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.
Stereotactic Body Radiation Therapy Or Stereotactic Ablative Radiation Therapy
Guided by advanced imaging techniques, SBRT delivers large doses of radiation over a short period of time to a precise area. SBRT is commonly referred to by the names of the machines used to deliver the radiation. SBRT can offer some patients with localized prostate cancer the convenience of fewer treatments while maintaining treatment effectiveness and safety. SBRT may also be used to treat metastases for some patients to reduce tumor mass and potentially enhance survival.
Side Effects Of Prostate Cancer Radiotherapy
Radiotherapy to the prostate can cause some side effects, such as loose or watery poo and passing urine more often.
Side effects tend to start a week or 2 after the radiotherapy begins. They gradually get worse during the treatment and for a couple of weeks after the treatment ends. But they usually begin to improve after around 2 weeks or so after treatment finishes
Everyone is different and the side effects vary from person to person. You may not have all of the effects mentioned.
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Urinary And Bladder Changes
Radiation therapy to the pelvis can cause urinary and bladder problems by irritating the healthy cells of the bladder wall and urinary tract. These changes may start 35 weeks after radiation therapy begins. Most problems go away 28 weeks after treatment is over. You may experience:
- Burning or pain when you begin to urinate or after you urinate
- Trouble starting to urinate
- Bladder spasms, which are like painful muscle cramps
Ways to manage include:
- Drink lots of fluids. Aim for 68 cups of fluids each day, or enough that your urine is clear to light yellow in color.
- Avoid coffee, black tea, alcohol, spices and all tobacco products.
- Talk with your doctor or nurse if you think you have urinary or bladder problems. You may need to provide a urine sample to check for infection.
- Talk with your doctor or nurse if you have incontinence. He/she may refer you to a physical therapist to assess your problem. The therapist may recommend exercises to help you improve your bladder control.
- Your doctor may prescribe medications to help you urinate, reduce burning or pain, and ease bladder spasms.
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.
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Do We Know Which Treatment Is Better For Prostate Cancer Brachytherapy Or External Beam Radiation
Its not a question of which therapy is better but rather which therapy is the most tailored, pinpointed radiation for the patients specific disease.
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 or the Gleason score or visible evidence of disease on an MRI we have learned over the years that higher doses of radiation are critical to achieving better results. Some evidence suggests that for patients with intermediate- or high-risk prostate cancer, a combined approach using brachytherapy along with external beam radiation may be best.
Data that we have published recently show that for patients with intermediate-risk disease, the combination of external beam radiation with brachytherapy not only provides better biochemical control, in terms of PSA level, but also reduces the risk of distant metastases, or spread of the disease. Another recent study from Canada, which compared outcomes in patients who were treated with external beam radiation or a combination approach, found superior results when the combined approach was used. These studies provide strong evidence that higher doses of radiation provide an important benefit to patients with intermediate-risk and high-risk prostate cancers.
Image Guided Radiation Therapy
In this type of radiation therapy, CT scans are taken both during the planning process and just before treatment begins. Comparing the two images allows doctors to adjust treatment as needed, since tumors can move between treatments. This allows precision targeting of the cancer while avoiding nearby healthy tissue.
In some cases, doctors will implant a tiny marker in or near the tumor to pinpoint it for IGRT to account for organ/tumor motion even if the body is immobilized.
Calypso is another form of IGRT where the prostate can be tracked during the treatment.
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New Prostate Cancer Guideline Offers Shortened Radiation Time
Men being treated for early-stage prostate cancer with external beam radiation therapy can safely choose an option that reduces the number of treatment sessions, according to a panel of experts from the American Society for Radiation Oncology, American Society of Clinical Oncology, and American Urological Association. The new guideline for doctors who treat men with prostate cancer was published October 11, 2018 in Practical Radiation Oncology, Journal of Clinical Oncology, and The Journal of Urology.
Men diagnosed with prostate cancer while its still at an early stage often have several treatment options, including active surveillance , surgery, or radiation. All have about the same cure rates for the earliest stage prostate cancers, although each type of treatment has pros and cons.
External beam radiation therapy , is a type of radiation therapy used to treat prostate cancer. A machine focuses beams of radiation on the prostate gland to kill the cancer cells. Patients typically receive treatments 5 days a week for several weeks. The new guideline uses hypofractionated radiation, where external beam radiation is given in larger doses and fewer treatments. Men treated with this approach can typically expect to complete treatment in 4 to 5 weeks, compared with 8 to 9 weeks for conventional EBRT. Ultrahypofractionated therapy increases the radiation dose even more and can be completed in as few as 5 treatments.
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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.
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What Side Effects Will I Have
During your treatment, radiation must pass through your skin. You may notice some skin changes in the area exposed to radiation.
Your skin may become red, swollen, warm, and sensitive, as if you have a sunburn. It may peel or become moist and tender. Depending on the dose of radiation you receive, you may notice hair loss or less sweat within the treated area.
These skin reactions are common and temporary. Theyâll fade gradually within 4 to 6 weeks after you finish your treatment. If you notice any skin changes outside the treated area, tell your doctor or nurse.
