Comparison Of The Leading Techniques Of Rp And Ebrt: Rarp Versus Vmat
A retrospective study has recently been published in Radiotherapy & Oncology, which reports comparative outcomes of RARP and VMAT, as the leading respective techniques of RP and EBRT . RARP is a novel, gold standard, surgical procedure for localized PC using the da Vinci Surgical System and has been reported to reduce blood loss complications and positive surgical margin rates, resulting in improved safety and feasibility . VMAT represents a sophisticated EBRT technique based on rotational IMRT, which delivers a highly conformal beam from a rotating radiation source to the target while avoiding risky organs such as the rectum in a short time, by computerized optimization. VMAT has been reported to reduce complications and improve oncological outcomes .
Seed Migration To The Kidneys And Batsons Vertebral Plexus Is Not Very Rare
The results of the present study show a total of four and five cases of seed migration to the kidneys and Batsonâs vertebral venous plexus, respectively, at only one institution, which suggests that such cases are not very rare. Meanwhile, in previous studies, a total of only four and four cases of seed migration to the kidneys and Batsonâs vertebral venous plexus, respectively, have been reported as rare cases, which is in disagreement with our conclusion . The same number or more cases of seed migration to these areas were found in our single study compared with all previous studies. A possible explanation is that, in the present study, orthogonal chest radiographs, an abdominal radiograph, and a pelvic radiograph were undertaken routinely to detect seed migration to the chest, abdomen, and pelvis at several time points after seed implantation. Moreover, in all patients who had seed migration to the abdomen and pelvis, a CT scan was undertaken to identify the exact location of the migrated seeds. Consequently, more cases of seed migration to the kidneys and Batsonâs vertebral venous plexus were found in the present study. We speculate that some seed migration to the kidneys and Batsonâs vertebral venous plexus might have gone undetected in other institutions.
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Possible Risks And Side Effects Of Brachytherapy
Radiation precautions: If you get permanent brachytherapy, the seeds will give off small amounts of radiation for several weeks or months. Even though the radiation doesnt travel far, your doctor may advise you to stay away from pregnant women and small children during this time. If you plan on traveling, you might want to get a doctors note regarding your treatment, as low levels of radiation can sometimes be picked up by detection systems at airports.
There’s also a small risk that some of the seeds might move . You may be asked to strain your urine for the first week or so to catch any seeds that might come out. You may be asked to take other precautions as well, such as wearing a condom during sex. Be sure to follow any instructions your doctor gives you. There have also been reports of the seeds moving through the bloodstream to other parts of the body, such as the lungs. As far as doctors can tell, this is uncommon and doesnt seem to cause any ill effects.
These precautions arent needed after HDR brachytherapy, because the radiation doesnt stay in the body after treatment.
Bowel problems: Brachytherapy can sometimes irritate the rectum and cause a condition called radiation proctitis. Bowel problems such as rectal pain, burning, and/or diarrhea can occur, but serious long-term problems are uncommon.
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For Prostate Seed Implantation Trust Experience And Skill
The outcome of implantation is highly operator-dependent. As such, it is important for the radiation oncologist to be experienced and proficient with this procedure. The physicians of Princeton Radiation Oncology are among the most experienced and have been instrumental in pioneering this treatment option.
Ebrt Or External Beam Radiation Therapy
The EBRT is a 10-minute radiation therapy where a single radiation beam treats the affected local area.
Pros
The main reason why most people undertake EBRT because of its painless treatment.
Few healthy cells are also destroyed, as the single beam is used to treat a specific area.
Cons
The patient undertaking EBRT would suffer from loose stools, frequent urination, and bleeding in the rectum area.
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What Are The Risks Of Surgery
Prostate surgery is associated with risks. It is common for men to experience one or more side effects after prostate surgeries. Some side effects are short-lived, while others persist for many years after surgery.
Common side effects of prostate surgeries are:
- Urinary complications, including painful urination, difficulty urinating, urinary incontinence. Most prostate cancer patients treated with surgery will experience urinary incontinence. This usually improves after four weeks. In some men, surgery-related urinary incontinence persists for many years.
- Erectile dysfunction, difficulty with getting, and maintaining an erection is frequent. More than 10% of men treated with prostate surgery develop erectile dysfunction. An injury to the nerves that control erection increases the risk of developing long-term erectile problems.
- and infertility occur in more than 90% of cases. This side effect occurs because radical prostatectomy removes the seminal vesicles .
