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Radiation Therapy For Prostate Cancer

Where You Get Treated Matters

Role of ADT with Radiation

Like all radiation therapies, brachytherapy is best administered by medical professionals who specialize in the treatment.

Fox Chase was the first to perform HDR prostate implants in the eastern United States and has one of the largest and most experienced brachytherapy programs in the region.

At Fox Chase, we have our own brachytherapy operating room in the radiation oncology department, Horwitz said. The physicians, the physicists, the nurses, the anesthesiologistsall of us do this all the time, so were very good at it.

Learn more about brachytherapy treatment at Fox Chase Cancer Center.

You can also request an appointment with a Fox Chase medical professional online. Or you can call .

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Radiation Therapy For Prostate Cancer

Radiation therapy is an effective treatment that kills prostate cancer cells by using high energy rays or particles. The radiation can be delivered in several ways, including brachytherapy and external beam radiation that projects the energy through the skin. Radiation therapy for prostate cancer is best delivered by experienced radiation oncologists who work in high volume centers of excellence.

Radiation therapy can:

  • Treat both early stage cancers of the prostate gland and more advanced cancers that may have spread beyond the prostate
  • Be used alone or with other treatments such as hormone deprivation
  • Treat recurrent prostate cancer following surgery
  • Treat men with limited spreading prostate cancer to reduce the tumors size and improve survival and quality of life
  • Slow cancer growth, reduce fracture risk
  • Be used as a palliative treatment to address pain from advanced cancer

What Side Effects Will I Have

During your treatment, radiation must pass through your skin. You may notice some skin changes in the area exposed to radiation. Your skin may become red, swollen, warm, and sensitive, as if you have a sunburn. It may peel or become moist and tender. Depending on the dose of radiation you receive, you may notice a loss of hair or decreased perspiration within the treated area.

These skin reactions are common and temporary. They will subside gradually within four to six weeks of completing treatment. If skin changes appear outside the treated area, inform your doctor or primary nurse.

Long-term side effects, which can last up to a year or longer after treatment, may include a slight darkening of the skin, enlarged pores, increased or decreased sensitivity of the skin, and a thickening of tissue or skin.

Another possible side effect is erectile dysfunction and urinary symptoms such as frequency, bleeding, or, rarely, incontinence. Keep these side effects in mind when considering your treatment options. If you have any concerns, don’t hesitate to talk to your doctor about them.

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How Well It Works

For men with localized prostate cancer, radiation works about as well as surgery . With either treatment, the chance of the cancer spreading is low. One study looked at men with localized prostate cancer and found that the risk of dying was very low, and about the same no matter what option men chose.footnote 1

For treating advanced prostate cancer that has grown beyond the prostate but not into lymph nodes or bones, external-beam radiation combined with hormone therapy can work better than surgery. This treatment often results in controlling cancer growth and in many years of disease-free survival.footnote 2

Radiation therapy also works well to treat pain when prostate cancer has spread to the bone.footnote 3

External Beam Radiation Therapy

Prostate cancer radiotherapy

This is the most common type of radiation therapy, and it is painless. Before treatment, your radiation team will use computerized tomography scans and magnetic resonance imaging scans to map out the location of the prostate and tumor cells.

During each treatment session, X-ray beams are focused on the targeted cancer areas. Oncologists can change the intensity of doses and radiation beams to better deliver high doses of radiation to tumor cells while delivering lower doses to surrounding healthy tissues.

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Who Can I Contact If I Have Personal Concerns About My Treatment

Many hospitals and clinics have a staff social worker who can help you during your treatment. Check with your doctor to see if this is available to you.

The social worker can discuss any emotional issues or other concerns about your treatment or your personal situation and provide information about resources. The social worker can also discuss housing or transportation needs if necessary.

People dealing with certain medical issues find it helpful to share experiences with others in the same situation. Your doctor can provide a list of support groups if you are interested. Your social worker can provide additional information, and you can look online for support group resources.

Radiation Therapy In Advanced Disease:

Some forms of radiation therapy, like external radiation therapy and radiopharmaceuticals, can help with advanced prostate cancer. One type of external radiation therapy is used along with hormone therapy to treat cancer that has spread outside the prostate to nearby tissue. In addition, radiopharmaceuticals are used to manage pain and symptoms of bone metastases. Scroll down to learn more about radiopharmaceuticals.

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If Youre Getting Radiation Therapy To The Chest

Radiation treatment to the chest may cause side effects such as:

  • Sore throat

Radiation can also cause other problems in the heart or lungs.

Heart complications

Getting radiation to the middle portion of the chest can raise your risk of heart disease. This risk increases with higher radiation doses and larger treatment areas in this part of your body. Radiation can also cause hardening of the arteries , heart valve damage, or irregular heartbeats.

