Prostate Cancer Side Effects Of Radiotherapy

Side Effects And How To Manage Them

Radiation Therapy Side Effects for Prostate Cancer Patients

Your radiation doctors plan treatments very carefully to lessen side effects. While some patients have little or no side effects from radiation therapy, others feel some discomfort. Side effects are usually short-term and can be treated. No matter what type of therapy you receive, our doctors and nurses are skilled in helping to manage side effects.

Side effects most often start by the second or third week of treatment. They can last up to several weeks after your final radiation treatment. Many people who get radiation have some fatigue and skin reactions. Based on the area of your body being treated, you may also have some:

Most side effects go away within 12 months after you have finished radiation therapy.

The Success Rate Of Prostate Surgery

Survival rates can tell you how many people with the same type and stage of cancer are still alive 5 years after being diagnosed. For example, if you have stage 3 colon cancer, there is a 66% chance that 5 years later, you will be alive. But the rates cannot tell you how long you will live. However, they may help give you an idea of how likely your treatment will be successful.

Survival rates are estimates. They are based on data from many people who have had cancer before. These numbers might be confusing because they dont tell you what will happen, but they can help doctors decide treatments. Talk with your doctor to see if these statistics apply to you because they know about your situation.

A relative survival rate tells how likely a person is to survive a particular type of cancer. I.e., if the 5-year close survival rate for prostate cancer is 90%, it means that men who have this type of cancer are about 90% as likely as other men to live a minimum of 5 years after being diagnosed with the disease.

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Coping And Support For You And Your Family

Coping with the side effects of prostate cancer radiotherapy can be difficult. There are things you can do, and people who can help you and your family to cope.

Prostate cancer: diagnosis and managementNational Institute for Health and Care Excellence , 2019. Last updated December 2021
Long-term urinary adverse effects of pelvic radiotherapy.P Elliott, B Malaeb.World Journal of Urology, 2011. Volume 29, Pages 35-41
Secondary malignancies following radiotherapy for prostate cancerPetros and others

Low Dose Rate Brachytherapy Implants

Prostate Cancer Treatment Side Effects Comparison

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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What Do I Need To Do To Get Ready For My Imrt Treatment

Getting ready for IMRT takes a great deal of planning. It can take two to three days for your radiation therapy team to plan your care. After giving you a physical exam and reviewing your medical history, your radiation oncologist will use different tools to plan your treatment. These tools will help your radiation oncologist decide the dose of radiation you need for your prostate cancer and how long your treatment will last.

Your radiation oncologist may send you to have one or more imaging tests to help plan where the radiation beams will be aimed. The imaging tests your radiation oncologist will use to plan your treatment may include:

X-ray this test uses radiation to take a picture of the inside of your body. You may have seen a chest x-ray or x-ray pictures of your teeth or your bones.
CT Scan is a type of x-ray that uses a computer to make pictures of your prostate cancer and the area around your prostate. You may be given contrast through an I.V. in your arm or to drink by mouth. Contrast will help your prostate cancer show up better during the CT Scan.
MRI Scan is a test that uses a large magnet to make pictures of your prostate cancer and the area around your prostate.
PET Scan is a test where you are given contrast before you have x-rays taken. The contrast will travel to the parts of your body where your prostate cancer is active. The x-ray will give your doctor a better picture of what your prostate cancer looks like.

Getting Ready For IMRT

Vitamins And Dietary Supplements

Its OK to take a multivitamin during your radiation therapy, but dont take more than the recommended daily allowance of any vitamin or mineral.

Dont take any other dietary supplements without talking with a member of your radiation therapy team. This includes vitamins, minerals, and herbal or botanical remedies.

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Online Support Groups For Prostate Cancer

Us TOO. This organization has more than 200 support groups in the United States and abroad.
Prostate Cancer Research Institute. This website allows you to search for support groups by state.
Cancer Care. This site offers 15-week online support groups for people diagnosed with prostate cancer. Co-sponsored by the National Alliance of State Prostate Cancer Coalitions.
Male Care. This organization offers online support groups for people with prostate cancer and their partners or caregivers.
Imerman Angels. This support community offers one-on-one support with a mentor.

