What Are The Results Of Using Proton Therapy In Patients
For patients facing prostate cancer, treatments and side effects present unique challenges in choosing a therapy. Proton radiation for prostate cancer treats the disease with successful outcomes and a low risk of side effects.
For thousands with cancer of the prostate, proton therapy has offered an effective, virtually painless option for prostate cancer treatment. Since the University of Florida Health Proton Therapy Institute opened in 2006, thousands have undergone proton therapy for prostate cancer, and prostate cancer patients at the UF Health Proton Therapy Institute enjoy a close-knit community of fellow patients, caregivers and spouses. Today, prostate cancer is one of many types of cancer treated at the Institute.
Survivor Spotlight
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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.
How To Decide Between Radiation And Surgery For Localized Prostate Cancer
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, radiation therapy or surgery. If you arent comfortable with active surveillance, or if its not an advisable 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.
Weve heard of some physicians telling men of their prostate cancer diagnosis and asking them to make a treatment decision at the same appointment. But prostate cancer progresses slowly, so most men have time to think about their options and shouldnt feel pressured into making an immediate decision.
How you feel about the big three possible side effects of treatmenturinary incontinence, sexual dysfunction and bowel healthmay be the deciding factor for you.
To help you through the process of making this decision, this article covers:
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Will I Need To See My Doctor After My Imrt Treatment Is Over
Once your IMRT is finished, it is important for you to have regular visits with your doctor to check how well your treatment is working and to deal with any side effects that you may have. Your doctor will want to see you every three to four months for two to three years. Your doctor will schedule your appointments and order any tests you need to make sure you have the best follow-up care possible. Dont be afraid to ask about any tests or treatments that your doctor orders. Use these appointments to learn about the things you need to do to take good care of yourself following your prostate cancer treatment. .
Helping Yourself After Your IMRT Treatments.
- When do you need to see your doctor or health care team?
- How can you reach your doctor or health care team?
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Prostate Cancer Treatment: Radiation Therapy
Radiation, focused as a beam, can be used to kill cancer cells, especially those cells that have migrated from the prostate gland. Beams of radiation can be used to reduce bone pain caused by invasive cancer cells.
Low Dose Rate Brachytherapy
In another type of radiation therapy termed low dose rate brachytherapy, radioactive pellets about the size of a grain of rice are inserted into the prostate.
High Dose Rate Brachytherapy
High dose rate brachytherapy applies more radioactive sources temporarily into the cancerous prostate gland.
Both methods have side effects that can include erectile dysfunction, urinary tract problems, diarrhea, and other side effects.
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External Beam Radiation Therapy
In EBRT, beams of radiation are focused on the prostate gland from a machine outside the body. This type of radiation can be used to try to cure earlier stage cancers, or to help relieve symptoms such as bone pain if the cancer has spread to a specific area of bone.
You will usually go for treatment 5 days a week in an outpatient center for at least several weeks, depending on why the radiation is being given. Each treatment is much like getting an x-ray. The radiation is stronger than that used for an x-ray, but the procedure typically is painless. Each treatment lasts only a few minutes, although the setup time getting you into place for treatment takes longer.
Newer EBRT techniques focus the radiation more precisely on the tumor. This lets doctors give higher doses of radiation to the tumor while reducing the radiation exposure to nearby healthy tissues.
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Prostate Cancer: Radiation Therapy
Radiation therapy, also called X-ray therapy, uses high levels of radiation to kill prostate cancer cells or keep them from growing and dividing while minimizing damage to healthy cells.
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.
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What The Results Showed
After five years, there were no significant differences in survival associated with any of the selected treatments. Just one man in the favorable risk category died from prostate cancer during the study, and there were eight deaths from the disease in the unfavorable risk group.
Many men in the study had initial problems with sexual, bowel, urinary, and hormonal functioning. Brachytherapy caused more irritative urinary problems during the initial six months than the other treatments, but then those symptoms steadily improved. Brachytherapy and EBRT were associated with minor bowel symptoms such as urgency, bleeding, frequency, and pain that resolved within a year in men from both risk groups.
Dr. Marc Garnick, Gorman Brothers Professor of Medicine at Harvard Medical School and Beth Israel Deaconess Medical Center, and editor in chief of HarvardProstateKnowledge.org, agreed the study provides a valuable resource that adds to existing information. Yet he cautioned against brachytherapy, warning that this particular treatment in some cases has long-term urinary side effects that can significantly alter a patients quality of life. I do not routinely recommend brachytherapy, Garnick said. This is especially true in patients with a pre-existing history of urinary tract infections or prostatitis.
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More Information And Support
Brachytherapy and its effects can have a huge impact on your physical and emotional wellbeing. You may be dealing with the effects of other treatments, such as chemoradiation, as well as continuing to process a cervical cancer diagnosis and all that can bring.
Your healthcare team, both at the hospital and at your GP surgery, are there to support you with any questions or worries you have. Remember that we are here for you too, whether you are waiting for radiotherapy, in the middle of treatment, or years past it. Our trained volunteers can listen and help you understand whats going on via our free Helpline on 0808 802 8000.
Sometimes connecting with others who have gone through a similar experience can be helpful. Our online Forum lets our community give and get support. You can read through the messages or post your own whichever feels most comfortable.
If you have general questions about the effects of brachytherapy, 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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What Are The Side Effects
Like all treatments, HDR brachytherapy can cause side effects. These will affect each man differently, and you may not get all the possible side effects. Before you start treatment, talk to your doctor, nurse or radiographer about the side effects. Knowing what to expect can help you deal with them.
