When Is Radiation Therapy Used
There are some instances where the practitioners opt for radiotherapy for prostate cancer as opposed to other forms of treatment. Here are some of the situations in which radiation therapy may be used:
- As the first treatment of cancer, which is still confined to the prostate gland.
- It is used along with hormone therapy during the first treatment for prostate cancer that has extended the nearby tissues.
- After the reoccurrence of cancer in the area, it was before surgery.
- To keep cancer under control and relieve you from the symptoms for as long as possible if the cancer is advanced.
Side Effects And How To Manage Them
Your radiation doctors plan treatments very carefully to lessen side effects. While some patients have little or no side effects from radiation therapy, others feel some discomfort. Side effects are usually short-term and can be treated. No matter what type of therapy you receive, our doctors and nurses are skilled in helping to manage side effects.
Side effects most often start by the second or third week of treatment. They can last up to several weeks after your final radiation treatment. Many people who get radiation have some fatigue and skin reactions. Based on the area of your body being treated, you may also have some:
Most side effects go away within 12 months after you have finished radiation therapy.
How We Approach Prostate Cancer Treatment At Ctca
When you come to CTCA for a diagnostic consultation or second opinion, your case is reviewed by a multidisciplinary team of genitourinary cancer experts before you arrive for your first appointment. This team may include a medical oncologist, a urologist or urologic oncologist and a radiation oncologist.
If we determine you need additional diagnostic evaluations, such as imaging or genomic testing, we schedule those procedures for you before your arrival.
Well also schedule appointments for you with our integrative care providers, who work to prevent and manage side effects of cancer and its treatment.
Together, we develop a treatment plan thats based on your unique needsusually within two to three days. Our goal is to give you and your caregivers a clear understanding of your options to empower you to make an informed decision about your care.
At CTCA, we strive to treat our patients as we would want our own loved ones to be treated: with compassion, dignity and respect. Its the basis of our foundation, and we call it the Mother Standardî of care.
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Radiopharmaceuticals That Target Psma
Prostate-specific membrane antigen is a protein that is often found in large amounts on prostate cancer cells.
Lutetium Lu 177 vipivotide tetraxetan is a radiopharmaceutical that attaches to PSMA, bringing radiation directly to the prostate cancer cells.
This drug can be used to treat prostate cancer that has spread and that has already been treated with hormone therapy and chemotherapy. The cancer cells must also have the PSMA protein. Your doctor will order a PSMA PET scan before you get this drug to make sure the cancer cells have PSMA.
This drug is given as an injection or infusion into a vein , typically once every 6 weeks for up to 6 doses.
Possible side effects
Some of the more common side effects of this drug include:
This drug can lower blood cell counts:
- A low red blood cell count can cause tiredness, weakness, pale skin, or shortness of breath.
- A low blood platelet count can lead to bleeding or bruising more easily than normal, or bleeding that is hard to stop.
- A low white blood cell count can lead to an increased risk of infections, which might show as a fever, chills, sore throat, or mouth sores.
This drug might damage the kidneys. Your doctor or nurse will likely advise you to drink plenty of fluids and to urinate often before and after getting this drug, to help protect the kidneys. Tell your doctor or nurse if you start to pass less urine than is normal for you.
Problems With Your Bones
Radiotherapy can damage the bone cells in the pelvic area, and also lower the blood supply to the bones. The bones can become weaker. This is called avascular necrosis. Damage to the bones can cause pain and sometimes makes it hard to walk or climb stairs.
Your doctor will monitor you carefully, including checking your bone strength with a DEXA scan. They might suggest treatment with painkillers and walking aids to help you get around. You might also need to take medicines to strengthen the bones called bisphosphonates. These drugs can help to control pain and reduce the risk of fractures.
Sometimes, tiny cracks can appear in the pelvic bones some years after treatment. They are called pelvic insufficiency fractures. This is more likely to happen in people who have general weakening of their bones as they get older . It is also more likely in people who are taking hormone therapies or steroids.
