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Nerve Damage From Radiation For Prostate Cancer

Short Term Side Effects

Nerve-Sparing Radiation for Prostate Cancer | Ask a Prostate Expert, Mark Scholz, MD

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

What Treatment Can I Have

There are different ways to treat pain. Whats best for you will depend on a number of things, including whats causing the pain, your general health, how you are feeling emotionally and what sort of things you do in your daily life. Because pain involves all of these things, treating it often means using a few different approaches.

You might need treatment for the pain itself, such as:

Pain might be a sign that your prostate cancer treatment isnt working as well as it was. A different treatment for your cancer may help the pain. Possible treatments include:

  • hormone therapy
  • a type of radiotherapy called radium-223.

There are other things that may also help with pain, including:

  • complementary therapies
  • emotional support
  • treatments for other causes of pain, such as antibiotics to treat infection.

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The study linked and exerpted below reviews different formulations of CU. The study itself lists the three most bioavailable formulation/brand of CU and Ive added an excerpt from a further review from Consumerlab.com that lists four additional bioavailable brands of CU.

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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.

Faq: Radiation Therapy For Prostate Cancer

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Why would I choose radiation therapy?

Radiation therapy, including external beam radiation therapy and brachytherapy, is an alternative form of treatment for prostate cancer. EBRT may be used after other treatments, such as surgery, to manage cancer that has recurred or is at high risk of recurrence. Radiation therapy has an excellent record of success, providing long-term disease control and survival rates equivalent to other treatments, including surgery.

How should I expect to feel during radiation therapy?

Undergoing external beam radiation therapy is similar to having a routine X-ray. Radiation cannot be seen, smelled or felt. Generally, side effects don’t appear until the second or third week of treatment. Because radiation therapy is a local treatment, only the areas of the body where it is directed will experience side effects. Most patients will experience some or all of the following:

  • Increase in the frequency of urination
  • Urinary urgency
  • Softer and smaller volume bowel movements
  • Increased frequency of bowel movements
  • Worsening of hemorrhoids or rectal irritation with occasional scant blood and fatigue

Many questions may arise during radiation therapy treatment. Your doctors will be available to answer questions throughout your treatment.

How should I expect to feel after radiation therapy?

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Who Will Be On My Treatment Team

From the time that you are diagnosed with prostate cancer, you may be cared for by one or more of a team of health professionals, including:

  • your family/whnau doctor who will often be the first person you see
  • a urologist a doctor who specialises in the care of men with prostate cancer, providing medical and surgical care
  • medical oncologists doctors who are responsible for prescribing targeted therapies, immunotherapy, chemotherapy and other aspects of cancer care
  • radiation oncologists doctors who specialise in the use of radiation treatment
  • radiation therapists people who plan and give you your radiationtreatment
  • a cancer nurse coordinator and/or clinical nurse specialist a person who acts as a point of contact for you in different parts of the health service. They support and guide you and your family/whnau to keep you fully informed about your care
  • outpatient nurses nurses who work alongside doctors during their clinics.

Treatments For Nerve Problems

Medicines. Medicines can relieve pain. Your doctor might recommend non-prescription medicines if your pain is mild. These include pills you take by mouth and creams you put on the skin, depending on the type of nerve problems.

Your doctor might also prescribe medicines for you. For painful neuropathy related to previous chemotherapy, ASCO recommends the antidepressant duloxetine .

You might take prescription medicines if the pain is severe. They might be anti-inflammatory drugs or painkillers. Prescription medicines can include pills you take by mouth and creams or patches you put on the skin, such as a lidocaine patch.

Medicines can relieve pain, but they do not help numbness.

Adjusting your chemotherapy treatment plan. If you develop peripheral neuropathy from ongoing chemotherapy that causes severe pain or affects your ability to function, your health care team may choose to give your doses of chemotherapy further apart, lower the amount of chemotherapy youre receiving, or change your treatment plan. Talk with your doctor about what they recommend and if you can receive a treatment that does not cause peripheral neuropathy instead.

Better nutrition. Eating a diet that includes specific nutrients might help your nerve problems.For example, you might need more B vitamins, including B1, B12, and folic acid . Or you might need more antioxidants. These are found in many fruits and vegetables.