- Lymphedema: Surgery can damage lymph nodes around the prostate gland, causing swelling and pain. Both can be improved with treatment.
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.
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Conditions Treated With Proton Therapy
Proton therapy is considered the most technologically advanced radiation delivery method for cancerous tumors. With this powerful, precise technology, tumors are more accurately targeted so healthy tissues and organs get less unnecessary radiation.
Proton therapy is commonly used to treat tumors in sensitive areas where traditional X-ray or photon radiation may not be the best option. Depending on your particular diagnosis, proton therapy may be a treatment option for cancers of the brain and central nervous system, breast, esophagus, head and neck, liver, lung, lymphatic system, eyes, pancreas, prostate, bone and others. It is particularly beneficial for many pediatric cancers.
Coping With The Side Effects
The side effects of both surgery and radiation can vary from mild to more severe and potentially significantly impact someones life.
The side effects of urinary and bowel problems can be distressing. There are ways to help manage these, such as with pelvic floor exercise, bladder training, and incontinence products. Other coping strategies include:
- Urinating every few hours
- Limiting caffeine intake
- Talking to your healthcare team about any medications or other interventions that may be helpful
Sexual dysfunction related to prostate cancer treatment can also be an unwelcome side effect. Helpful ways to cope with this can include:
- Having open communication with your partner
- Prioritizing activities for the day and taking breaks as needed
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Are Surgery And Radiation Therapy Ever Used Together
In some cases, your care team may use both surgery and radiation therapy as part of your prostate cancer treatment plan. Typically, radiation therapy is delivered after surgery to target remaining cancer cells or that came back. However, in some situations, doctors may recommend radiation therapy first to kill cancer cells in tissues near the prostate gland before performing the prostatectomy.
If Treatment Does Not Work
Recovery from cancer is not always possible. If the cancer cannot be cured or controlled, the disease may be called advanced or terminal.
This diagnosis is stressful, and for some people, advanced cancer may be difficult to discuss. However, it is important to have open and honest conversations with your health care team to express your feelings, preferences, and concerns. The health care team has special skills, experience, and knowledge to support patients and their families and is there to help. Making sure a person is physically comfortable, free from pain, and emotionally supported is extremely important.
People who have advanced cancer and who are expected to live less than 6 months may want to consider hospice care. Hospice care is designed to provide the best possible quality of life for people who are near the end of life. You and your family are encouraged to talk with the health care team about hospice care options, which include hospice care at home, a special hospice center, or other health care locations. Nursing care and special equipment, including a hospital bed, can make staying at home a workable option for many families. Learn more about advanced cancer care planning.
After the death of a loved one, many people need support to help them cope with the loss. Learn more about grief and loss.
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Over 17000 Men From Every Us State Chose The Same World Class Prostate Cancer Treatment
It is critical to research Prostate Cancer treatment options to make an informed decision that is best for you and your family. And, with few exceptions, your first treatment gives you the best chance for success.
ProstRcision® is a unique and highly effective Prostate Cancer Treatment. It is an alternative to Prostate Removal Surgery, and has a high proven success rate*.
*We strictly define success as having PSA below 0.2 ng/ml 15 years after treatment.
It’s important to know when you need to be screened for prostate cancer as well as understand the symptoms so that you can be an advocate for your health.
Fill out your information or call us at 678-607-6707 to:
- Receive your free prostate cancer screening and symptoms guide.
- Speak with a Board-Certified Radiation Oncologist or Registered Nurse at NO COST to get your questions answered.
What Is Radiation Therapy
Radiation is the strategic use of ionizing radiation or photons to kill cancer cells. It works by damaging the cancer cells DNA .The targeted cells die without growing or replicating themselves. Radiation therapy, like surgery, is very effective at killing localized or locally advanced prostate cancer and has the same cure rate as surgery.
Just as surgical skill can play an important role in determining outcomes from prostatectomy, the technical skill of your radiation oncologist can play an important role in radiation outcomes. When choosing a radiation oncologist, look for a physician who has broad experience with an assortment of approaches and can objectively help you decide on the best course of treatment.
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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.
Seed Therapy Offers Faster Recovery
There are a lot of advantages to the seed therapy, he tells WebMD. Its minimally invasive no cutting, no suturing. Youre discharged two hours later, with no physical restrictions. The procedure is well tolerated.
Prostate cancer surgery, on the other hand, can cause incontinence and impotence, Potters says.
