Side Effects Of Radiation For Prostate Cancer

If Youre Getting Radiation Therapy To The Breast

If you have radiation to the breast, it can affect your heart or lungs as well causing other side effects.

Short-term side effects

Radiation to the breast can cause:

• Skin irritation, dryness, and color changes
• Breast soreness
• Breast swelling from fluid build-up

To avoid irritating the skin around the breasts, try to go without wearing a bra. If this isnt possible, wear a soft cotton bra without underwires.

If your shoulders feel stiff, ask your cancer care team about exercises to keep your shoulder moving freely.

Breast soreness, color changes, and fluid build-up will most likely go away a month or 2 after you finish radiation therapy. If fluid build-up continues to be a problem, ask your cancer care team what steps you can take. See Lymphedema for more information.

Long-term changes to the breast

Radiation therapy may cause long-term changes in the breast. Your skin may be slightly darker, and pores may be larger and more noticeable. The skin may be more or less sensitive and feel thicker and firmer than it was before treatment. Sometimes the size of your breast changes it may become larger because of fluid build-up or smaller because of scar tissue. These side effects may last long after treatment.

After about a year, you shouldnt have any new changes. If you do see changes in breast size, shape, appearance, or texture after this time, tell your cancer care team about them right away.

Less common side effects in nearby areas

Side effects of brachytherapy

What Are The Side Effects Of Brachytherapy

• Frequent urination or urinary retention or burning with urination
• Erectile dysfunction
• Urethral stricture or narrowing of the urethra
• Diarrhea or blood in the stool
• Secondary cancers

For the short time that the seeds are giving off larger amounts of radiation, you should avoid close proximity to children or pregnant women. Make sure to talk with your radiation oncologist or oncology nurse for instruction about radiation safety and exposure for family members or pets.

If you are traveling through an airport following brachytherapy treatment, there is a chance that radiation detectors will be set off. Talk to your radiation oncologist and ask for a note to indicate youve just had radiation treatment.

What Are The Different Types Of Internal Radiation Therapy

Brachytherapy and radiopharmaceuticals are both considered internal radiation therapies because they both work after being inserted inside the body, rather than being directed from outside. However, the similarities mostly end there. Brachytherapy works by implanting radioactive material into the prostate and is used for localized prostate cancer. Radiopharmaceuticals are injected into the bloodstream and are used for advanced, metastatic prostate cancer. Read on to find the details of each.

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What Should Patients Know About Msks Approach To Treating Prostate Cancer

At MSK, we manage prostate cancer in a very comprehensive way, tailored to each patients disease. There is no one specific therapy that is best for everyone.

Our initial assessment includes a carefully evaluated biopsy and a very detailed MRI to show the location of the disease, the integrity or soundness of the capsule surrounding the prostate, and the amount of disease. We will often obtain next-generation imaging and do genomic testing. Then, based on that information and with input from the urologist, the radiation oncologist, and the medical oncologist we can provide a comprehensive recommendation.

The radiotherapy we do here at MSK is state-of-the-art and unparalleled. We are one of the few centers in the world to do MRI-based treatment planning and one of the few centers in the US to offer MRI-guided treatment. When we give brachytherapy, we use computer software that provides us with real-time information about the quality and accuracy of the seed implant during the procedure. It requires a great deal of collaboration with our medical physics team to try to get the most accurate positioning of the prostate during the actual three or four minutes of the treatment.

We make adjustments while the patient is still under anesthesia, so that when the procedure is completed, we have been able to achieve ideal placement of the radiation seeds. This translates into improved outcomes.

When Is Radiation Therapy Given

Radiation therapy may be used:

• for localised or locally advanced prostate cancer it has similar rates of success to surgery in controlling prostate cancer that has spread to the lymph nodes
• if you are not well enough for surgery or are older
• after a prostatectomy for locally advanced disease, if there are signs of cancer left behind or the cancer has returned where the prostate used to be
• for prostate cancer that has spread to other parts of the body.

There are two main ways of delivering radiation therapy: from outside the body or inside the body . You may have one of these or a combination of both.

In intermediate and high-risk prostate cancer, radiation therapy is often combined with androgen deprivation therapy .

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Image Guided Radiation Therapy

In this type of radiation therapy, CT scans are taken both during the planning process and just before treatment begins. Comparing the two images allows doctors to adjust treatment as needed, since tumors can move between treatments. This allows precision targeting of the cancer while avoiding nearby healthy tissue.

In some cases, doctors will implant a tiny marker in or near the tumor to pinpoint it for IGRT to account for organ/tumor motion even if the body is immobilized.

Calypso is another form of IGRT where the prostate can be tracked during the treatment.

Online Support Groups For Prostate Cancer

• Us TOO. This organization has more than 200 support groups in the United States and abroad.
• Prostate Cancer Research Institute. This website allows you to search for support groups by state.
• Cancer Care. This site offers 15-week online support groups for people diagnosed with prostate cancer. Co-sponsored by the National Alliance of State Prostate Cancer Coalitions.
• Male Care. This organization offers online support groups for people with prostate cancer and their partners or caregivers.
• Imerman Angels. This support community offers one-on-one support with a mentor.

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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.

What Is A Late Effect

A late effect is a side effect related to a cancer diagnosis or treatment that happens months to years after treatment. Some side effects that you develop during treatment can last for months to years after treatment is completed . These are often called long term side effects.

Late effects can be health issues or psychological, emotional and practical challenges.