  • Relaxation and mindfulness meditation

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Symptoms Of Peripheral Neuropathy

Peripheral neuropathy may feel different for everyone. It may range from pain to numbness. The symptoms of peripheral neuropathy that you have depend on the types of nerves that are damaged.

Autonomic nerves control your blood pressure, heart rate, digestion and urination, among other functions. Autonomic nerve damage symptoms include:

  • New onset constipation or diarrhea
  • Dizziness or lightheadedness
  • Urinary problems, such as difficulty emptying your bladder

Motor nerves help your muscles function properly. Peripheral neuropathy symptoms associated with motor nerves include:

  • Achy or weak muscles, which may lead to falling easily or having trouble with tasks like buttoning shirts
  • Coordination problems
  • Difficulty walking
  • Muscle cramping or twitching

Sensory nerves help you feel sensations like pain, heat and cold. Peripheral neuropathy in the sensory nerves may cause the following symptoms:

  • Inability to feel cold or hot sensations
  • Inability to feel pain from an injury
  • Numbness or tingling in your feet or hands
  • Pain that may feel like burning, pinching or sharp stabbing
  • Problems walking or picking things up, especially in the dark

Getting Support With Nerve Damage

Side Effects of Radiation Therapy for Prostate Cancer | Prostate Cancer Staging Guide

It can feel like a big step to talk to a healthcare professionals about any symptoms you have, but its important that you get support based on your individual situation. Accessing support for nerve damage may be more difficult at the moment because of the coronavirus pandemic. If you are not sure where to turn, you can give our free Helpline a call on 0808 802 8000. Our trained volunteers can talk through your options or simply listen to whats going on.

Sometimes connecting with others who have gone through a similar experience can be helpful. Our online Forum lets our community give and get support. It even has a section dedicated to relationships. You can read through the messages or post your own whichever feels most comfortable.

If you have general questions about PRD or nerve damage, our panel of medical experts may be able to help. They cant give you answers about your individual situation or health its best to speak with your GP or healthcare team for that.

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Coping With Nerve Problems

Managing symptoms, which can include nerve problems, is an important part of cancer care and treatment. This is called palliative care or supportive care. Talk with your health care team about any symptoms or side effects you or the person you are caring for experience. This is important to do both during your cancer treatment and after treatment is completed.

The right treatment for nerve problems depends on the cause, whether chemotherapy is completed, and your specific problems. You should know that these problems often go away a few months or years after treatment. But sometimes, they are long-lasting or permanent, so you need ways to make the best of your function and recovery.

Hormone Therapy For Prostate Cancer

Hormone therapy, also called endocrine therapy, uses these hormones to slow or stop cancer growth.

Prostate cancer cells need the male hormone testosterone to grow. There are different ways your treatment team can lower the amount of testosterone in your body.

These treatments include:

Luteinising hormone-releasing hormoneLuteinising hormone-releasing hormone lowers the amount of testosterone made in the testicles. LHRH therapy is usually given as a monthly or three-monthly injection.

Anti-androgen tabletsAndrogen is another hormone in the body. Anti-androgen tablets stop testosterone from helping the growth of prostate cancer. They are normally used when LHRH therapy is no longer working well.

AbirateroneAbiraterone is a hormone therapy that stops your body from making testosterone. This treatment is used for men with advanced prostate cancer where other treatments are no longer working.

OrchidectomyAn orchidectomy is a small operation where the testicles are permanently removed. This treatment is not commonly used.

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Swelling Bruising Or Tenderness Of The Scrotum

Symptoms generally resolve on their own within three to five days. Oral anti-inflammatory medications such as ibuprofen are usually sufficient for pain relief, if necessary. You should avoid hot tubs and Jacuzzis for at least two to three days after the procedure. Postpone bike riding until the tenderness is gone.

Do We Know Which Treatment Is Best For Prostate Cancer Brachytherapy Or External Beam Radiation

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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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Problems With Your Bowels And Back Passage

Your bowel movements might be looser or more frequent than before your treatment. You might need to take anti diarrhoea medicines, such as loperamide . Bulking agents, such as Fybogel might also help.

You might find that you need to avoid high fibre foods as it might make long term diarrhoea worse. Some people find it best to avoid high fibre vegetables, beans and pulses .

Inflammation of the back passage is another possible long term side effect. Proctitis can cause a feeling of wanting to strain whether or not you actually need to pass a bowel movement. You might also have bleeding from your back passage or a slimy mucous discharge.