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What Is A Late Effect

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

A late effect is a side effect related to a cancer diagnosis or treatment that happens months to years after treatment. Some side effects that you develop during treatment can last for months to years after treatment is completed . These are often called long term side effects.

Late effects can be health issues or psychological, emotional and practical challenges.

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Stereotactic Body Radiation Therapy Or Stereotactic Ablative Radiotherapy

This type of therapy is used to deliver high doses of radiation to a precise area in the prostate using specialized techniques not achievable by standard conventional radiation therapy. This allows the total dose of radiation to be given in a shorter amount of time, usually 4 -5 treatments over 1 2 weeks rather than the several weeks used for other types of external radiation therapy.

The radiation beam needs to be extremely accurate in order to limit the side effects on healthy tissue. During treatment, the body immobilization used is often more restrictive than with IMRT due to the high doses of radiation. Fiducials, or internal prostate markers, are often used in this type of treatment.

Cyberknife and Truebeam are two types of LINACs used for SBRT treatment of prostate cancer.

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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The Side Effects Of Radiation Therapy For Prostate Cancer

There are a few side effects of radiation therapy for prostate cancer, like diarrhea and passing urine regularly.

These side effects often occur after one or two weeks of starting RT. The symptoms can worsen during treatment and after the treatment ends. But you can feel relief after two weeks of treatment.

The side effects that occur in one person may not come in another person. They can vary from person to person. The possible side effects of radiation therapy for prostate cancer are as follows:

When Is Radiation Treatment Used For Prostate Cancer

There are a number of circumstances in which radiation therapy is an appropriate method for treating prostate cancer:

In early or localized stages of the disease.
In combination with other treatment methods for cases that have spread.
As a method of preventing cancers return after surgery.
As a method for treating a recurrent cancer following remission.
As pain alleviation when the disease reaches an advanced state.

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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.

Are There Side Effects Of The Combination Approach

There is a slightly higher chance that patients who receive the combined therapy will have rectal irritation or urinary side effects. This is common with prostate cancer radiation therapy because the radiation can damage cells in the tissues surrounding the prostate. But at MSK, we routinely use sophisticated computer-based planning techniques that help us reduce the dose given to normal tissues such as the rectum, bladder, and urethra, lessening the chances of side effects and complications. We have also found that, when treating with the combined approach, using the high-dose-rate brachytherapy compared to low-dose-rate brachytherapy may have less in the way of side effects.

In addition, at MSK, we routinely use a rectal spacer gel, which we inject between the prostate and the rectum while the patient is under mild anesthesia, to create a buffer between these two tissues. By creating this space, we can further reduce the dose of radiation the rectum is exposed to. This leads to fewer side effects for the patient. The rectal spacer gel is biodegradable and dissolves on its own within the body after a few months.

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British Columbia Specific Information

You are considered a low-risk patient if you have a PSA value that is equal or less than 10 nanograms per millilitre , a Gleason score that is equal or less than 6, and your cancer stage is T1c/T2a. PSA is your prostate specific antigen measured by a blood test, the Gleason score indicates how aggressive the cancer is by looking at tissue biopsy results, and the cancer stage describes how much the cancer has spread.

Active surveillance has been developed to allow for careful management of men with low-risk prostate cancer. For more information, visit BC Cancer Agency Prostate.

Side Effects Of Radiation Therapy

Side Effects of Surgery Vs Radiation for Prostate Cancer

Compared to earlier radiation methods, these modern techniques reduce the chance of urinary and bowel problems.

With several treatment options available, your doctor will work with you to develop and oversee a treatment plan that precisely addresses your prostate cancer while minimizing the risk to surrounding tissues.

