Side Effects For Prostate Radiation

Lipid Alterations And Insulin Resistance

Treatment-related changes in body composition are accompanied by adverse metabolic effects. GnRH agonists increase serum total cholesterol, low-density lipoprotein cholesterol, and triglycerides.116,144 In a prospective 12-month study, for example, GnRH agonists increased serum total cholesterol, low-density lipoprotein cholesterol, and triglycerides by 9.0%, 7.3%, and 26.5%, respectively.142 GnRH agonists increase fasting plasma insulin level, a surrogate for insulin resistance.142,145 In a prospective study of non-diabetic men with prostate cancer initiating GnRH-agonist therapy, fasting plasma insulin levels increased by 26%, and the whole-body insulin sensitivity index decreased by 11%.146

The Success Rate Of Prostate Surgery

Survival rates can tell you how many people with the same type and stage of cancer are still alive 5 years after being diagnosed. For example, if you have stage 3 colon cancer, there is a 66% chance that 5 years later, you will be alive. But the rates cannot tell you how long you will live. However, they may help give you an idea of how likely your treatment will be successful.

Survival rates are estimates. They are based on data from many people who have had cancer before. These numbers might be confusing because they dont tell you what will happen, but they can help doctors decide treatments. Talk with your doctor to see if these statistics apply to you because they know about your situation.

A relative survival rate tells how likely a person is to survive a particular type of cancer. I.e., if the 5-year close survival rate for prostate cancer is 90%, it means that men who have this type of cancer are about 90% as likely as other men to live a minimum of 5 years after being diagnosed with the disease.

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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.

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Frequent Or Loose Poo

Your bowel movements might be looser or more frequent than before your treatment.

You might need to take anti diarrhoea medicines, such as loperamide . Bulking agents, such as Fybogel might also help. Your doctor or nurse can prescribe these for you, talk to your doctor before taking these.

You might find that you need to avoid high fibre foods. Although we normally think that a high fibre diet is the most healthy, it might make long term diarrhoea worse. Some people find it best to avoid high fibre vegetables, beans and pulses .

Let your doctor know if you have ongoing problems with frequent bowel movements or bleeding. They can refer you to a specialist team. The team includes cancer doctors, digestive system specialists, bowel surgeons, dietitians and specialist nurses.

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Surgery For Prostate Cancer

If the cancer has not spread in your body, the whole prostate gland can be surgically removed. This is called a radical prostatectomy.

During the surgery, your surgeon will try to save the two bundles of nerves attached to the prostate that help you get erections. This is only possible if the cancer is not in or close to these nerves.

Sometimes lymph nodes are also removed during the surgery if the cancer has a higher risk of spreading.

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Sore Skin In The Treatment Area

Your skin in the treatment area might get sore, or redden or darken. Following these tips can help with this:

• Wear loose fitting underwear and clothes. Natural fibres can be more comfortable than man-made fibres.
• Gently wash the area each day. Use mild, unperfumed soap and warm or cool water. Try baby soap or liquid baby wash but check with the radiotherapy staff first.
• Gently pat the skin dry with a soft towel. Rubbing the skin can make it sore.
• Don’t use perfumed lotions on the area. Use only creams or dressings recommended by your specialist or radiographer.
• Don’t use talcum powder because it can contain tiny metal particles. The particles can make the soreness worse.

What Happens At A Follow

Discussion with your doctor or nurse

At each appointment, your doctor or nurse will ask how youve been since your last appointment.

Tell them about any symptoms or treatment side effects youve had, as well as any other problems or concerns. You can tell them how you are feeling emotionally as well as physically. You can also discuss any practical problems you might have, such as problems at work or with day-to-day activities. You may be given a questionnaire about your physical, social, emotional and practical needs. You might hear this called a holistic needs assessment form.

Your GP or hospital doctor or nurse can help you deal with side effects, or refer you to someone else who can. For example, if you have problems with leaking urine , they might refer you to a continence service. Or if you have problems getting or keeping erections , they can refer you to an erectile dysfunction service. They can also help you get support for emotional problems, such as feeling anxious or depressed, and practical problems, such as managing your finances.

You might feel embarrassed talking about some of the side effects of treatments, such as erection problems. But remember doctors and nurses see people with these problems every day, so be as open as you can. They are there to help.

PSA test

You may be asked to avoid any vigorous exercise or ejaculating in the 48 hours before a PSA test, as this could cause a temporary rise in your PSA level.

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Are There Side Effects Of The Combination Approach To Prostate Cancer Radiation Therapy

When it comes to early stages of disease, patients very frequently do well with either brachytherapy or external beam radiation. Success rates of around 90% or higher can be achieved with either approach. When the disease is somewhat more advanced based on the PSA level, Gleason score, extent of visible disease on magnetic resonance imaging we have learned over the years that higher doses of radiation are critical to achieving better results. Some evidence, including a large trial, suggests that for patients with intermediate- or high-risk prostate cancer, a combined approach using brachytherapy along with external beam radiation may be best compared to standard dose external beam radiation therapy alone.