Radiation pneumonitis

Radiation pneumonitis is inflammation of the lungs that can be caused by radiation treatment to the chest . It may occur about 3 to 6 months after getting radiation therapy. Its more likely if you have other lung diseases, like emphysema . Common symptoms of radiation pneumonitis include:

  • Shortness of breath that usually gets worse with exercise
  • Chest pain, which is often worse when taking in a deep breath
  • Cough
  • Weakness

Sometimes there are no symptoms, and radiation pneumonitis is found on a chest x-ray.

Symptoms often go away on their own, but if treatment is needed, it is based on trying to decrease the inflammation. Steroids, like prednisone, are usually used. With treatment, most people recover without any lasting effects. But if it persists, it can lead to pulmonary fibrosis . When this happens, the lungs can no longer fully inflate and take in air.

Be sure you understand what to look for, and tell your cancer care team if you notice any of these side effects.

Heres What You Should Know About This Treatment Option

Getting a Second Opinion for Cancer Treatment with Radiation Oncologist Dr. Nguyen

Men who get diagnosed with prostate cancer have several options to choose from for their next step. Many men with slow-growing, low-risk cancer follow active surveillance, a wait-and-see approach that monitors the cancer for changes.

But if the cancer shows higher risk or has already begun to spread, other treatments are recommended. There are two options: surgery to remove the prostate or radiation to destroy the cancer cells.

Studies comparing these two approaches demonstrate no advantage of one over the other with respect to cancer control. Your path will depend on factors like your current health, the specifics of your cancer, and personal preference. Yet for many men, radiation can be the better option.

“Its much more precise than the traditional radiation used for other kinds of cancer, and research also has found that long-term quality of life is often better, with fewer adverse health effects compared to surgery,” says Dr. Anthony DAmico, a radiation oncologist with Harvard-affiliated Dana-Farber Cancer Institute and Brigham and Womens Hospital.

There are two main ways to deliver radiation to the prostate: external beam radiation and brachytherapy.

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Expert Review And References

  • American Cancer Society. Treating Prostate Cancer. 2019: .
  • American Society of Clinical Oncology. Prostate Cancer. 2020: .
  • Tracy, CR. Prostate Cancer. eMedicine/Medscape 2020: .
  • PDQ® Adult Treatment Editorial Board. Prostate Cancer Treatment Patient Version. Bethesda, MD: National Cancer Institute 2020: .
  • PDQ® Adult Treatment Editorial Board. Prostate Cancer Treatment Health Professional Version. Bethesda, MD: National Cancer Institute 2020: .
  • National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology: Prostate Cancer . 2020: .
  • Zelefsky MJ, Morris MJ, Eastham JA. Cancer of the prostate. DeVita VT Jr., Lawrence TS, Rosenberg SA, eds.. DeVita, Hellman, and Rosenberg’s Cancer: Principles & Practice of Oncology. 11th ed. Philadelphia, PA: Wolters Kluwer 2019: 70: 1087-1136.
  • Parker C, Castro E, Fizazi K et al . Prostate cancer: ESMO clinical practice guidelines for diagnosis, treatmentand follow-up. Annals of Oncology. 2020: 31: 1119-1134. .

Proton Beam Radiation Therapy

Proton beam therapy focuses beams of protons instead of x-rays on the cancer. Unlike x-rays, which release energy both before and after they hit their target, protons cause little damage to tissues they pass through and release their energy only after traveling a certain distance. This means that proton beam radiation can, in theory, deliver more radiation to the prostate while doing less damage to nearby normal tissues. Proton beam radiation can be aimed with techniques similar to 3D-CRT and IMRT.

Although in theory proton beam therapy might be more effective than using x-rays, so far studies have not shown if this is true. Right now, proton beam therapy is not widely available. The machines needed to make protons are very expensive, and they arent available in many centers in the United States. Proton beam radiation might not be covered by all insurance companies at this time.

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Tips To Get The Most From Your Follow

Write down any questions or concerns beforehand

Itâs easy to forget what you want to say once youre at your appointment.

Bring someone with you

It can be hard to take everything in at your appointments. Some people find it helpful to take someone with them, to listen and discuss things with later. If your appointment is on the phone, you could ask a friend or family member to listen with you.

Make notes

It can help to write things down during or after your appointment. Theres space for this in the appointment diary in our booklet, Follow-up after prostate cancer treatment: What happens next?

Ask to record your appointment

You could do this using your phone or another recording device. You have the right to record your appointment if you want to because its your personal data. But let your doctor or nurse know if you are recording them.

Ask for help

If there is anything bothering you, let your doctor or nurse know.

Ask for copies of any letters

If your appointment is at the hospital, ask for a copy of the letter that is sent to your GP. This will happen automatically at some hospitals. It will help to remind you of what was said at your appointment. If you donât understand the letter, call your main contact at the hospital or contact our Specialist Nurses.