Speak to your doctor if you have any pain in your bones. The pain usually gets worse if you move around or do exercise and gets better when you sit still or rest. Your doctor might ask you to have x-rays, a CT scan or an MRI scan to see if there are any fractures in the bones.
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What Are The Advantages And Disadvantages Of External Beam Radiotherapy
What may be important for one person might not be so important for someone else. If youre offered external beam radiotherapy, speak to your doctor, nurse or radiographer before deciding whether to have it. They can tell you about any other treatment options and help you decide if radiotherapy is right for you.
Advantages of external beam radiotherapy
- If your cancer is localised or locally advanced, radiotherapy will aim to get rid of the cancer completely.
- Many men can carry on with many of their normal activities while having treatment, including going to work and driving.
- Radiotherapy can be an option even if youre not fit or well enough for surgery.
- Radiotherapy is painless .
- The treatment itself only lasts around 10 minutes, including the time it takes to get you into position. But youll probably need to be at the hospital for up to an hour each day to prepare for your treatment. You dont need to stay in hospital overnight.
Disadvantages of external beam radiotherapy
I was able to continue working throughout my treatment, although I got tired quickly. I had some side effects but nothing I couldnt cope with. A personal experience
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Urinary And Bladder Changes
Radiation therapy to the pelvis can cause urinary and bladder problems by irritating the healthy cells of the bladder wall and urinary tract. These changes may start 35 weeks after radiation therapy begins. Most problems go away 28 weeks after treatment is over. You may experience:
- Burning or pain when you begin to urinate or after you urinate
- Trouble starting to urinate
- Bladder spasms, which are like painful muscle cramps
Ways to manage include:
- Drink lots of fluids. Aim for 68 cups of fluids each day, or enough that your urine is clear to light yellow in color.
- Avoid coffee, black tea, alcohol, spices and all tobacco products.
- Talk with your doctor or nurse if you think you have urinary or bladder problems. You may need to provide a urine sample to check for infection.
- Talk with your doctor or nurse if you have incontinence. He/she may refer you to a physical therapist to assess your problem. The therapist may recommend exercises to help you improve your bladder control.
- Your doctor may prescribe medications to help you urinate, reduce burning or pain, and ease bladder spasms.
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Who Might Benefit From Radiation Therapy
Your doctor might recommend radiation therapy in several situations.
It can be the first treatment for cancer that hasnât spread outside your prostate gland and is âlow grade.â The grade is a number that tells you how abnormal your cancer cells look under a microscope. The lower the grade, the more normal-looking your cancer cells are â and, in general, the more likely your cancer is slow-growing.
Radiation, along with hormone therapy, might also be part of your first cancer treatment if the disease has spread beyond your prostate into nearby tissues.
If you get surgery for prostate cancer, your doctor might recommend you get radiation therapy afterward, too. It can be helpful if the surgeon couldnât remove all of the cancer or if the cancer comes back in the area of your prostate.
If you have advanced prostate cancer, radiation could help keep the disease under control for as long as possible. It can also help prevent or ease symptoms that the cancer might cause.
Why Are There Marks On My Skin
Your radiation therapist will make small marks resembling freckles on your skin along the treatment area. These marks provide targets for the treatment and are a semi-permanent outline of your treatment area.
Donât try to wash these marks off or retouch them if they fade. The therapist will re-mark the treatment area when necessary.
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How To Avoid The Side Effects Of Radiation Therapy
While the risks associated with radiation therapy are low, there are still some potential side effects that patients should be aware of. Here is how you can avoid the side effects:
- Diet and lifestyle can impact the risks associated with it. Eating a healthy diet and maintaining a healthy weight can help reduce the risks of side effects from radiation therapy.
- Exercise is also important for cancer patients undergoing radiation therapy, as it can help to reduce fatigue and improve the overall quality of life.
