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Radiation Machine For Prostate Cancer

Meet Your Radiation Therapy Team

Radiation therapy for prostate cancer: What to expect

Your radiation therapy team is a group of healthcare providers. Their goal is to make your treatment as effective and comfortable as possible. This team includes:

Radiation Oncologist Dr. Selva is a radiation oncologist and medical director at the San Antonio Cancer Center. He treats more prostate cancer patients than any radiation oncologist in the city. This incredible expertise helps you get the best results. As the radiation oncologist, he will:

  • Lead the radiation therapy team
  • Create your customized radiation therapy regimen, which includes the amount of radiation and how the treatment will be delivered.
  • Closely monitor your progress throughout treatment.
  • Direct any care needed if you experience side effects from radiation therapy.

Radiation Physicist The radiation physicist makes sure the machine that delivers radiation is working properly. The machine is a linear accelerator. It moves around you to deliver precise doses of radiation.

Radiation Nurse The radiation nurse will assist you through your treatment process and interact with the rest of your radiation team.

Radiation Therapist The radiation therapist works with you during each treatment. He or she will make sure you have the proper position for treatment. They will also operate the linear accelerator to deliver the radiation.

Dosimetrist The dosimetrist is a professional that calculates the proper radiation doses

Active Surveillance And Watchful Waiting

If prostate cancer is in an early stage, is growing slowly, and treating the cancer would cause more problems than the disease itself, a doctor may recommend active surveillance or watchful waiting.

Active surveillance. Prostate cancer treatments may seriously affect a person’s quality of life. These treatments can cause side effects, such as erectile dysfunction, which is when someone is unable to get and maintain an erection, and incontinence, which is when a person cannot control their urine flow or bowel function. In addition, many prostate cancers grow slowly and cause no symptoms or problems. For this reason, many people may consider delaying cancer treatment rather than starting treatment right away. This is called active surveillance. During active surveillance, the cancer is closely monitored for signs that it is worsening. If the cancer is found to be worsening, treatment will begin.

ASCO encourages the following testing schedule for active surveillance:

  • A PSA test every 3 to 6 months

  • A DRE at least once every year

  • Another prostate biopsy within 6 to 12 months, then a biopsy at least every 2 to 5 years

Treatment should begin if the results of the tests done during active surveillance show signs of the cancer becoming more aggressive or spreading, if the cancer causes pain, or if the cancer blocks the urinary tract.

Effective Treatment To Target And Destroy Cancer Cells

Your prostate cancer team may recommend radiation therapy as part of your treatment plan. We often use radiation therapy alongside prostate cancer surgery to kill any remaining cancer cells, or if the prostate cancer has spread . We also can combine it with other treatments, such as chemotherapy.

or request an appointment online.

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How Well It Works

For someone with localized prostate cancer, radiation works about as well as surgery to treat the cancer. With either treatment, the chance of the cancer spreading is low.footnote 1

For someone with advanced prostate cancer, radiation is often combined with hormone therapy, chemotherapy, or other treatments. This can help to control cancer growth and provide longer survival.

Radiation therapy also works well to treat pain when prostate cancer has spread to the bone.

Will My Faecal Incontinence Get Better

New prostate cancer treatment at CentraState protects men from ...

There is no doubt that your poo related problems are having a significant impact on your life and mental strength. You may have noticed it negatively affecting your personal relationships, social life and desire to do the things you love. On top of this, much of your time getting out of the house will be spent with concern and meticulous planning around toilet visits. These factors can quickly take their toll on your quality of life and others around you, which makes it much more important to best prepare yourself and minimise its impact.

Unfortunately there is a degree of uncertainty regarding your ability to recover normal bowel control after radiotherapy due to the complexity of side effects and the reaction from each individual. With the research showing that symptoms can begin and persist long after treatment, it can seem like a doom and gloom scenario. Despite the scary statistics, you need to take a position of strength and control the things you can to combat faecal incontinence. Fortunately, the positives are that radiotherapy techniques are becoming more effective at treating the cancer and reducing its side effects.

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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.

How Common Is Recurrence

The recurrence of prostate cancer depends on when it was caught and treated the first time. If your doctor was able to remove the cancer while it was still confined in the prostate gland, your chances of recurrence are fairly low. If your cancer spread before treatment, such as in the case of about 10% of men, recurrence is more likely to occur. Recurrence, therefore, occurs if not all of the cancer cells were treated the first time or if the cancer was more advanced than originally believed.

