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Prostate Removal After Radiation Therapy

Management Of Erectile Dysfunction

Doctor Explains Radiation for Rising PSA after Prostate Cancer Surgery

About 75% of men who undergo nerve-sparing prostatectomy or more precise forms of radiation therapy have reported successfully achieving erections after using these drugs. However, they are not for everyone, including men who take medications for angina or other heart problems and men who take alpha-blockers.

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.

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Treating Prostate Cancer That Doesnt Go Away Or Comes Back After Treatment

If your prostate-specific antigen blood level or another test shows that your prostate cancer has not been cured or has come back after the initial treatment, further treatment can often still be helpful. Follow-up treatment will depend on where the cancer is thought to be and what treatment you’ve already had. Imaging tests such as CT, MRI, or bone scans may be done to get a better idea about where the cancer is.

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Side Effects Of Prostate Radiation

Side effects of prostate radiation is an important topic, which many doctors and their patients have to discuss before proceeding to the procedure further on. In most cases, radiation treatment for prostate cancer has the same side effects as brachytherapy . But its important to keep in mind that every person will have different side effects from the same procedure and health in general.

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Urinary And Bowel Changes

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Radiation therapy can cause permanent urinary and bowel changes. Many people dont notice any changes or have any symptoms. However, some people have late side effects.

Late side effects may be similar to the ones you had during treatment. Theres a very small chance you may develop other side effects. For example:

  • The opening of your bladder may become narrower.
  • You may lose your ability to control your bladder.
  • You may have blood in your urine.
  • You may have bleeding from your rectum.
  • Your rectum may be injured.

These side effects are rare. They may come and go over time or be persistent and chronic. Your healthcare team will help you manage them.

Even if you dont develop any late side effects, remember that the tissues in your bladder and rectum were affected by your radiation therapy. Call your radiation oncologist if you:

  • Have any new urinary, bladder, or bowel symptoms.
  • Need to have a colonoscopy. Avoid having a colonoscopy for the first year after radiation therapy.
  • Need any type of urological or rectal procedure.

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How Can I Help Myself

Urinary problems can affect your self-esteem and independence, and affect your work, social and sex life.

Making some changes to your lifestyle may help, and there are some practical steps that can make things easier.

  • Try to drink plenty of fluids, but cut down on fizzy drinks, alcohol, tea and coffee as these may irritate the bladder
  • Do regular pelvic floor muscle exercises to help strengthen the muscles that control when you urinate.
  • Try to stay a healthy weight. Being overweight can put pressure on your bladder and pelvic floor muscles.
  • If you smoke, try to stop. Smoking can cause coughing which puts pressure on your pelvic floor muscles. NHS Choices has more information about stopping smoking
  • Plan ahead when you go out. For example, find out where there are public toilets before leaving home.
  • Pack a bag with extra pads, underwear and wet wipes. Some men also find it useful to carry a screw-top container in case they cant find a toilet.
  • Get our Urgent toilet card to help make it easier to ask for urgent access to a toilet.
  • Disability Rights UK runs a National Key Scheme for anyone who needs access to locked public toilets across the UK because of a disability or health condition.
  • If you often need to use the toilet at night, leave a light on in case youre in a hurry, or keep a container near your bed.

What To Expect After Radiation Treatment For Prostate Cancer

What to Expect After Radiation Treatment for Prostate Cancer? Many patients wonder what to expect after receiving radiation treatment for prostate cancer. It is the most widely used method of treatment regardless of the cancers stage. Radiation therapy can be followed by a radical prostatectomy, which removes the prostate gland and nearby lymph nodes.

Prostatecancer is the most diagnosed solid tumor type among men. In the early stages ofprostate cancer, indolent cases without major symptoms will receive activesurveillance and watchful waiting to observe how the disease progresses. If thecancer spreads outside of the prostate gland, other treatment options areconsidered, the first of which being radiation.