- Patients should also be aware of the potential for skin reactions from radiation therapy. The skin is the most common site of side effects of this treatment and reactions can range from mild to severe. It is important to keep the skin clean and moisturised during this therapy to help reduce the risk of skin reactions.
We hope the above information collected from the cancer research institute in India has helped you understand the possible future cancer risks associated with radiation therapy treatment for prostate cancer. People must understand what this treatment entails as well as the risks that are involved. Its important to know that the treatment itself does not cause cancer, but there is a possibility that it can increase your risk of developing cancer in the future.
During Your Radiation Treatments
When its time for your treatment, your radiation therapists will bring you to the treatment room and help you onto the treatment table. Youll be positioned exactly how you were during your simulation. Your radiation therapists will do everything they can to make sure youre comfortable during your treatment. Then, theyll leave the room and start your treatment.
Breathe normally during your treatment, but dont move. Your radiation therapists will be able to see you on a monitor and hear you through an intercom during your whole treatment. Tell them if youre uncomfortable or need help.
Neither you nor your clothes will be radioactive during or after treatment. Its safe for you to be around other people.
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Will I Be Able To Have Sex During And After Imrt
Most men who get IMRT for their prostate cancer worry about not being able to have intercourse . Most men do not have a problem with erections or intercourse during or right after IMRT.
Over time, you may find that you are not having as many erections as you used to. This is because the radiation can harm the nerves near your prostate that help you have erections. If this happens, talk to your doctor or health care team about things you can do to deal with this. If you could not get an erection before IMRT, this will not get better after IMRT.
You may find that during treatment that your desire to have sex is lower. This is probably caused more by the stress of you having cancer or fatigue than your treatment. Once the treatment ends and you get better, your sexual desire will probably return.
If you have questions or concerns about having sex during and after your prostate cancer treatment, talk to your doctor or health care team.
Are There Side Effects With Imrt
Yes, there can be side effects or unwanted changes in your body when you have IMRT. Side effects are different from person to person. Some people have no or very mild side effects. Some have bothersome side effects that may last for only a short period of time. Other men may have side effects that last for a longer period of time or forever. Some side effects occur within days or weeks of your treatment and others may not happen for six or more months after your treatment.
The side effects that you have depend on:
- The radiation dose you get during your prostate cancer treatment, and
- Your general health
Before beginning your treatment, your doctor and health care team will talk with you about the side effects you might have, how long they might last, and what you can do to help make them better.
The good news is that most side effects will go away in time. When you do have side effects, there are ways to make you feel better. If you have a side effect that is really bad, your doctor may stop your radiation therapy for a short time or change your treatment in some way. Be sure to tell your doctor or health care team about any side effects that you have. They can help you treat the problems and tell you how to lower the chances that the side effects will come back.
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Low Levels Of Vitamin B12
You might have low vitamin B12 after radiotherapy to the pelvis . This is called a vitamin B12 deficiency.
Radiotherapy can stop your digestive system from taking in vitamin B12 from the food you eat. This is called malabsorption. This means you can have a B12 deficiency even if you eat a balanced diet.
A B12 deficiency can be a cause of anaemia. This can lead to weakness, diarrhoea, numbness and tingling.
Its important that you go to your doctor if youre experiencing these symptoms so that they can help you.
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.
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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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Long Term Side Effects Of Prostate Cancer Radiotherapy
Most side effects of radiotherapy gradually go away in the weeks or months after treatment. But long term side effects can continue. Or you might notice that some side effects begin months or years later.
Everyone is different and the side effects vary from person to person. You may not have all of the effects mentioned. Tell your doctor or nurse if you have any of these problems. They can help you to find ways of controlling the effects.
What Are The Different Types Of External Beam Radiation Therapy
Many of the techniques noted below use technology to direct the treatment to target the cancer. Each type of external beam radiation starts with a CT scan to map your body and custom tailor the radiation to your specific anatomy. Special computers are then used to plan radiation treatment to deliver an adequate dose to the prostate while sparing nearby organs, such as the rectum and bladder, as much as possible.
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