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Does Msk Offer Proton Therapy For Prostate Cancer

Some men with prostate cancer may choose to receive another form of external-beam radiation therapy called proton therapy. Proton therapy can deliver a high radiation dose to the prostate while lowering the radiation dose to normal surrounding tissue. It is unclear if there is any advantage to proton therapy compared with IMRT. We are now studying how these approaches compare in terms of side effects and outcomes at the New York Proton Center. These efforts are being led by radiation oncologist Daniel Gorovets.

How Does Brachytherapy Work

Radiotherapy for Prostate Cancer – What to expect

Brachytherapy involves implanting small, permanent radioactive seeds or temporary needles into the cancerous prostate.

After you are identified as a good candidate for brachytherapy, an ultrasound is used to guide the placement of needles into the prostate. Depending on whether you and your doctor have chosen permanent/low-dose brachytherapy or temporary/high-dose brachytherapy, these needles are then used to either put in permanent seeds or temporary radiation sources.

Placement of seeds is a minimally invasive procedure and does not require incisions. Men undergoing the procedure can return to full activity in less than a week. This is done as an outpatient procedure before you begin treatment.

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What Is Brachytherapy For Prostate Cancer

In high-dose brachytherapy , a single radioactive source is temporarily placed in the prostate using catheters. Typically, the catheters are inserted in the morning in the operating room under general anesthesia, then a CT scan is obtained for treatment planning, and the 5 to 15 minute treatment takes place in the afternoon. A combination of a long-acting local anesthetic and other medications keep the patient comfortable until treatment delivery. The catheters are removed at the end of the treatment. Patients go home that day and are not radioactive.

The time and position of the radioactive source is carefully controlled to maximize the radiation dose to the prostate and minimize the dose to the urethra, rectum, and bladder.

HDR brachytherapy alone can be used to treat low-risk patients, and can be used as a boost for higher-risk patients receiving external beam radiotherapy. In select patients, HDR brachytherapy can be used to treat failures from LDR brachytherapy or external beam radiotherapy.

Siteman is the first and only medical center in the region to perform HDR brachytherapy for prostate cancer. More than 200 patients have received the treatment since our program opened in 2014.

Low Dose Rate Brachytherapy Implants

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 Are The Side Effects Of Prostate Radiation

Even though both external beam radiation and brachytherapy use the same radiation as the cure from the cancer cells, they have some common side effects.

  • Bowel problems: Radiation proctitis is a very common inflammation of the rectum that occurs as a result of the radiation treatment of prostate cancer where damage to the rectum was acquired. Proctitis can lead to diarrhea, with the 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. In order to minimize bowel problems, doctors will advise what kind of diet to follow during radiation therapy to help limit bowel movement during treatment.
  • Urinary problems: Radiation cystitis is the side effect of inflammation and subsequent destruction of the normal work of the urinary bladder at the cellular level after the usage of radiation in the treatment. Patients will feel the need to urinate more often, have a burning sensation while the urinate process, and/or find blood in the urine itself. Urinary problems usually improve over time, but in some men, they never go away.
  • Erection problems : Patience after the treatment, with radiation or through surgery, has the same rate of impotence level. These problems do not occur right after radiation therapy but are slowly developing over time. The effect of radiation treatment is more visible if the patient is elderly, where impotence is already on the low level.

External Beam Radiation Therapy For Cancer

RapidArc

External beam radiation therapy comes from a machine that aims radiation at your cancer.

External beam radiation therapy comes from a machine that aims radiation at your cancer. It is a local treatment, which means it treats a specific part of your body. For example, if you have cancer in your lung, you will have radiation only to your chest, not to your whole body.

External beam radiation therapy is used to treat many types of cancer.

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Which Approach Is Better: Active Surveillance Surgery Or Radiotherapy

The 10 year outcomes of the Prostate Testing for Cancer and Treatment trial from the United Kingdom has provided valuable insights into the management of localized PCa.4 The trial recruited 1643 men 50 to 69 years old. Of these 545 men underwent active surveillance, 553 surgery, and 545 radiotherapy. For the participants, the median follow-up was 10 years, the median age was 62 years, the median PSA was 4.6 , 77% were Gleason 6 and 21% were Gleason 7, and 76 % were T1c and the remaining T2. There were 17 prostate-cancerspecific deaths overall: 8 in the active surveillance group, 5 in the surgery group, and 4 in the radiotherapy group. The difference was not statistically significant among groups.

