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What To Expect From Radiation Treatment For Prostate Cancer

What Happens Between Appointments

Radiation therapy for prostate cancer: What to expect

Contact your doctor or nurse if you have any concerns or get any new symptoms or side effects between your follow-up appointments.

Its important to speak to them if youre concerned about anything dont worry about them being too busy.

You can get support or advice over the telephone, or they might bring forward the date of your nextfollow-up appointment.

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Do We Know Which Treatment Is Best For Prostate Cancer Brachytherapy Or External Beam Radiation

Its not a question of which type of radiation therapy is best in general, but rather which therapy is best for the patients specific disease and quality-of-life concerns. We want to use the most tailored, pinpointed radiation to treat the prostate tumor effectively while minimizing side effects. This can depend on the tumors size and stage as well as other patient characteristics and even a patients individual preferences.

Q: What Is The Success Rate Of Radiation Therapy For Prostate Cancer

Long-term studies show the success rate for patients who undergo radiation therapy is actually the same as those who get surgery. If you catch it in its early stages, the 5-year survival rate is very high – in the high 90s, but early screening and early intervention is key and makes all the difference in the world, says Dr. Gejerman.

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What Symptoms Should I Look Out For

If your cancer does come back, the first sign is likely to be a rise in your PSA level, rather than any symptoms. And problems will often be side effects of treatment rather than a sign that your cancer has come back.

However, its important to let your doctor or nurse know if you do get any new symptoms or side effects, or are worried that your cancer might have come back. If your cancer has come back and has spread from the prostate to other parts of the body, it can cause symptoms, such as extreme tiredness â rel=ânofollowâ> fatigue), bone pain and problems urinating.

Your doctor or nurse can help find out what might be causing your symptoms and help you manage any side effects. They can also look at your PSA level and do other tests to see whether or not your cancer might have come back.

What other tests might I have?

If your doctor or nurse is concerned about your PSA level or if you have new symptoms that suggest your cancer might have come back, they may recommend that you have some other tests, such as a prostate biopsy, MRI scan, CT scan, bone scan or PET scan.

Your doctor or nurse will explain these tests to you if you need them, or you can get in touch with our Specialist Nurses for more information.

Is Ebrt Right For You

RT Answers

If you were recently diagnosed with prostate cancer and are in the process of reviewing your treatment options, you probably have questions. A prostate cancer specialist in the renowned Urologic Oncology Program at Moffitt Cancer Center can provide the reliable answers you need and help you decide if radiation treatment is right for you.

To rapidly connect with an experienced oncologist at Moffitt, call or complete our new patient registration form online. We provide new patients with access to a cancer expert within one day, which is faster than any other cancer hospital in the nation. You can feel confident that planning for your treatment will begin even before you walk through our doors.

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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 person’s 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.

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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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. It is advisable that you meet with all of the specialists involved in your cancer treatment planning prior to making a decision regarding treatment, including:

  • your primary care physician as well as a urologist to discuss surgery
  • a radiation oncologist to discuss radiation therapy.

Once you have met with these doctors, you will be able to make a more informed decision regarding your treatment options. If you have an early-stage cancer or moderately advanced cancer and there is no evidence of spread to other organs , the two major options for treatment are surgery or radiation therapy .

If your cancer is advanced and you require hormonal suppression therapy or chemotherapy, then you will also need a medical oncologist, who administers these drugs. Hormone-ablation therapy, which is often used to treat more advanced prostate cancer by suppressing your androgen hormones since most prostate cancer growth is stimulated by androgen or testosterone. The androgen suppression treatment can be administered by your internist, urologist, radiation oncologist or medical oncologist. Depending on the stage of the cancer, hormone suppression therapy may be used in addition to radiation therapy to help control the cancer. Hormone suppression therapy may be administered for as little as four to six months, or for as long as two to three years.

