Radiation Markings For Prostate Cancer

How Should You Prepare For Fiducial Marker Placement

Prostate Cancer Radiation Fiducial Marker and SpaceOAR Gel Procedure ABS Virtual Reality (360 VR)

When prepping to have your fiducial markers placed you will be asked to do a few things. They may include:

Stopping certain medications. Examples: Aspirin, ibuprofen, steroids, vitamin E, or blood thinners. Make sure your provider is aware of all medications and supplements you are taking.
Doing an enema to clean out your bowels the morning of your procedure.
On the day of your procedure, you may need to take an antibiotic to prevent infection.
You can usually eat and drink like normal on the day of your procedure.

The prep needed depends on where your fiducials markers are being placed. Your provider will talk to you about the specific prep you need to do.

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Another type of prostate issue is chronic prostatitis, or chronic pelvic pain syndrome. This condition causes pain in the lower back and groin area, and may cause urinary retention. Symptoms include leaking and discomfort. In severe cases, a catheter may be required to relieve the symptoms. If the problem is unresponsive to other treatments, your doctor may suggest a surgical procedure. If these do not work, your symptoms could progress and become chronic.

An acute bacterial infection can cause a burning sensation. Inflammation of the prostate can affect the bladder and result in discomfort and other symptoms. This is the most common urinary tract problem in men under 50, and the third most common in men over 65. The symptoms of acute bacterial prostatitis are similar to those of CPPS. Patients may experience a fever or chills as a result of the infection.

Prevalence Of Bowel Symptoms

Diarrhoea was the most prevalent symptom during the acute phase, 76% in the NIG and 69% in the SCG reported at least quite a bit of diarrhoea .4). Other symptoms rated quite a bit during the acute phase were limitations to daily activities due to bowel symptoms and bloated abdomen. Bloated abdomen was also the most common symptom during the late phase. Blood in stools was less prevalent in the NIG compared with the SCG during the acute and the late phase. There were no differences between the groups regarding the self-reported data on other bowel symptoms, or use of medication due to bowel symptoms during or after RT .

The Evolution Of Radiation Treatment Options For Prostate Cancer

From Dr. Holly Campbell, BSc, MD, FRCPC

As a radiation oncologist, I am never bored. I have the privilege of working with a great team of smart and motivated people and the privilege of meeting many interesting patients and their families.

There are constant and rapid advances in radiation treatment planning, the technology available and treatment delivery. I see constant evolution of technology in imaging patients tumors, image guidance for accurate treatment delivery, improvements in treatment delivery and improvements in quality of life after treatment.

Five years ago, we were treating localized prostate cancer with up to 39 daily treatments of radiation. With the development of our new stereotactic body radiation therapy program, eligible patients have the option of receiving radiation over five treatment days.

It is very exciting that we now have the ability to offer SBRT at Horizons Saint John Regional Hospital. We are the first oncology centre in Atlantic Canada to offer this treatment and we are helping our colleagues in Halifax develop their program.

Not long ago we used X-ray images of pelvic bones to target the prostate. This evolved into using daily small CT scans through the pelvis and now, in addition to daily CT scans, we can use gold markers called fiducial markers implanted in the prostate to accurately target the prostate throughout treatment and to stop treatment if there is any movement of the patient or prostate.

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How To Prepare For Your Procedure

If youre scheduled to have fiducial markers inserted before starting radiation, your care team will let you know exactly how to prepare.

Before your fiducial marker insertion:

Inform your care team about any allergies or medical conditions you have and all prescription and over-the-counter medicines and supplements you take. Due to the risks of radiation, be sure to tell your doctor if theres a possibility that youre pregnant.
Your care team may ask you to temporarily stop taking certain prescription and over-the-counter medications the week before the procedure, such as blood thinners, aspirin and ibuprofen.
You may be prescribed an antibiotic to take on the day of the procedure. This is intended to help lower your chance of infection.
You can go about your day normally and eat meals, because fasting isnt required for this procedure.
Its a good idea to arrange for someone to take you home after the procedure.

When you arrive, youll be asked to remove your jewelry, glasses and clothing and change into a hospital gown, as this prevents interference with the X-ray machines.

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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Will Radiation Therapy Make Me Tired

Everyone has their own energy level, so radiation treatment will affect each person differently.

People often feel fatigue after several weeks of treatment. For most, this fatigue is mild. But some people lose a lot of energy and need to change their daily routine.

If your doctor thinks you should limit how active you are, theyâll discuss it with you.

To minimize fatigue while youâre receiving radiation treatment:

Get enough rest.
Pace yourself, and plan rest breaks throughout your day.

External Beam Radiation Therapy

What to Expect Before Starting Radiation Treatment for Prostate Cancer

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.

How Will I Know If My Procedure Was Successful

After an X-ray, your doctor should be able to determine that the markers were inserted correctly into the body. Once your first course of radiation is scheduled, the markers will be used by your radiation oncologist to plan your treatment.

If you have any questions or concerns about your upcoming radiation treatment or your fiducial markers, your care team is always there to help.

Expert cancer care

*recipe For Black Bean And Corn Soup

28-ounce can of low-sodium crushed tomato and basil
8 ounces of low-sodium tomato juice
16-ounce can of rinsed black beans
16-ounce can of rinsed white beans
16-ounce can of rinsed kidney beans
16-ounce can of sweet corn
1 teaspoon of dry oregano
½ teaspoon of rosemary
½ teaspoon cracked red pepper flakes

Mix ingredients in a large pot and bring to a boil. Turn down heat and let simmer for 10 minutes. Serves 4.

