another doctor.
When youre deciding on a cancer treatment plan, the healthcare facility should be able to provide support for that decision.
Many treatment facilities provide financial counselors, patient navigators, or social workers who will discuss treatment costs with the patients based on their specific insurance plans. They will also try to find financial assistance for patients through organizations such as ours, McCourt said.
However, McCourt added that the demand for assistance is greater than the amount of available funding.
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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.
What To Expect After Radiation Therapy For Prostate Cancer
Patients who receive radiation therapy for prostate cancer may experience a wide range of short-term and long-term side effects. And side effects may vary widely from patient to patient depending on a variety of factors, including the extent of the disease and the patients overall health. For instance, some patients may need a urinary catheter to help empty the bladder. Other patients may experience sexual side effects.
At CTCA, our trained supportive care providers work closely with you and your doctors to determine how best to address radiation therapy side effects. Services may include:
- Pelvic floor therapy
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Prostate Cancer: Radiation Therapy
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.
Why Choose Valley For Prostate Cancer Radiation
- Fewer side effects through precision: Your decision whether to treat prostate cancer vs. choose active surveillance will typically factor in the risks and benefits of treatment. With radiation therapy that is extremely precise, many of the risks and side effects of treatment are severely reduced, if not eliminated. Thats why Valley invests in the very latest radiation technologylike the ExacTrac Dynamic systemto provide patients with the highest level of precision, effectiveness and safety.
- SpaceOAR hydrogel: As an additional level of safety, we use SpaceOAR hydrogel during treatment to separate the prostate from the rectum. This separation allows our team to protect the rectum from radiation, and through that, preserve normal bowel function. This also allows us to treat your prostate cancer with higher doses of radiation in a shorter period.
- Team approach to treatment recommendations: Valleys Urologic Oncology Program brings together prostate cancer experts to discuss each case and come to a joint treatment recommendation. That means you will hear one opinion about how to address your cancer from radiation oncologists, urologic surgeons and medical oncologists. In that way, you can feel confident moving forward with treatment vs. watching and waitingor vice versa.
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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.
Original Medicare Covers Chemotherapy And Cancer Treatments
Medicare Part A and Part B make up Original Medicare, which covers some hospital and medical care needs.
Medicare Part B covers doctor visits, surgeries and outpatient hospital services, including chemotherapy. Medicare Part A provides coverage for inpatient hospital care.
How Medicare pays for chemotherapy depends on where you receive your treatment:
- Hospital outpatientYou will typically pay a Medicare Part B copayment for chemotherapy received in a hospital outpatient setting. Your copay will typically be a set dollar amount, rather than a percentage of costs.
- Doctors office or freestanding clinicAfter meeting your Part B deductible , youre typically responsible for paying 20% of the Medicare-approved amount for the treatment.
Original Medicare can also provide coverage for the following cancer treatment and screening services:
- Prostate cancer screenings
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Main Findings Of Economic Evaluations Identified In The Systematic Reviews
Table shows the main findings of the cost effectiveness studies that compared IMRT with 3D-CRT.
Table 3 Main findings of Cost-effectiveness studies comparing IMRT and 3D-CRT for localized prostate cancer
Carter et al. found that IMRT was dominant strategy i.e. both more effective and less costly than 3DCRT over 20 years. After 20 years the model estimated a cost for IMRT is $32,816 and for 3D-CRT it was $33,917. The estimated QALYs for the IMRT and 3D-CRT were 10.079 and 10.060 respectively. This showed an additional 20 QALYs gained and over $1.1 million saved per 1000 patients treated over 20 years. The authors performed a one-way sensitivity analysis and showed that the model was highly robust to changes in individual parameters and IMRT remained the dominant treatment in all scenarios. For the probabilistic sensitivity analysis, the authors also showed that IMRT had an 86% probability of being dominant and a 93% probability of being a cost-effective treatment given an ICER threshold of $50,000 per QALY.
Table 4 Main findings of Cost-effectiveness studies comparing IMRT, SBRT and PBT for localized prostate cancer
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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Your Cancer Care Team
People with cancer should be cared for by a multidisciplinary team . This is a team of specialists who work together to provide the best care and treatment.