John Blasko, MD, medical director of the Seattle Prostate Institute and discussant of Potters talk at the meeting, agrees seed implants for prostate cancer offer certain advantages: ease of treatment upfront, rapid return to normal activities, and lack of incontinence or impotence.
But, he says, prostate cancer surgery shouldnt be dismissed outright.
People have a choice, says Blasko, who is clinical professor of radiation oncology at the University of Washington in Seattle. Some men might prefer surgery because it offers answers upfront you know right then and there if the cancer was confined to the prostate.
Also, PSAblood levels, which rise when a man has prostate cancer, stabilize within a few days to weeks after surgery, while they can take years to normalize after seed therapy. This makes some people anxious, Blasko says. Surgery gives them psychological reassurance.
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What Are The Side Effects
Urinary symptoms are the most common side effects of the procedure. These symptoms include frequent urination and a need to get to the bathroom quickly. There might also be burning with urination and, in a few cases, an inability to empty the bladder completely. These symptoms can usually be managed with medicine, and improve over time. Temporary self-catheterization might be necessary to help drain the bladder if it cant be emptied adequately, but only about 5% of patients require it.
Urinary incontinence is rare in general. The risk might be somewhat increased in patients who have undergone a previous surgical procedure to remove a part of the prostate called a transurethral resection of the prostate . This risk can be minimized by performing a careful prostate ultrasound before the procedure to determine how much prostate tissue is still present to implant.
Rectal bleeding occurs in less than 1% of patients. Diarrhea is rare.
The impotence rate for those fully potent prior to the procedure at five years after the procedure is approximately 25% using brachytherapy alone. If hormone therapy is added, the impotence rate rises to 50%.
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A Brief History Of Prostate Treatment From Surgery To Radiation
Surgery has been the standard of care for prostate cancer for the past 150 years. Although effective, radical prostatectomies are invasive and not without complications. But then, shortly after the discovery of X-rays and radium at the turn of the last century, physicians began to explore how these modalities might improve survival and decrease potential side effects from the radical surgery. In 1917, Dr. Benjamin Barringer, chief of urology at what is now known as Memorial Sloan Kettering Hospital, espoused the use of radium needles for prostate cancer.
Initially, radioactive seed implantation was performed via free-hand technique, using direct visualization of the prostate to guide the radiation oncologist with seed placement. However, the results of this preliminary approach were hampered by suspect dose distribution in the prostate.
In 1987, Dr. John Blasko from Seattle described a reproducible system to implant radioactive iodine seeds in the prostate. This Seattle system employs a rectal ultrasound probe to directly visualize the prostate and a plastic template placed on the patients perineum . The template guides the placement of the needles that are loaded with radioactive seeds. This technique allows a reproducible, uniform dose distribution to the prostate.
At Princeton Radiation Oncology, our radiation oncologists have been performing the prostate seed procedure since 1997. We use the Seattle groups criteria for implant selection.
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Prostate Cancer: Radioactive Seed Implants
Radioactive seed implants are a form of radiation therapy for prostate cancer. Brachytherapy, or internal radiation therapy, are also terms used to describe this procedure. There are two types of prostate brachytherapy: permanent and temporary.
Compared to external radiation, which requires five to eight weeks of daily treatments, convenience is a major advantage of brachytherapy.
The Main Advantage Of Prostatectomy
This is a very important comment I am gonna make right now. If your cancer ever comes back after surgery, the idea of having a plan B of having low-dose radiation after surgery is feasible. If you start with radiation and cancer comes back, surgery would be very difficult and challenging. So, I want you to know this because not too many people are aware of this.
Again, one more time. If you start with surgery, you still have the radiation as an option. If you start with radiation, surgery would be very difficult because the tissue becomes like a cement attached to the rectum and the surrounding tissues and it would be very difficult to do that operation.
As you get older, because we have removed the prostate with the surgery, you do not have to worry about the old-man disease, an enlarged prostate. With radiation may be some consequences with bleeding from the rectum or bleeding from the bladder. Certainly, in the hands of an experienced radiation oncologist, the results are better. We have superb doctors at St. Francis Hospital. One of my colleagues, Dr. Jay Bosworth, whom I am looking forward to interviewing him at this program, is a fine radiation oncologist and you will have what to learn from him. So, the risks of side-effects in the hands of an experienced radiation oncologist would be less. But there is a small chance of having secondary cancers such as rectal cancer or bladder cancer at some point down the road after radiation.
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