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Treatment Areas And Possible Side Effects

Part of the Body Being Treated	Possible Side Effects
Urinary and bladder changes

Healthy cells that are damaged during radiation treatment usually recover within a few months after treatment is over. But sometimes people may have side effects that do not improve. Other side effects may show up months or years after radiation therapy is over. These are called late effects. Whether you might have late effects, and what they might be, depends on the part of your body that was treated, other cancer treatments youve had, genetics, and other factors, such as smoking.Ask your doctor or nurse which late effects you should watch for. See the section on Late Effects to learn more.

• Posted:May 1, 2018

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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.

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Possible Side Effects Of Ebrt

Some of the side effects from EBRT are the same as those from surgery, while others are different.

Bowel problems: Radiation can irritate the rectum and cause a condition called radiation proctitis. This can lead to diarrhea, sometimes with 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. To help lessen bowel problems, you may be told to follow a special diet during radiation therapy to help limit bowel movement during treatment. Sometimes a balloon-like device or gel is put between the rectum and the prostate before treatment to act like a spacer to lessen the amount of radiation that reaches the rectum.

Urinary problems: Radiation can irritate the bladder and lead to a condition called radiation cystitis. You might need to urinate more often, have a burning sensation while you urinate, and/or find blood in your urine. Urinary problems usually improve over time, but in some men they never go away.

Some men develop urinary incontinence after treatment, which means they cant control their urine or have leakage or dribbling. As described in the surgery section, there are different levels and types of incontinence. Overall, this side effect occurs less often with radiation therapy than after surgery. The risk is low at first, but it goes up each year for several years after treatment.

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. 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.

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Swollen Legs Or Scrotum

You might get swelling in the legs or the sack of skin around the testicles . The swelling is called lymphoedema . It happens when the lymph channels that drain fluid from the legs are damaged by the radiotherapy. The swelling can be uncomfortable.

You can do various things to lower your risk of getting lymphoedema. Early treatment can reduce the swelling and stop it from getting worse.

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Side Effects Of Prostate Radiation

Side effects of prostate radiation is an important topic, which many doctors and their patients have to discuss before proceeding to the procedure further on. In most cases, radiation treatment for prostate cancer has the same side effects as brachytherapy . But its important to keep in mind that every person will have different side effects from the same procedure and health in general.

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Reducing Side Effects During Radiotherapy For Prostate Cancer

Radiation is a very effective treatment for prostate cancer, but in a small percentage of patients it also can cause toxicities to nearby organs, particularly the rectum. Side effects are usually minor and can include hemorrhoidal type bleeding and rectal incontinence. But for a very small subset of patients, the side effects can be more serious.

Patients who take blood thinners or who have Crohns disease or ulcerative colitis, for example, are at greater risk for complications from radiation therapy for prostate cancer than are other patients. For these patients, sparing the rectum is a significant concern.

Serious complications are rare, but as Dr. Greg Cooley, Department of Human Oncology clinical associate professor and radiation oncologist at UW Health East, says, If they happen to one patient, thats one too many.

For patients who are susceptible to complications, Cooley uses a relatively new technique to move the rectum away from the treatment area to reduce the likelihood that the rectum will be exposed to radiation during treatment. He injects a substance called SpaceOAR into the space between the patients prostate and rectum, which pushes these two organs apart by about 1 cm and solidifies into a soft hydrogel that remains stable for three months.

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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Treating Advanced Prostate Cancer

If the cancer has reached an advanced stage, it’s no longer possible to cure it. But it may be possible to slow its progression, prolong your life and relieve symptoms.

Treatment options include:

• hormone treatment
• chemotherapy

If the cancer has spread to your bones, medicines called bisphosphonates may be used. Bisphosphonates help reduce bone pain and bone loss.

How Does External Beam Radiation Therapy Work

External beam radiation therapy, or EBRT, uses a machine to direct high-energy X-rays at the cancer in daily doses. The radiation beam is generated by a machine called a linear accelerator or LINAC. Using treatment planning computers and software, your treatment team controls the size and shape of the beam as well as how it is directed at your body to most effectively treat your tumor and minimize damage to surrounding normal tissue.

To minimize side effects, the treatments are typically given five days a week over a six-to-nine week period. The break in days allows the doctors to get enough radiation into the body to kill the cancer while giving healthy cells time to recover.

Watch our expert medical oncologist, Dr. Alicia Morgans from Vanderbilt-Ingram Cancer Center, discuss external beam radiation therapy:

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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.

Side Effects From Radiation Therapy

September 13, 2017PCRI

Radiation for prostate cancer may cause short- or long-term side effects. Even though radiation targets the cancer cells, normal body tissues near the tumor can be affected. Specifically, we are talking about the rectum, small intestine, bladder, urethra, bone marrow, and sexual organs. If these organs repair incompletely, the radiation effects may devolve into scar tissue. Most side effects from radiation resolve within 1-2 months after treatment. However, a minority of men encounter long-term problems.

Fatigue

There is one radiation-related side effect that has nothing to do with the surrounding organsfatigue, which may begin to be noticeable after two weeks or so. The maximum level of fatigue usually occurs after about four weeks of treatment and persists until the end of the treatment. After the radiation is complete, normal energy levels typically recover in four to eight weeks. Moderate-intensity exercisewalking 30 minutes at least three days each weeksubstantially reduced fatigue.

Sexual Function

Genitourinary System

Rectum

Small Intestine

The Importance of Skillful Treatment

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