Metastases developed in more men in the active-monitoring group than in the surgery group or the radiotherapy group . Higher rates of disease progression were seen in the active-monitoring group than in the surgery group or the radiotherapy group . In summary, at a median of 10 years, prostate-cancerspecific mortality was low irrespective of the treatment assigned, with no significant difference among treatments. Surgery and radiotherapy were associated with lower incidences of disease progression and metastases than was active monitoring, while 44% of the patients who were assigned to active monitoring did not receive radical treatment and avoided side effects.5

Types Of Radiation Therapy For Prostate Cancer

The San Antonio Cancer Center uses the most advanced and precise methods of radiation therapy for prostate cancer.

External Beam Radiation Therapy EBRT uses beams of radiation from a machine outside the body to treat the prostate. Its used to try to cure early-stage cancers or relieve symptoms such as bone pain if cancer has spread to a specific area in a bone.

Intensity-modulated radiation therapy IMRT is an advanced type of EBRT. It uses a computer-driven machine that rotates around the patient to deliver targeted radiation. By modulating the intensity of the radiation beam, your therapy team is able to limit exposure to nearby healthy tissue. It also helps deliver higher doses of radiation directly to the cancer.

Stereotactic body radiation therapy SBRT is another type of EBRT. While it is in some ways similar to IMRT, it delivers a more intense, precise dose of radiation. SBRT usually requires fewer sessions and generally has fewer side effects.

Image-guided radiation therapy IGRT is an enhancement to IMRT that incorporates imaging techniques before each treatment session. There are different forms of IGRT. Cone Beam CT can visualize any soft tissue and On-Board Imaging can visualize bone. At our center, all IMRT treatments incorporate the use of the IGRT technology.

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Are You A Candidate

Whether your doctor recommends radiation depends on various factors, including your age, health, and personal preferences. The type of radiation is often dictated by your risk group and whether the cancer is localized or has spread.

Sometimes hormone therapy is given before radiation or along with it. ADT reduces levels of male hormones, called androgens, which can slow or even stop the cancers growth. Studies have found this one-two punch leads to higher survival rates than radiation alone among men with localized prostate cancer and a Gleason score of 7 or higher.

If you opt for surgery, your doctor may suggest radiation afterward, called adjuvant radiation therapy. “You have surgery to remove cancer, and then radiation to eliminate any remaining tumor deposits to keep cancer from returning,” says Dr. Anthony DAmico, a radiation oncologist with Harvards Dana-Farber Cancer Institute. Cancer that has grown beyond the prostate also may require post-surgery radiation.

After youve had radiation, youll have a prostate-specific antigen test every three to six months for five years and then annually after that to check for recurrence of the cancer. “If your PSA ever rises above 2, then imaging tests are done, and if needed, additional radiation or other appropriate treatment is given,” says Dr. DAmico.

Helping People Imagine Their Future

External Beam Radiation Therapy is a non-invasive treatment option for prostate cancer

The hardest thing we can do as physicians is help patients envision their future selves, Dr. Buyyounouski said. So patient-reported outcomes are very helpful, because you can tell patients exactly what side effects people had, and the frequency and bother of those side effects at points in time.

For many, he added, the trade-off in more side effects right after treatment will be worth it for a shorter treatment duration.

Unless youve been a patient, its hard for folks to imagine all the things that need to happen for somebody to go and get treatment every for weeks, Dr. Buyyounouski said.

Theres transportation costs, gas, parking, co-pays. And there are costs associated with the things youre not doing, like time away from work or responsibilities at home. Its more than just the medical bills.

I think people are itching to shorten the treatment because there are a lot of patients for whom its a barrier to getting treatment. And radiation therapy is a potentially curative treatment, added Dr. Citrin. So, making it easier for patients without increasing the long-term side effects is a huge win.

However, a less-intensive standard course of radiation will still likely appeal to some people, she added, especially if they are experiencing ongoing side effects from surgery.

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Video: What Is Radiation Therapy

Watch this short video to learn more about radiation therapy.

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.

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