Minimizing Side Effects Of Radiation

Barrigel rectal spacer can help minimize prostate radiation side effects by temporarily positioning the rectum away from the prostate during radiation therapy for prostate cancer.2 In creating this space, Barrigel reduces the radiation dose delivered to the rectum.3 Barrigel is composed of biocompatible material that is naturally absorbed by the body and maintains space for the entire course of your prostate radiation treatment.3

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Radiation Therapy: What It Is

This therapy, also known as radiotherapy, is a cancer treatment procedure that uses high doses of radiation to kill cancerous cells and shrink the tumor as well. At low doses, this procedure is used as an x-ray.

This therapy can be internal or external or both form. For external beam, a machine that is outside your body aims at the cancerous cells. For internal therapy, the radiations are placed inside your body inside or near the cancer.

For radiotherapy for prostate cancer, high-energy rays are used to kill the cancer cells. This treatment procedure does not cause pain. However, it may result in various side effects that might cause pain and make you feel uncomfortable. The good thing is that there are numerous ways to manage radiotherapy side effects with the help of your radiation oncologist.

Vitamins And Dietary Supplements

Its OK to take a multivitamin during your radiation therapy, but dont take more than the recommended daily allowance of any vitamin or mineral.

Dont take any other dietary supplements without talking with a member of your radiation therapy team. This includes vitamins, minerals, and herbal or botanical remedies.

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Study Process And Results

Researchers working at 10 hospitals in Spain enrolled 355 men with newly diagnosed prostate cancer that was still confined to the prostate and seminal vesicles . The men were divided into two groups: one group received a short course of hormonal therapy lasting four months, and the other group was treated for a longer duration of 24 months. All the patients were also treated with high-dose radiation.

After 10 years, only men who had been diagnosed initially with high-risk prostate cancer benefited from the long-term treatments. Specifically, 67.2% of these men avoided subsequent increases in prostate-specific antigen that signified worsening cancer. By contrast, 53.7% of men with high-risk cancer who received four months of hormonal therapy avoided similar PSA increases. Importantly, 78.5% of high-risk men who had long-term hormonal therapy were still alive after 10 years, compared to 67% of high-risk men treated with hormonal therapy for four months.

Among men with intermediate-risk prostate cancer, the duration of hormonal therapy made little difference. Just four men with intermediate-risk cancer developed worsening cancer that had spread to other sites in the body. Two came from the short-term treatment group, and two from the group that received hormonal therapy for 24 months. And after 10 years, none of the intermediate-risk patients had died from prostate cancer, regardless of how long the hormonal therapy treatments lasted.

Tips To Get The Most From Your Follow

Write down any questions or concerns beforehand

Its 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 dont understand the letter, call your main contact at the hospital or contact our Specialist Nurses.

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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.

Bowel Changes After Pelvic Radiotherapy

Bowel changes caused by pelvic radiotherapy can show as a variety of symptoms. These may be uncomfortable and inconvenient, or even painful and distressing.

We hope the information on this page helps explain why you might have bowel symptoms and how to manage them. We are also here if you need some extra support or arent sure where to start.

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When Is Radiation Treatment Used For Prostate Cancer

There are a number of circumstances in which radiation therapy is an appropriate method for treating prostate cancer:

• In early or localized stages of the disease.
• In combination with other treatment methods for cases that have spread.
• As a method of preventing cancers return after surgery.
• As a method for treating a recurrent cancer following remission.
• As pain alleviation when the disease reaches an advanced state.

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Prostate Radiation Vs Robotic Prostatectomy

It is not possible to decide which treatment is better or more effective radiation or robotic prostatectomy, due to the fact that everybody has different stages of prostate cancer and other health-related issues. Below are enumerated pros and cons for each type of treatment, but every patient needs to take into account what his doctor is telling and suggesting.

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Questions To Ask Your Doctor Nurse Or Radiographer

You may find it helpful to keep a note of any questions you have to take to your next appointment.

• What type of radiotherapy will I have?
• How many sessions will I need?
• What other treatment options do I have?
• What are the possible side effects and how long will they last?
• What treatments are available to manage the possible side effects from radiotherapy?
• Will I have hormone therapy and will this carry on after radiotherapy?
• How and when will I know if radiotherapy has worked?
• If the radiotherapy doesnt work, which other treatments can I have?
• Who should I contact if I have any questions?
• What support is there to help manage long-term side effects?

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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.

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When Is Brachytherapy Alone The Right Choice

For some patients with disease that is confined to the prostate and not too aggressive , brachytherapy alone is a good option. It is also convenient for the patient as it is done in an outpatient setting and most people can get back to work within a few days.

But brachytherapy is not right for everyone. For some patients with less-aggressive disease, a watch-and-wait approach would be preferred. At MSK, our philosophy is that when the disease is caught very early, it is very appropriate to do active surveillance and hold off on treatment.

This philosophy applies to patients with 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. There are also very select patients with Gleason 7 disease who may be candidates for active surveillance.

What Is A Radiation Oncologist

If a patient is undergoing radiation, the cancer treatment plan may be managed by a radiation oncologist who carefully monitors the persons overall health and well-being through the process.

With advanced cancer, a patient may also be referred to a medical oncologist. This specialized doctor uses medicines such as chemotherapy and hormone therapy to treat cancers. Its common for several medical specialists to work together on a treatment plantheyre known as a cancer care team.

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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 personâs 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.

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