The team often consists of specialist cancer surgeons, oncologists , radiologists, pathologists, radiographers and specialist nurses.
Other members may include physiotherapists, dietitians and occupational therapists. You may also have access to clinical psychology support.
When deciding what treatment is best for you, your doctors will consider:
- the type and size of the cancer
- what grade it is
- whether the cancer has spread to other parts of your body
Having Your Planning Scan
The scan will help your doctor work out the exact dose and area of your treatment.
Before your scan, you may need to have a special diet or take medicine to empty your bowel. You may also need to drink water to fill your bladder. This is to get very clear CT pictures to help plan your treatment.
You may also have a very small amount of liquid passed into your rectum to empty your bowel. You may need to do this before each session of radiotherapy.
During the scan, you need to lie still in the same position you will be in for your radiotherapy.
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Working During Radiation Therapy
Some people are able to work full-time during radiation therapy. Others can work only part-time or not at all. How much you are able to work depends on how you feel. Ask your doctor or nurse what you may expect from the treatment you will have.
You are likely to feel well enough to work when you first start your radiation treatments. As time goes on, do not be surprised if you are more tired, have less energy, or feel weak. Once you have finished treatment, it may take just a few weeks for you to feel betteror it could take months.
You may get to a point during your radiation therapy when you feel too sick to work. Talk with your employer to find out if you can go on medical leave. Check that your health insurance will pay for treatment while you are on medical leave.
How Prostate Cancer Is Treated
In cancer care, different types of doctorsincluding medical oncologists, surgeons, and radiation oncologistsoften work together to create an overall treatment plan that may combine different types of treatments to treat the cancer. This is called a multidisciplinary team. Cancer care teams include a variety of other health care professionals, such as palliative care experts, physician assistants, nurse practitioners, oncology nurses, social workers, pharmacists, counselors, dietitians, physical therapists, and others.
The common types of treatments used for prostate cancer are described below. Your care plan may also include treatment for symptoms and side effects, an important part of cancer care.
Treatment options and recommendations depend on several factors, including the type and stage of cancer, possible side effects, and the patients preferences and overall health.
Cancer treatment can affect older adults in different ways. More information on the specific effects of surgery, chemotherapy, and radiation therapy on older patients can be found another section of this website.
Because most prostate cancers are found in the early stages when they are growing slowly, you usually do not have to rush to make treatment decisions. During this time, it is important to talk with your doctor about the risks and benefits of all your treatment options and when treatment should begin. This discussion should also address the current state of the cancer:
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How Does Radiotherapy Work
Radiotherapy aims to destroy prostate cancer cells without causing too much damage to healthy cells. External beam radiotherapy is high-energy X-ray beams targeted at the prostate from outside the body. These X-ray beams damage the cancer cells and stop them from growing and spreading to other parts of the body . Radiotherapy permanently damages and kills the cancer cells, but healthy cells can repair themselves and recover more easily.
Radiotherapy treats the whole prostate. It aims to treat all the cancer cells, including any that have spread to the area just outside the prostate. The treatment itself is painless but it can cause side effects that may cause you problems.
You may have radiotherapy to a wider area, including the nearby lymph nodes, if there is a risk that the cancer has spread there. Lymph nodes are part of your immune system and are found throughout your body. The lymph nodes in your pelvic area are a common place for prostate cancer to spread to. If you do have radiotherapy to a wider area, you will be more likely to get side effects.
What If I Have A Concession Card
Holding a Concession Card does not automatically mean that out of pocket costs will be lower. Please let the radiation therapy centre know that you have this as it helps them to understand your individual circumstances.
Holding a Concession Card reduces the level at which the Medicare Safety Net Threshold applies and provides extra support to reduce your out of pocket costs.
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Stereotactic Body Radiation Therapy
This technique uses advanced image guided techniques to deliver large doses of radiation to a precise area, such as the prostate. Because there are large doses of radiation in each dose, the entire course of treatment is given over just a few days.
SBRT is often known by the names of the machines that deliver the radiation, such as Gamma Knife, X-Knife, CyberKnife, and Clinac.
The main advantage of SBRT over IMRT is that the treatment takes less time . The side effects, though, are not better. In fact, some research has shown that some side effects might actually be worse with SBRT than with IMRT.
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.
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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.