What Will I Learn By Reading This
You and your doctor may be talking about using IMRT to treat your prostate cancer. It is important for you to learn about IMRT so that you will know what to expect and how best to take care of yourself before, during, and after treatment. In this booklet, you will learn about the following:
- What IMRT is
- How you get ready for IMRT
- What to expect when you have IMRT
- Possible side effects of IMRT
- How you can take care of yourself before, during, and after IMRT
It is important to think about how you will work these things into your everyday life if you and your doctor decide that IMRT is the best way to treat your prostate cancer.
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I visited the Colon specialist this week, wants to do a flexible sigmoidoscopy next week to look around and see what the problem may be. Hopefully after that we can agree a treatment plan. I updated the Radiation Oncologist and GP, hoping the GP would give me a holistic view, with all the problems, my lack of sleep, pain management and weight loss but he was less than helpful. Told me that I should relax and I am getting the best people involved in my treatment. Not what I was looking for after 4 months of pain and no resolution. So after this procedure next week I may start looking for a new GP.
What Happens On Treatment Days
External radiation therapy requires regular sessions during a period of about five to eight weeks. For each treatment, the radiation therapist will help you onto the treatment table and into the correct position. Once the therapist is sure you are positioned well, they will leave the room and start the radiation treatment.
You will be under constant observation during the treatment. Cameras and an intercom are in the treatment room, so the therapist can always see and hear you. Be sure to remain still and relaxed during treatment. Let the therapist know if you have any problems or discomfort.
The therapist will be in and out of the room to reposition the machine and change your position. The treatment machine will not touch you, and you will feel nothing during the treatment. Once the treatment is complete, 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 you are being positioned accurately during your treatments.
Port films do not provide diagnostic information, so radiation therapists cannot learn about your progress from these films. However, port films are important to help the therapists make sure the radiation is delivered to the precise area that needs treatment.
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Will I Need To See My Doctor After My Imrt Treatment Is Over
Once your IMRT is finished, it is important for you to have regular visits with your doctor to check how well your treatment is working and to deal with any side effects that you may have. Your doctor will want to see you every three to four months for two to three years. Your doctor will schedule your appointments and order any tests you need to make sure you have the best follow-up care possible. Dont be afraid to ask about any tests or treatments that your doctor orders. Use these appointments to learn about the things you need to do to take good care of yourself following your prostate cancer treatment. .
Helping Yourself After Your IMRT Treatments.
- When do you need to see your doctor or health care team?
- How can you reach your doctor or health care team?
Bowel And Bladder Problems
You may have bowel or bladder changes because of radiotherapy. For example, blood vessels in your bowel and bladder can become more fragile. This may cause blood in your urine or from the back passage . If you notice any bleeding, always tell your doctor so they can check it out.
Let them know about any bowel or bladder symptoms you have. They can give you advice and may do some tests. You may also find it helpful to contact the Bladder and Bowel Community for support.
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Bowel Dysfunction After Prostate Cancer Treatment
The broad term of bowel dysfunction includes:
Diarrhea or frequent stools
Fecal incontinence or the inability to control bowel movements
All of these side effects are far more common following external beam radiotherapy than any other primary therapy, but as techniques and dose planning strategies improve, even these rates have been dropping.
Possible Late Effects Of External Beam Radiotherapy
You may have side effects that do not improve, or side effects that happen months to years after radiotherapy finishes. These are called long-term or late effects. Your doctor or nurse will explain these to you. There are different ways late effects of pelvic radiotherapy can be managed.
Possible late effects include the following:
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Diarrhea Flatulence Or Painful Defecation
These symptoms usually occur after the second or third week of treatment. Symptoms will resolve after the treatment ends. During radiation, dietary modification usually helps reduce the frequency and severity of diarrhea. Try to avoid or reduce fried foods, greasy foods and highly spiced foods. Reduce foods with insoluble fiber, such as lettuce and cauliflower, and increase low-fiber and soluable-fiber foods, such as bananas, mashed potatoes, applesauce, white rice, canned or cooked fruits and vegetables.
Maintain your intake of lean proteins, such as turkey, chicken and fish, and increase your fluid intake to avoid dehydration. Using moist toilet paper, baby wipes or sitz baths may help relieve rectal irritation. Your doctor may recommend anti-diarrheal medications. Contact your doctor if you see blood in your stool, if the diarrhea worsens or if you become light-headed or dizzy.
What Does External Beam Radiotherapy Involve
You will have your treatment at a hospital radiotherapy department. Youll see a specialist doctor who treats cancer with radiotherapy, known as a clinical oncologist. You may also see a specialist nurse and a specialist radiographer. Theyll talk to you about your treatment plan and ways to manage any side effects.
Before your radiotherapy treatment
Radiotherapy planning session
A week or two before your treatment, youll have a planning session. This is to make sure the radiographers know the exact position, size and shape of your prostate. It will help them make sure the radiotherapy is aimed at your prostate and that the surrounding areas get as little radiation as possible.
During your radiotherapy treatment
You will have one treatment at the hospital five days a week, with a rest over the weekend. You can go home after each treatment.
If you have localised prostate cancer, the course of radiotherapy usually involves 20 treatment sessions over four weeks. You might hear this called hypo-fractionated radiotherapy.
At some hospitals, youll have 37 sessions over seven or eight weeks instead. If you have 37 sessions, youll receive a slightly larger overall dose of radiotherapy but the dose you receive at each session will be lower than if you have 20 sessions.
Its safe for you to be around other people, including children and pregnant women, during your course of radiotherapy. The radiation doesnt stay in your body so you wont give off any radiation.