This is why it is important to choose an experienced radiation oncologist who specializes in the management of prostate cancer. High volume centers where practitioners have significant experience and treat large numbers of patients with prostate cancer may be associated with good outcomes and fewer lasting problems related to treatment. The majority of patients who undergo radiation do not have permanent effects on bowel or urinary function, and patients who develop erectile difficulty after these therapies can often be treated successfully with medications such as sildenafil or tadalafil.

Radical Prostatectomy vs. Radiation: How to Compare the Results

Making a decision about prostate cancer treatment is not easy. When considering radiation therapy or radical prostatectomy, one of your top concerns is seeking reassurance that your cancer will be cured following treatment.

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Video: What Is Radiation Therapy

Watch this short video to learn more about radiation therapy.

Understanding Radiation Therapy ebook1001kB

A/Prof Ian Vela, Urologic Oncologist, Princess Alexandra Hospital, Queensland University of Technology, and Urocology, QLD A/Prof Arun Azad, Medical Oncologist, Urological Cancers, Peter MacCallum Cancer Centre, VIC A/Prof Nicholas Brook, Consultant Urological Surgeon, Royal Adelaide Hospital and A/Prof Surgery, The University of Adelaide, SA Peter Greaves, Consumer Graham Henry, Consumer Clin Prof Nat Lenzo, Nuclear Physician and Specialist in Internal Medicine, Group Clinical Director, GenesisCare Theranostics, and Notre Dame University Australia, WA Henry McGregor, Mens Health Physiotherapist, Adelaide Mens Health Physio, SA Jessica Medd, Senior Clinical Psychologist, Department of Urology, Concord Repatriation General Hospital, NSW Dr Tom Shakespeare, Director, Radiation Oncology, Coffs Harbour, Port Macquarie and Lismore Public Hospitals, NSW A/Prof David Smith, Senior Research Fellow, Daffodil Centre, Cancer Council NSW Allison Turner, Prostate Cancer Specialist Nurse , Canberra Region Cancer Centre, Canberra Hospital, ACT Maria Veale, 13 11 20 Consultant, Cancer Council QLD Michael Walkden, Consumer Prof Scott Williams, Radiation Oncology Lead, Urology Tumour Stream, Peter MacCallum Cancer Centre, and Professor of Oncology, Sir Peter MacCallum Department of Oncology, The University of Melbourne, VIC.

View the Cancer Council NSW editorial policy.

Low Levels Of Vitamin B12

You might have low vitamin B12 after radiotherapy to the pelvis . This is called a vitamin B12 deficiency.

Radiotherapy can stop your digestive system from taking in vitamin B12 from the food you eat. This is called malabsorption. This means you can have a B12 deficiency even if you eat a balanced diet.

A B12 deficiency can be a cause of anaemia. This can lead to weakness, diarrhoea, numbness and tingling.

Its important that you go to your doctor if youre experiencing these symptoms so that they can help you.

What Is Stereotactic Body Radiation Therapy And What Advantages Does It Offer

Stereotactic body radiation therapy, or SBRT, involves the use of sophisticated image guidance that pinpoints the exact three-dimensional location of a tumor so the radiation can be more precisely delivered to cancer cells. Traditionally, external beam radiation has been delivered in anywhere from 45-48 sessions over multiple weeks. But large, randomized studies have shown that shorter courses of radiation are just as safe and effective. Therefore, at MSK, we have shortened all our radiation courses.

There is increasing interest in giving this radiation in very short courses of treatment using intense radiation doses, called hypofractionated radiation therapy. Many of the people we care for have a type of radiation therapy called MSK PreciseTM. This is a hypofractionated form of SBRT that can be given in five sessions. MSK has been doing this for the past 20 years, and the results in the several hundred people whove been treated have been excellent so far. The treatment is very well tolerated and quite effective

Because of its superior precision, MSK Precise can have fewer side effects than more conventional radiation techniques, with extremely low rates of incontinence and rectal problems. The sexual side effects are low, similar to what is experienced with more extended external radiation techniques. And of course, its much more convenient for patients.

What Should Patients Know About Msks Approach To Treating Prostate Cancer

Radiation Therapy For Prostate Cancer And Erectile Dysfunction

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.