Talk to your doctor or specialist nurse if you have any of these side effects. They will be able to refer you to a specialist team that can help you to find ways of controlling the effects.

Stereotactic Body Radiation Therapy

This form of treatment is also referred to as stereotactic ablative radiotherapy . This technique targets pinpointed beams of very intense, strong radiation directly at a tumor. Because it is so targeted, SBRT is effective at reducing the amount of radiation that reaches surrounding tissue.

Because the radiation dosage is high, the number of visits required is reduced. Unlike IMRT, SBRT can be completed in days, rather than weeks.

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Long Term Side Effects Of Prostate Cancer Radiotherapy

Most side effects of radiotherapy gradually go away in the weeks or months after treatment. But long term side effects can continue. Or you might notice that some side effects begin months or years later.

Everyone is different and the side effects vary from person to person. You may not have all of the effects mentioned. Tell your doctor or nurse if you have any of these problems. They can help you to find ways of controlling the effects.

Late Effects After Radiation For Prostate Cancer

How Radiation Affects The Prostate | Mark Scholz, MD

Side effects from radiation treatment are directly related to the area of the body being treated. Any area in the treatment field has a risk of being damaged, causing side effects. As radiation techniques have improved over the years, the risk of late effects has decreased.

Bladder Problems

Radiation to the bladder area can cause late effects to the bladder including:

Bowel Problems

The bowel is sensitive to the effects of radiation. The late effects that may occur after radiation treatment that includes the rectum, colon, or small bowel include:

Lymphedema Risk

Surgery to remove lymph nodes or radiation to lymph nodes can cause damage to lymph nodes and lead to lymphedema. Lymphedema is swelling that can happen in the genital area, belly, buttocks, legs or feet after treatment. It can cause pain, be disfiguring, make activity difficult, and increase the risk of infection in the area.

  • Talk to your provider if you are having any new swelling. A Certified Lymphedema Therapist should be consulted at the first sign of swelling to try to keep the lymphedema from worsening.
  • You are at risk of infection in any area with lymphedema or that is at risk for lymphedema. If you experience any signs of infection, contact your care team right away or go to the emergency room. These signs include a sudden increase in swelling, an increase in pain, redness, the area is warm to the touch, or fever.

Impact on Reproductive Organs, Sexual Function, and Fertility

Nerve Damage

Skin Changes

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Proton Beam Radiation Therapy

Proton beam therapy focuses beams of protons instead of x-rays on the cancer. Unlike x-rays, which release energy both before and after they hit their target, protons cause little damage to tissues they pass through and release their energy only after traveling a certain distance. This means that proton beam radiation can, in theory, deliver more radiation to the prostate while doing less damage to nearby normal tissues. Proton beam radiation can be aimed with techniques similar to 3D-CRT and IMRT.

Although in theory proton beam therapy might be more effective than using x-rays, so far studies have not shown if this is true. Right now, proton beam therapy is not widely available. The machines needed to make protons are very expensive, and they arent available in many centers in the United States. Proton beam radiation might not be covered by all insurance companies at this time.

What Causes The Pain

We feel pain when our bones, muscles, organs, nerves or other parts of our bodies are damaged or irritated. Cancer which has spread into these areas might cause pain.

Sometimes pain can be due to cancer treatments. For example, radiotherapy to treat bone pain can sometimes cause your pain to get worse during treatment and for a few days afterwards. But this isnt very common.

Pain can also be caused by problems not linked to the cancer, such as an infection.

Your doctors and nurses will work with you to find out what is causing your pain and will talk to you about suitable treatments. There are effective ways to treat different types of pain.

Bone pain

If prostate cancer spreads to the bone, it can damage or weaken the bone and may cause pain. But not all men with cancer in their bones will get bone pain. Prostate cancer can spread to any area of bone around the body. It most commonly spreads to the spine. Pain in these areas can sometimes make it painful to walk and move around. The pain might remain in only one area, but over time it can spread to several parts of your body.

Bone pain is a very specific feeling. Some men describe it as feeling similar to a toothache but in the bones, or like a dull aching or stabbing. It can get worse when you move and can make the area tender to touch. Each mans experience of bone pain will be different. The pain may be constant or it might come and go. How bad it is can also vary and may depend on where the affected bone is.

Nerve pain

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