You may have more side effects if you have HDR brachytherapy and external beam radiotherapy together although this doesnt always happen. External beam radiotherapy can cause side effects months or even years after treatment.
You might also get more side effects if you had problems before treatment. For example, if you already had urinary, erection or bowel problems, you may find these are worse after HDR brachytherapy.
Tiredness and fatigue
You may feel tired for the first few days after treatment as you recover from the anaesthetic. The effect of radiation on the body may make you feel tired for longer, especially if you are on hormone therapy as well. If you are getting up a lot during the night to urinate, this can also make you feel tired in the day.
Fatigue is extreme tiredness that can affect your everyday life. It can affect your energy levels, your motivation and your emotions.Fatigue can continue after the treatment has finished and may last several months.
If you are also having external beam radiotherapy, this can also cause tiredness.
There are things you can do to help manage fatigue. Read more about fatigue and managing fatigue. Or contact our Specialist Nurses.
High Dose Rate Brachytherapy
How it works
This is a form of brachytherapy using a single high energy radioactive source to deliver a high dose to the prostate over a short time. It is nearly always used in addition to external beam radiotherapy as a boost, enabling a higher dose to be delivered to the prostate cancer.
Who is suitable?
This treatment may be used for men with higher risk prostate cancers.
What are the benefits and side effects?
The main advantage of HDR brachytherapy is that it delivers a higher dose directly inside the prostate than can typically be delivered with external beam radiation therapy alone. It is usually part of a package of treatment that includes external beam radiation therapy.
The side effects include temporary bladder irritation and bruising from the needles. In the long term the treatment risks are similar to external beam radiotherapy. There is a slightly higher risk of urethral scarring and bladder irritation in the long term.
What is the procedure for treatment?
This procedure requires patients to have either a spinal or general anaesthetic and spend up to 24 hours in hospital without getting out of bed.
Results of HDR brachytherapy
Results of HDR brachytherapy in terms of long-term cure/control of prostate cancer are at least as favourable as external beam radiation therapy or surgery .
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When Can Hdr Brachytherapy Be Used
HDR brachytherapy is primarily used to enhance external prostate cancer radiotherapy, but it is also used as the monotherapy for prostate cancer.
HDR brachytherapy can be used as monotherapy for local low-risk prostate cancers. When it comes to medium-high-risk and high-risk cancers as well as locally advanced prostate cancers, the combination of external radiotherapy and HDR therapy appears to be particularly effective, while the recurrence of cancer in the prostate gland is considerably less likely and the probable appearance of metastases is smaller compared with mere external radiotherapy or surgery.
Even though the radiation dose level in HDR brachytherapy is very high, the external healthy tissues, such as the bladder or the rectum, will be spared from adversely high doses of radiation, as it is possible to deliver the high radiation dose directly to the prostate area only. Consequently, it is possible to minimise the adverse effects. This also explains why there is hardly any reason for active follow-up for low-risk prostate cancer.
HDR brachytherapy may also be combined with other treatments for metastatic prostate cancer.
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
- 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
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New Gel Reduces Side Effects Of Prostate Cancer Treatment
Tuesday, January 23, 2018
Radiation therapy is a popular and effective treatment for many men with prostate cancer, and now a temporary gel offers greater protection for organs at risk during treatments.
Treating prostate cancer with radiation therapy can cause unintended injury to adjacent, healthy tissue, which can lead to bowel and urinary problems, as well as erectile dysfunction, said Daniel Krauss, M.D., a Beaumont radiation oncologist who specializes in radiotherapy for prostate and bladder cancers. There is now a new technique in which a temporary gel is injected through a small needle between the prostate and rectum. The gel pushes the rectum farther from the path of the radiation treatment beam. Harmful rectal doses of radiation can be almost nil.
The minimally invasive gel technique is now available at Beaumont Hospital, Royal Oak for men having radiation therapy for prostate cancer.
The absorbable gel, called SpaceOAR hydrogel, creates a barrier and separates the rectum and the prostate to protect the rectum and reduce injury during radiation treatments. Patients who choose the new gel technique, receive a local or general anesthesia in an outpatient setting. The gel is injected as a liquid and then solidifies, remaining in place for three months during prostate radiotherapy. It then liquefies, is absorbed by the body and cleared in the patients urine.
What Should Patients Know About Msks Approach To Treating Prostate Cancer
At MSK, we manage prostate cancer in a very comprehensive way, tailored to each patients disease. There is no one specific therapy that is best for everyone.
Our initial assessment includes a carefully evaluated biopsy and a very detailed MRI to show the location of the disease, the integrity or soundness of the capsule surrounding the prostate, and the amount of disease. We will often obtain next-generation imaging and do genomic testing. Then, based on that information and with input from the urologist, the radiation oncologist, and the medical oncologist we can provide a comprehensive recommendation.
The radiotherapy we do here at MSK is state-of-the-art and unparalleled. We are one of the few centers in the world to do MRI-based treatment planning and one of the few centers in the US to offer MRI-guided treatment. When we give brachytherapy, we use computer software that provides us with real-time information about the quality and accuracy of the seed implant during the procedure. It requires a great deal of collaboration with our medical physics team to try to get the most accurate positioning of the prostate during the actual three or four minutes of the treatment.
We make adjustments while the patient is still under anesthesia, so that when the procedure is completed, we have been able to achieve ideal placement of the radiation seeds. This translates into improved outcomes.
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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.