How Does Radiotherapy Work

What to Expect Before Starting Radiation Treatment for Prostate Cancer

Radiotherapy aims to destroy prostate cancer cells without causing too much damage to healthy cells. External beam radiotherapy is high-energy X-ray beams targeted at the prostate from outside the body. These X-ray beams damage the cancer cells and stop them from growing and spreading to other parts of the body . Radiotherapy permanently damages and kills the cancer cells, but healthy cells can repair themselves and recover more easily.

Radiotherapy treats the whole prostate. It aims to treat all the cancer cells, including any that have spread to the area just outside the prostate. The treatment itself is painless but it can cause side effects that may cause you problems.

You may have radiotherapy to a wider area, including the nearby lymph nodes, if there is a risk that the cancer has spread there. Lymph nodes are part of your immune system and are found throughout your body. The lymph nodes in your pelvic area are a common place for prostate cancer to spread to. If you do have radiotherapy to a wider area, you will be more likely to get side effects.

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What Are The Different Types Of Radiation Treatments

Radiation therapy uses concentrated doses of radiation to kill cancer cells and reduce the size of tumors. Depending on the type of cancer present in the body, one of two types of radiation therapy may be used.

External beam radiation therapy uses a large machine to send radiation into the specific area containing cancer. The radiation machine never touches the body, but it does move around to deliver radiation into precise parts of the body. External beam radiation is the most common type of treatment for many cancers.

Internal radiation therapy, on the other hand, uses a solid or liquid radiation source to physically deliver radiation inside the body. If a solid source of radiation is used, it only targets a specific part of the body for localized treatment, especially for cancers of the head, neck, breast, cervix, prostate, and eye. If a liquid source of radiation is used, its considered a systemic therapy that travels through the blood into tissues throughout the entire body.

Radiation therapy is often used in conjunction with other treatments or surgeries to target cancer in the most strategic way possible. Its often used to make surgery easier by shrinking the size of the tumor beforehand. Radiation therapy is even used during surgery to go straight into cancer cells without passing through the skin.

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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What Happens After Radiation Therapy Treatment Ends

Once treatment ends, you will have follow-up appointments with the radiation oncologist. It’s important to continue your follow-up care, which includes:

  • Checking on your recovery

  • Watching for treatment side effects, which may not happen right away

As your body heals, you will need fewer follow-up visits. Ask your doctor for a written record of your treatment. This is a helpful resource as you manage your long-term health care.

Stereotactic Body Radiation Therapy

Radiation Machine

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.

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Radiation Therapy For Advanced Prostate Cancer

When prostate cancer spreads, it tends to travel first to the bones. This may be diagnosed using imaging tests such as computed tomography scans. Cancer in the bones may cause pain and discomfort, so radiation is one tool that doctors may recommend to help manage the disease. Other commonly used treatments for advanced prostate cancer include chemotherapy, hormone therapy or immunotherapy.

External radiation therapy may be used to help reduce bone pain by targeting specific tumors, especially on the spine.

Some patients with advanced cancer may qualify to be part of a clinical trial involving radiation. In clinical trials, researchers study the effect of new treatments to see whether these are as safe and comprehensive as current treatments, or better.

Q: What Should Men With Prostate Cancer Look For In A Treatment Center

A: There are several things to look for in a cancer treatment center, but four critical components are:

  • Expertise: Research published in the New England Journal of Medicine shows that positive treatment outcomes are linked to the number of patients a center treats. It is especially clear with prostate and pancreatic cancer that receiving treatment in a center with a high volume of patients and experienced staff makes a huge difference, says Dr. Gejerman. For example, at John Theurer Cancer Center we do more robotic surgeries than any other cancer center in the country – and the more you do, the better you get.
  • Team Diversity: Its important to find a cancer center that offers all the different types of treatment you might need under one roof. Having expertise at all levels ensures that the best course of treatment is defined and at your fingertips. Hackensack Meridian Healths cancer teams have tumor board discussions where everyone comes together to discuss a case and determine the best treatment plan, says Dr. Patel. Radiation Oncology requires teamwork among physicians, nurses, dosimetrists, physicists, navigators and therapists to deliver the best plan for that patient.
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    Are There Side Effects Of The Combination Approach