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When Is Radiation Therapy Used

There are some instances where the practitioners opt for radiotherapy for prostate cancer as opposed to other forms of treatment. Here are some of the situations in which radiation therapy may be used:

  • As the first treatment of cancer, which is still confined to the prostate gland.
  • It is used along with hormone therapy during the first treatment for prostate cancer that has extended the nearby tissues.
  • After the reoccurrence of cancer in the area, it was before surgery.
  • To keep cancer under control and relieve you from the symptoms for as long as possible if the cancer is advanced.

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Sexual And Reproductive Health

What to Expect after Radiation Therapy for Prostate Cancer

You can be sexually active during your radiation therapy, unless your radiation oncologist gives you other instructions. You wont be radioactive or pass radiation to anyone else.

If youre sexually active with someone whos able to get pregnant, its important to use birth control during and for 1 year after your radiation therapy. During your radiation therapy, your sperm may be damaged by the radiation. If you conceive a baby with this sperm, the baby might have birth defects. Using birth control helps prevent this.

For more information about your sexual health during cancer treatment, read Sex and Your Cancer Treatment. The American Cancer Society also has resources about sexual health issues during cancer treatment. The one for men is called Sex and the Adult Male with Cancer. You can search for it at www.cancer.org or call for a copy.

Male Sexual and Reproductive Medicine Program

MSKs Male Sexual and Reproductive Medicine Program helps people address the impact of their disease and treatment on sexual health. You can meet with a specialist before, during, or after your treatment. We can give you a referral, or you can call for an appointment.

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What Are The Side Effects Of Brachytherapy

  • Frequent urination or urinary retention or burning with urination
  • Erectile dysfunction
  • Urethral stricture or narrowing of the urethra
  • Diarrhea or blood in the stool
  • Secondary cancers

For the short time that the seeds are giving off larger amounts of radiation, you should avoid close proximity to children or pregnant women. Make sure to talk with your radiation oncologist or oncology nurse for instruction about radiation safety and exposure for family members or pets.

If you are traveling through an airport following brachytherapy treatment, there is a chance that radiation detectors will be set off. Talk to your radiation oncologist and ask for a note to indicate youve just had radiation treatment.

Defining Patients At Risk After Radical Prostatectomy

Accurate risk characterization could result in an appropriate management of post-RP patients. However, the optimal post-operative approach to these patients is a subject of continuous debate because the risk definition after RP relies on clinical, pathological features and PSA kinetics. Furthermore, the choice of treatment should be tailored according to prognostic factors and/or risk stratification.

Up to one-third of patients treated with RP may have adverse pathologic features , defined as positive surgical margins, extra-prostatic extension, seminal vesicle invasion, and/or lymph node invasion and high Gleason score.

Only patients with at least two of the following pathologic features are at higher risk of cancer specific mortality and may significantly benefit from adjuvant treatment after RP: pathologic Gleason score 8, pT3/pT4 disease, and the presence of nodal disease .

In the study of Abdollah et al. men with low-volume nodal disease , ISUP grade 25 and pT34 or R1, as well as men with 3 to 4 positive nodes were more likely to benefit from RT after surgery, while the other subgroups did not .

However, the level of evidence for the management of pN1 patients is still low .

The most sensitive and the only validated biomarker for disease persistence and recurrence remains PSA and PSA-based parameters . Persistent PSA is defined in the majority of studies as detectable post-RP PSA of 0.1 ng/mL within 4 to 8 weeks of surgery and occurs in 520% of men after RP .

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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.

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Are There Side Effects Of Radiation Therapy For Prostate Cancer Treatment

Dr Swati Shah

There are common types of side effects that result from the use of radiation therapy and treatment of prostate cancer some of these include sexual dysfunctions, bowel problems as well as urinary issues.

Urinary leaking, low sexual drive and bowel problems such as loose stools and diarrhea are the reported side effects of radiation therapy for prostate cancer. The best thing is that these are just temporary issues that are resolved after the completion of the treatment.

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What Determines Erection Recovery After Surgery

The most obvious determinant of postoperative erectile dysfunction is preoperative potency status. Some men may experience a decline in erectile function over time, as an age-dependent process. Furthermore, postoperative erectile dysfunction is compounded in some patients by preexisting risk factors that include older age, comorbid disease states , lifestyle factors , and the use of medications such as antihypertensive agents that have antierectile effects.