Long-term side effects, which can last up to a year or longer after treatment, may include:
- A slight darkening of the skin
- Enlarged pores
- Skins feels more or less sensitive
- A thickening of tissue or skin
Other possible side effects of external beam radiation therapy are:
Tiredness. Your fatigue might not lift until a few weeks or months after you finish getting radiation therapy.
Lymphedema. If radiation therapy damages the lymph nodes around your prostate gland, the fluid can build up in your legs or genital area. That can bring on swelling and pain. Physical therapy can usually treat lymphedema, but it might not go away completely.
Urinary problems. Radiation can irritate your bladder, and that could lead to a condition called radiation cystitis. You might:
- Have to pee more often
- Feel like it burns when you pee
- Notice blood in your urine
What Happens During Each Treatment Visit
External radiation is a lot like getting a regular x-ray. The treatment itself is painless and takes only a few minutes. But each session can last 15 to 30 minutes because of the time it takes to set up the equipment and put you in the right position.
External radiation therapy is usually given with a machine called a linear accelerator which delivers a beam of radiation. The machine has a wide arm that extends over the treatment table. The radiation comes out of this arm. The machine can move around the table to change the angle of the radiation, if needed, but it wont touch you. The radiation beams are invisible and you will not feel anything, but the machine will make noise.
Depending on the area being treated, you might need to undress, so wear clothes that are easy to take off and put on. Youll be asked to lie on the treatment table next to the radiation machine.
The radiation therapist might put special heavy shields between the machine and parts of your body that arent being treated to help protect normal tissues and organs.
Once youre in the right position, the radiation therapist will go into a nearby room to operate the machine and watch you on a TV screen. The room is shielded, or protected from the radiation so that the therapist isnt exposed to it. You can talk with the therapist over an intercom. Youll be asked to lie still during the treatment, but you wont have to hold your breath.
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Why Are There Marks On My Skin
Your radiation therapist will make small marks resembling freckles on your skin along the treatment area. These marks provide targets for the treatment and are a semi-permanent outline of your treatment area.
Donât try to wash these marks off or retouch them if they fade. The therapist will re-mark the treatment area when necessary.
Scheduling Appointments For Enlarged Prostate Treatment At New York Urology Specialists
We offer affordable appointment prices with or without insurance. We offer weekday, weekend, and evening office hours.
Dr. Alex Shteynshlyuger is a board-certified urologist and specialist in the treatment of urinary problems in men. He is one of the few urologists who offers a full range of treatment options for BPH . He specializes in all aspects of care for men with an enlarged prostate and urinary problems, including frequent urination at night, difficulty emptying the bladder, urinary urgency, and incontinence. He has successfully treated thousands of men with urinary problems, including urinary retention, painful urination, and frequent urination.
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Radiation For Prostate Cancer
Radiation therapy may be a treatment option for certain men with prostate cancer.
Aside from surgery to remove the prostate, it is the only way to eliminate prostate cancer. Urology San Antonios Reyna Cancer Center is an entire facility dedicated to radiation therapy for cancer treatment. Although we treat many types of cancers, we specialize in radiation for prostate cancer.
Blood In Urine After Radiation For Prostate Cancer
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
- 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 .
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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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Surgical procedures to remove the diseased prostate are usually necessary. Surgical procedures are not always necessary. If the disease is caused by bacterial infections, a doctor can treat the symptoms using alpha-blockers or surgery. Physical therapy, relaxation exercises, and warm baths are all recommended. A physician may also prescribe antibiotics to cure the infection. A bacterial infection can also cause a recurrence of the condition.
An enlarged prostate can be uncomfortable for both men and women. Some of the symptoms of an enlarged male reproductive organ include a weakened urine stream, urgent need to urinate, and urinary tract infections. BPH can also cause damage to the kidneys. A sudden inability to urinate can be life-threatening, as it can lead to bladder and kidney damage. Unfortunately, most men with enlarged prostrates put up with the symptoms for years before they seek treatment. However, many of the men with symptoms finally decide to go to a doctor for proper gynecological evaluation and to begin enlarged prostatic therapy.
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Possible Side Effects Of Radiation Treatment For Prostate Cancer
The radiation used to destroy cancer cells can also hurt normal cells in the nearby area. Side effects from radiation treatment are related to the area of the body being treated. Patients start to have side effects a few weeks into their treatment. While side effects may be unpleasant, there are treatments to help deal with them. Most side effects are temporary and slowly start to go away once treatment is done.
You will be seen by your radiation oncology providers often during treatment. These visits are a chance to ask questions and to talk about any side effects and how to best manage them. You can also call your providers to speak about any side effects.
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.
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What Is 3d Conformal Radiation Therapy
Itâs a procedure that uses a computer to make a three-dimensional picture of your tumor. It helps your treatment team deliver the highest possible dose of radiation to the tumor while minimizing the damage to normal tissue.
3D conformal radiation therapy uses CT-based treatment combined with three-dimensional images of a prostate tumor. CT is short for computed tomography, which uses X-rays to produce detailed pictures inside the body.
So far, this technique has worked well for localized tumors such as prostate cancer limited to the prostate gland.