    There is a slightly higher chance that patients who receive the combined therapy will have rectal irritation or urinary side effects. This is common with prostate cancer radiation therapy because the radiation can damage cells in the tissues surrounding the prostate. But at MSK, we routinely use sophisticated computer-based planning techniques that help us reduce the dose given to normal tissues such as the rectum, bladder, and urethra, lessening the chances of side effects and complications. We have also found that, when treating with the combined approach, using the high-dose-rate brachytherapy compared to low-dose-rate brachytherapy may have less in the way of side effects.

    In addition, at MSK, we routinely use a rectal spacer gel, which we inject between the prostate and the rectum while the patient is under mild anesthesia, to create a buffer between these two tissues. By creating this space, we can further reduce the dose of radiation the rectum is exposed to. This leads to fewer side effects for the patient. The rectal spacer gel is biodegradable and dissolves on its own within the body after a few months.

    What Is Proton Beam Radiation Therapy

    What to Expect after Radiation Therapy for Prostate Cancer

    This type of therapy treats tumors with protons instead of X-ray radiation. It may be able to deliver more radiation specifically to a prostate cancer tumor with less damage to normal tissue.

    Proton beam therapy might be a safe treatment option when a doctor decides that using X-rays could be risky for a patient. But so far, research hasnât shown that it works better than traditional radiation therapy against solid cancers in adults.

    The side effects of proton beam therapy are similar to the ones that other types of radiation treatment bring on. But since proton therapy may be less damaging to normal tissue, the side effects might be milder.

    After treatment, you may gradually have ones like:

    • Fatigue or low energy
    • Sore, reddened skin around the area where you got treated
    • Hair loss around the treatment spot

    One of the disadvantages of proton therapy is that it might not be covered by all insurance companies. Youâd need to check with your health plan to find out.

    Proton therapy also isnât widely available. You can get it only at certain centers in the U.S.

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    Surgically Removing The Prostate Gland

    A radical prostatectomy is the surgical removal of your prostate gland. This treatment is an option for curing prostate cancer that has not spread beyond the prostate or has not spread very far.

    Like any operation, this surgery carries some risks.

    A recent trial showed possible long-term side effects of radical prostatectomy may include an inability to get an erection and urinary incontinence.

    Before having any treatment, 67% of men said they could get erections firm enough for intercourse.

    When the men who had a radical prostatectomy were asked again after 6 months, this had decreased to 12%. When asked again after 6 years, it had slightly improved to 17%.

    For urinary incontinence, 1% of men said they used absorbent pads before having any treatment.

    When the men who had a radical prostatectomy were asked again after 6 months, this had increased to 46%. After 6 years, this had improved to 17%.

    Out of the men who were actively monitored instead, 4% were using absorbent pads at 6 months and 8% after 6 years.

    In extremely rare cases, problems arising after surgery can be fatal.

    Itâs possible that prostate cancer can come back again after treatment. Your doctor should be able to explain the risk of your cancer coming back after treatment, based on things like your PSA level and the stage of your cancer.

    After a radical prostatectomy, youâll no longer ejaculate during sex. This means you will not be able to have a child through sexual intercourse.

    External Beam Radiation Therapy

    In EBRT, beams of radiation are focused on the prostate gland from a machine outside the body. This type of radiation can be used to try to cure earlier stage cancers, or to help relieve symptoms such as bone pain if the cancer has spread to a specific area of bone.

    You will usually go for treatment 5 days a week in an outpatient center for at least several weeks, depending on why the radiation is being given. Each treatment is much like getting an x-ray. The radiation is stronger than that used for an x-ray, but the procedure typically is painless. Each treatment lasts only a few minutes, although the setup time getting you into place for treatment takes longer.

    Newer EBRT techniques focus the radiation more precisely on the tumor. This lets doctors give higher doses of radiation to the tumor while reducing the radiation exposure to nearby healthy tissues.

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