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How Has Radiation Therapy For Prostate Cancer Evolved In Recent Years

Radiotherapy Gives Long

Radiation has evolved dramatically in the last 40 years, and during that time, our ability to plan and deliver treatment has changed at about the same rate as computers have progressed. Think of your computer 10 years ago and your iPad now, says Dr. Yu. You might have heard about your fathers or grandfathers perhaps difficult radiation experience in the 1970s or 80s, so you may be wary. But todays radiation therapy is so different we plan, deliver, and aid in recoveries that have better outcomes and fewer side effects than in the past.

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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.

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. Do not 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.
  • Do not apply any ointment, cream, lotion, or powder to the treated area unless your radiation oncologist or nurse has prescribed it.
  • Do not wear tight-fitting clothing or clothes made from harsh fabrics such as wool or corduroy. These fabrics can irritate the skin. Instead, choose clothes made from natural fibers such as cotton.
  • Do not apply medical tape or bandages to the treated area.
  • Do not expose the treated area to extreme heat or cold. Avoid using an electric heating pad, hot water bottle, or ice pack.
  • Do not expose the treated area to direct sunlight, as sun exposure may intensify your skin reaction and lead to 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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Stereotactic Body Radiation Therapy

This technique uses advanced image guided techniques to deliver large doses of radiation to a precise area, such as the prostate. Because there are large doses of radiation in each dose, the entire course of treatment is given over just a few days.

SBRT is often known by the names of the machines that deliver the radiation, such as Gamma Knife®, X-Knife®, CyberKnife®, and Clinac®.

The main advantage of SBRT over IMRT is that the treatment takes less time . The side effects, though, are not better. In fact, some research has shown that some side effects might actually be worse with SBRT than with IMRT.

What Are The Dangers Of Radiotherapy Prostate Cancer Treatment

Prostate Cancer & Treatment Options – Dr. Luis Carrascosa, FCS Radiation Oncologist

Radiotherapy is considered effective for treatment of cancer with a success rate of above 90%. But is it safe for prostate cancer treatment? Does it cause any side effects? And if yes, are radiation therapy side effects reversible?

Well, radio frequency is pain-free and considered safe for prostate cancer treatment. To help you understand the safety of this procedure we shall look at both the short and long-term side effects resulting from this treatment.

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How Can I Choose From Among The Options

In addition to talking with family and friends, you will need a team of physicians to help advise you. You should meet with everyone involved in your treatment planning before choosing a treatment, including:

  • your primary care doctor
  • a urologist to discuss surgery
  • a radiation oncologist to discuss radiation therapy
  • a medical oncologist to discuss hormone suppression, if your cancer is more advanced

After you meet with these doctors, you can make an informed decision regarding your treatment options. You may have an early-stage or moderately advanced cancer with no evidence of spread to other organs . If so, your two major treatment options are active surveillance , surgery or radiation therapy .

You may have advanced cancer and require hormonal suppression therapy or chemotherapy. If so, you will need a medical oncologist to administer these drugs. Doctors use hormone-ablation therapy to treat advanced prostate cancer. It suppresses androgen because these hormones stimulate most prostate cancer growth. Your internist, urologist, radiation oncologist or medical oncologist may administer the treatment. Depending on the stage of the cancer, your doctor may use hormone suppression therapy and radiation therapy to help control your disease. You may receive hormone suppression therapy for as little as four to six months, or for as long as two to three years.

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Having Radiotherapy For Prostate Cancer

You have external beam radiotherapy as an outpatient in the radiotherapy department. Radiotherapy is given using a machine that is like a big x-ray machine. This is called a linear accelerator .

You usually have it as a series of short, daily treatments. The treatments are given from Monday to Friday, with a rest at the weekend. Radiotherapy is not painful, but you will need to lie still while you have it.

You may have radiotherapy over either:

  • 4 weeks the dose you get for each treatment session is higher.
  • 7 weeks the total overall dose of radiation is higher.

Both ways are effective, and the side effects are the same. You usually have radiotherapy over 4 weeks as it is a shorter treatment.

If you have a type of radiotherapy called stereotactic ablative radiotherapy you have it over a much shorter time.

Your doctor or nurse will explain how long your course of radiotherapy will take. It is safe for you to be with other people during external radiotherapy, including children.

There are different techniques used to treat prostate cancer more effectively. They treat the cancer while protecting healthy tissue and reducing side effects.

Your cancer doctor plans your radiotherapy carefully to make sure it is as effective as possible. During the planning visit, you will have a CT scan.

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How Long Do Side Effects Last

Remember that the type of radiation side effects you might have depends on the prescribed dose and schedule. Most side effects go away within a few months of ending treatment. Some side effects may continue after treatment ends because it takes time for the healthy cells to recover from radiation.

Side effects might limit your ability to do some things. What you can do will depend on how you feel. Some patients are able to go to work or enjoy leisure activities while they get radiation therapy. Others find they need more rest than usual and cant do as much. If you have side effects that are bothersome and affecting your daily activities or health, the doctor may stop your treatments for a while, change the schedule, or change the type of treatment youre getting. Tell your cancer care team about any side affects you notice so they can help you with them.

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