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Power Analysis And Randomisation

A 5-point change in the European Organisation for Research and Treatment of Cancer quality-of-life questionnaire scales is considered clinically significant . Given a mean difference of five in bowel symptoms between groups, and using a standard deviation of 9.4 from previous research , the effect size was calculated to 0.53. To reach a power of 80%, with our estimated effect size and a 0.05 significance level, 57 patients in each group were required. Expecting an attrition rate of approximately 30% due to the extensive follow-up period, we decided to include 90 patients in each group. Patients were stratified by radiation technique and site, and randomly assigned to a nutrition intervention group or a standard care group . Randomisation was performed by two persons unrelated to the trial, using the Efrons biased coin design .

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Some Cancer Patients Try Special Diets To Improve Their Prognosis

Fiducial Marker Implantation in Prostate Radiation Therapy

Cancer patients may try special diets to make their treatment work better, prevent side effects from treatment, or to treat the cancer itself. However, for most of these special diets, there is no evidence that shows they work.

Vegetarian or vegan diet

It is not known if following a vegetarian or vegan diet can help side effects from cancer treatment or the patients prognosis. If the patient already follows a vegetarian or vegan diet, there is no evidence that shows they should switch to a different diet.

Macrobiotic diet

A macrobiotic diet is a high-carbohydrate, low-fat, plant-based diet. No studies have shown that this diet will help cancer patients.

Ketogenic diet

A ketogenic diet limits carbohydrates and increases fat intake. The purpose of the diet is to decrease the amount of glucose the tumor cells can use to grow and reproduce. It is a hard diet to follow because exact amounts of fats, carbohydrates and proteins are needed. However, the diet is safe.

Several clinical trials are recruiting glioblastoma patients to study whether a ketogenic diet affects glioblastoma tumor activity. Patients with glioblastoma who want to start a ketogenic diet should talk to their doctor and work with a registered dietitian. However, it is not yet known how the diet will affect the tumor or its symptoms.

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What Happens Before Radiation Therapy Treatment

Each treatment plan is created to meet a patientâs individual needs, but there are some general steps. You can expect these steps before beginning treatment:

Meeting with your radiation oncologist. The doctor will review your medical records, perform a physical exam, and recommend tests. You will also learn about the potential risks and benefits of radiation therapy. This is a great time to ask any questions or share concerns you may have.

Giving permission for radiation therapy. If you choose to receive radiation therapy, your health care team will ask you to sign an âinformed consentâ form. Signing the document means:

Your team gave you information about your treatment options.
You choose to have radiation therapy.
You give permission for the health care professionals to deliver the treatment.
You understand the treatment is not guaranteed to give the intended results.

Simulating and planning treatment. Your first radiation therapy session is a simulation. This means it is a practice run without giving radiation therapy. Your team will use imaging scans to identify the tumor location. These may include:

Depending on the area being treated, you may receive a small mark on your skin. This will help your team aim the radiation beam at the tumor.

You may also be fitted for an immobilization device. This could include using:

Radiation therapy is used for:

Cancer That Clearly Has Spread

If the cancer has spread outside the prostate, it will most likely go to nearby lymph nodes first, and then to bones. Much less often the cancer will spread to the liver or other organs.

When prostate cancer has spread to other parts of the body , hormone therapy is probably the most effective treatment. But it isnt likely to cure the cancer, and at some point it might stop working. Usually the first treatment is a luteinizing hormone-releasing hormone agonist, LHRH antagonist, or orchiectomy, sometimes along with an anti-androgen drug or abiraterone. Another option might be to get chemotherapy along with the hormone therapy. Other treatments aimed at bone metastases might be used as well.

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Displacement Of Prostate Centroid

The clinical characteristics of the patients who participated in this study are shown in .

The shift in the prostate centroid due to marker matching was highest along the AP-axis and lowest along the LR-axis . The shift due to bone matching was highest along the AP-axis . When comparisons were made between marker and bone matching, the shift in the prostate centroid was lower in the LR- and AP-axes when marker matching was used. Overall, the 3D displacement was significantly lower for marker matching than for bone matching .

Shift in prostate centroid: marker matching compared with bone matching values are given as the mean ± SD

.

How Is A Recurrence Detected

Which is Better – Surgery vs. Radiation for Prostate Cancer?

After prostate cancer treatment, you will go for medical check-ups every few months as determined by your doctor. At each follow-up appointment, your doctor will order a blood test to measure PSA levels. This test helps your doctor detect a cancer recurrence. You will also be examined. New symptoms should be reported to the doctor, as these may prompt other testing.

When PSA test results suggest that the cancer has come back or continued to spread, X-rays or other imaging tests may be done, depending on your situation and symptoms. Your doctor may use a radioactive tracer called Axumin with a PET scan to help detect and localize any recurrent cancer so that it could be biopsied or treated.

Your doctor may also use a new drug called Ga 68 PSMA-11 in the scan which binds to PSMA-positive prostate cancer lesions in the tissues of the body so they can be targeted for treatment.

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How Can Your Diet Help Manage Cancer Treatment Side Effects

Some dietary changes can help you manage side effects after your treatment begins. These side effects include:

Appetite loss. Eat small meals or nutritious snacks throughout the day, rather than three large meals.
Constipation. Drink plenty of water, consider a fiber supplement, and add veggies and beans to your meals.
Diarrhea. Choose foods or drinks with sodium and potassium .
Loss of taste. Knowing what to eat when you cant taste can be difficult. Consider trying new foods with different spices or marinades. You can also add strong flavors, such as lemon or lime juice.
Nausea. Anti-nausea foods include citrus, ginger and peppermint oil. You can suck on a slice of lemon, drink ginger tea or eat ginger chews.

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Sexual And Reproductive Health

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 males 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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