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Types Of Prostate Radiation
The most common types of radiation for prostate cancer are external beam radiation and brachytherapy .
1. This type of radiation uses beams of radiation, which are focused on the prostate gland from a machine outside the body. Its very helpful in the early stage of prostate cancer or in cases when it is needed to relieve pain symptoms . Such treatment is usually done 5 days a week for several weeks, depending on the condition of the patient. External beam radiation for treatment of prostate cancer has different categories of treatment, such as:
- Three-dimensional conformal radiation therapy
- Intensity-modulated radiation therapy
- Stereotactic body radiation therapy
- Proton beam radiation therapy.
2. Brachytherapy for prostate cancer also called seed radiation for prostate cancer uses very small balls or pellets, which are placed into the patients prostate. Seed radiation differs in the dosage rate of the radioactive material: permanent and temporary .
Side Effects From Hormone Therapy
Hormone therapy for prostate cancer, known as androgen deprivation therapy , suppresses production of testosterone. ADT can cause several side effects. These include fatigue, hot flashes, decreased bone density, ED, depressed mood, decreased sex drive, weight gain, heart risks, breast growth and cognitive decline.
The severity and length of side effects depend on how long treatment lasts. “If a man has only six months of treatment, their level of testosterone rises again, and they’ll go back to feeling like themselves,” Calvaresi said.
Often, mood changes in men on ADT are caused by other side effects such as weight gain and hot flashes. “If we can manage those other side effects, then often that improves mood,” she said. Following a healthy diet and exercising regularly often helps to decrease fatigue, prevent weight gain and improve overall mood. Before beginning hormone therapy, you should discuss the effects of ADT with your doctor, and talk about how you can change your exercise and eating habits to help head off side effects before they occur.
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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
Life After Prostate Cancer Treatment
Adjusting to life after prostate cancer treatment can take time. For some men, the emotional impact of what they have been through may not hit them until they have finished treatment. For others, working through the physical side effects is their immediate focus.
Although prostate cancer treatment can be lifesaving, it can also take a toll on the body. This can result in a disruption to normal urinary, bowel and sexual function.
Whether you have surgery, radiation or hormone therapy, you are likely to have side effects.
Its important to talk with your health care provider about these side effects before you start treatment, so you can learn about the range of options to treat them, says Anne Calvaresi, DNP, CRNP, RNFA, Urology Nurse Practitioner at the Kimmel Cancer Center, Thomas Jefferson University in Philadelphia.
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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.
How Does Brachytherapy Work
Brachytherapy involves implanting small, permanent radioactive seeds or temporary needles into the cancerous prostate.
After you are identified as a good candidate for brachytherapy, an ultrasound is used to guide the placement of needles into the prostate. Depending on whether you and your doctor have chosen permanent/low-dose brachytherapy or temporary/high-dose brachytherapy, these needles are then used to either put in permanent seeds or temporary radiation sources.
Placement of seeds is a minimally invasive procedure and does not require incisions. Men undergoing the procedure can return to full activity in less than a week. This is done as an outpatient procedure before you begin treatment.
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What Does Every Man Need To Know About Radiation Therapy For Prostate Cancer
Prostate cancer ranks as one of the most common cancers in men. It is estimated that prostate cancer will affect 13 out of every 100 American men. However, in current times, there are several great cancer treatments available that increase the survival rate of patients substantially. Earlier detection is also more common and will help prevent the progression of cancer.
Currently, there are several effective therapies available for prostate cancer treatment. Advanced radiation therapy and surgery are now available to prostate cancer patients. This article discusses how effective radiation therapy is for prostate cancer.
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.
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 Standard® of care.
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Urinary And Bowel Changes
Radiation therapy can cause permanent urinary and bowel changes. Many people dont notice any changes or have any symptoms. However, some people have late side effects.
Late side effects may be similar to the ones you had during treatment. Theres a very small chance you may develop other side effects. For example:
- The opening of your bladder may become narrower.
- You may lose your ability to control your bladder.
- You may have blood in your urine.
- You may have bleeding from your rectum.
- Your rectum may be injured.
These side effects are rare. They may come and go over time or be persistent and chronic. Your healthcare team will help you manage them.
Even if you dont develop any late side effects, remember that the tissues in your bladder and rectum were affected by your radiation therapy. Call your radiation oncologist if you:
- Have any new urinary, bladder, or bowel symptoms.
- Need to have a colonoscopy. Avoid having a colonoscopy for the first year after radiation therapy.
- Need any type of urological or rectal procedure.
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What Side Effects May I Have During Or After My Imrt Treatments
There are several side effects that you may have during or after your IMRT treatments. They are urinary problems, bowel problems, erectile dysfunction or impotence , skin problems, loss of appetite and tiredness. Remember, that IMRT treatments are focused on your prostate cancer. This protects the healthy cells around your prostate, which means you may have fewer side effects and that the side effects you do have wont be as bad.
The urinary problems you may have are:
The bowel problems you may have are:
- Soreness in your rectal areaYou may have soreness in your rectal area. This usually goes away by itself. If you are very sore, let you doctor or health care team know. There are medicines and things that you can do to be more comfortable.
- Rectal Urgency
The erectile dysfunction problem you may have is:
- Fewer erectionsMost men do not have problems 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. Talk to your doctor or health care team if you have a problem like this.
The skin problems you may have are:
Another problem you may have is:
If you have trouble figuring out how to make changes to deal with your tiredness, you may want to talk with your doctor or health care team.
Another problem you may have is:
Managing your 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 for lymphoedema can reduce the swelling and stop it getting worse.