Chemotherapy Drugs For Prostate Cancer

The drugs listed above are only a sample of what is available and is used to illustrate a truth. Because of the range and variety of drugs used in both these treatments the impact on sexual function can range from sever to insignificant.

Hormone replacement therapy for prostate cancer, for example, can often impact sex drive rather that create erectile dysfunction. It is important to work with your physician to explore all available treatment options. How to keep a healthy erection?

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Side Effects Of Treatment

Treatments for prostate cancer can cause side effects, which might carry on after your treatment has finished. Some side effects can even start several months or years after treatment finishes.

Side effects will affect each man differently you may not get all the possible side effects from your treatment.

Read more about:

Managing side effects

Side effects can affect your day-to-day life, but there are treatments for them, as well as things you can do to manage them yourself. Its important to speak to your doctor, nurse or GP about them.

If youre having problems with a side effect, you might have a meeting with your doctor or nurse to work out what support you need. They may refer you to someone who can give you more advice and support.

Read more about managing the side effects of prostate cancer treatment.

Treating Advanced Prostate Cancer

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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.

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Management Of Bowel Dysfunction

Short of treating individual symptoms as needed, there are few, if any, treatment options for bowel dysfunction following radiation therapy. Laser therapy can stop rectal bleeding caused by radiation. Anti-diarrheal agents can help with loose bowel movements. Increasing fiber intake through whole grains, fruits and vegetables, or fiber supplements can also help.Avoiding foods that might irritate the gastrointestinal tract is important, but complete elimination of fibrous, bulky foods can lead to constipation and straining, which in turn can exacerbate rectal bleeding.

If I Choose Radiation Therapy Will Surgical Treatment Still Be An Option

If radiation therapy is used as the primary treatment, and the treatment is not successful, surgery or repeat radiation therapy are not considered to be desirable treatments due to the high risk of serious complications. It is important to note that the cure rates for surgery and radiation are similar. Therefore, you may have the same risk of cancer recurring if surgery is performed. If surgery is performed after radiation, or additional radiation is recommended, the physician performing the re-treatment should have a high level of experience. There are experimental clinical studies being evaluated for use of very localized re-irradiation for this group of patients. Some patients for which radiation is not effective are treated by systemic therapy or by close surveillance.

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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.

Analysis Of Missing Data

Complications of Prostate Cancer Treatment: Spectrum of Imaging ...

Table shows the reasons for nonresponse to the 5-year survey by treatment group. Overall, statistically significantly fewer men in the external beam radiotherapy group than in the radical prostatectomy group completed the 5-year survey . However, differences between treatment groups in the specific reasons for nonresponse were relatively small for example, 7% of radical prostatectomy patients had died compared with 11% of external beam radiotherapy patients. Refusal was the leading reason for nonresponse.

We further evaluated the possible effects of differential response levels by age at diagnosis on our reported outcomes by performing a last value forward analysis on urinary, bowel, sexual, and general health outcomes. We used data from the 2-year survey or from the 12- or 6-month surveys to estimate outcomes at 5 years after diagnosis. The impact of estimating outcomes on the reported comparisons was negligible.

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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

When Is Brachytherapy Alone The Right Choice

For a patient with disease that is confined to the prostate and not too aggressive, brachytherapy alone is a good option. With the use of sophisticated real-time computer-based planning, we can use brachytherapy to deliver radiation in an extraordinarily precise way, with minimal exposure to the surrounding normal tissues. It is also convenient for the patient as it is done in an outpatient setting and most people are able to get back to work the next day.

But brachytherapy is not right for everyone. For some patients with less-aggressive disease, a watch-and-wait approach would also be very reasonable. At MSK, our philosophy is that when the disease is caught very early meaning a low PSA level, or nonaggressive disease as reflected by a Gleason score of 6 with evidence of cancer in only a few of the biopsy samples and no evidence from the MRI of a significant amount of disease then it would be very appropriate to do active surveillance and hold off on treatment.

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