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Can You Have Radiation Twice For Prostate Cancer

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Important Study Changed Treatment

Which is Better – Surgery vs. Radiation for Prostate Cancer?

The study is based on data from a large and important study that was completed in 2009, called the SPCG-7 study.

The study involved 875 Swedish, Norwegian and Danish prostate patients, who were randomly selected for either hormone therapy, or for both radiation and hormone therapy. A randomized study where people are divided by chance means that the groups are more or less similar, which in turn means they can be compared more fairly.

The study showed that men had a better chance of living for a long time if they were treated with both radiation and hormone therapy if they had advanced, local prostate cancer. Advanced, local prostate cancer means that the tumour has grown outside of the prostate capsule, but has not spread to the rest of the body.

The SPCG7 study made radiation with hormone therapy the standard treatment for this patient group, says Aksnessæther.

Special Diet Needs While On Radiation Therapy

Radiation can cause side effects that make it hard to eat, such as nausea, mouth sores, and throat problems called esophagitis. Since your body uses a lot of energy to heal during radiation therapy, it is important that you eat enough calories and protein to maintain your weight during treatment.

If you are having trouble eating and maintaining your weight, talk to your doctor or nurse. You might also find it helpful to speak with a dietitian. For more information about coping with eating problems see the booklet Eating Hints or read more about side effects.

Can I Lower My Risk Of Getting A Second Cancer

There are steps you can take to lower your risk and stay as healthy as possible. For example, people who have had colorectal cancer should do their best to stay away from tobacco products. Smoking might further increase the risk of some of the second cancers that are more common after colorectal cancer.

To help maintain good health, colorectal cancer survivors should also:

  • Get to and stay at a healthy weight
  • Keep physically active and limit the time you spend sitting or lying down
  • Follow a healthy eating pattern that includes plenty of fruits, vegetables, and whole grains, and limits or avoids red and processed meats, sugary drinks, and highly processed foods
  • It’s best not to drink alcohol. If you do drink, have no more than 1 drink per day for women or 2 per day for men

These steps may also lower the risk of some other health problems.

See Second Cancers in Adults for more information about causes of second cancers.

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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 Fertility Might Be Affected

Can Hormonal Rx for Prostate Cancer Raise Dementia Risk?

For women: Talk to your cancer care team about how radiation might affect your fertility . Its best to do this before starting treatment so you are aware of possible risks to your fertility.

Depending on the radiation dose, women getting radiation therapy in the pelvic area sometimes stop having menstrual periods and have other symptoms of menopause. Report these symptoms to your cancer care and ask them how to relieve these side effects.Sometimes menstrual periods will return when radiation therapy is over, but sometimes they do not.

See Fertility and Women With Cancer to learn more.

For men: Radiation therapy to an area that includes the testicles can reduce both the number of sperm and their ability to function. If you want to father a child in the future and are concerned about reduced fertility, talk to your cancer care team before starting treatment. One option may be to bank your sperm ahead of time.

See Fertility and Men With Cancer to learn more.

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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 Is Prostate Cancer

Prostate cancer develops in the prostatea small gland that makes seminal fluid. It is the second most common type of cancer in men. Prostate cancer usually grows over time and in the beginning stays within the prostate gland, where it may not cause serious harm. While some types of prostate cancer grow slowly and may need minimal or no treatment, other types are aggressive and can spread quickly.

Prostate cancer that is caught early has a better chance of successful treatment.

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What Can Be Done

If your prostate cancer has recurred, your doctor will likely order some imaging tests to better determine where in your body the cancer has returned. Bone scans, CT scans, and MRIs are the most common tests ordered to find where in the body prostate cancer has recurred.

Many treatment options are available for prostate cancer that has returned. The one that you and your physician choose depends on individual factors such as what treatment you have already received, where in the body your prostate cancer has returned, how your cancer has spread, your general health, and your age.

If your prostate cancer is thought to have recurred in only a small area and has not spread to other areas of the body, then radiation therapy to that area may be an option.

If your prostate cancer has most likely spread to multiple areas of the body, then hormonal therapy would likely be an option. Chemotherapy can also be used when the cancer has spread to multiple sites.

  • Geller J. Basis for Hormonal Management of Advanced Prostate Cancer. Cancer. 1993 Feb 1 71:1039-45.

  • Kupelian PA, Buchsbaum JC, Elshaikh M, et al. Factors Affecting Recurrence Rates After Prostatectomy or Radiotherapy in Localized Prostate Carcinoma Patients With Biopsy Gleason Score 8 or Above. Cancer. 2002 Dec 1 95:2302-7.

  • Vickers AJ, Bianco FJ Jr, Boorjian S, et al. Does a Delay Between Diagnosis and Radical Prostatectomy Increase the Risk of Disease Recurrence? Cancer. 2006 Feb 1 106:576-80.

Radiation Treatment Is Ok

Radiation vs. Surgery for Prostate Cancer | Ask a Prostate Expert, Mark Scholz, MD

Aksnessæther emphasizes that they dont advise patients not to receive radiation.

“We see that 85 percent of cases of bladder cancer are superficial cancers, which the patient is unlikely to die from,” she says.

In today’s treatment regimen, a greater proportion of patients with local, advanced prostate cancer are treated surgically. But still, a good number of people receive radiation and hormone therapy. It is uncertain what gives the best results, and there is a Scandinavian study underway to investigate this.

We see that a fair amount of the patients who have been operated need radiation therapy afterwards because they have relapses the operation has not succeeded in removing all parts of the tumour. We look forward to receiving the results of this new study so that we can give even better advice to patients regarding choice of treatment, Aksnessæther said.

Reference:

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How Should I Take Methotrexate

YOU MAY NOT NEED TO TAKE METHOTREXATE EVERY DAY. This medicine is sometimes taken only once per week, or 2 to 4 times per week. Some conditions are treated daily for just a few days followed by a rest period of 1 week or longer before taking the medicine again.

You must use the correct dose. Some people have died after incorrectly taking methotrexate every day.

Take methotrexate exactly as it was prescribed for you. Follow all directions on your prescription label and read all medication guides or instruction sheets.

Measure liquid medicine carefully. Use the dosing syringe provided, or use a medicine dose-measuring device .

Methotrexate can be toxic to your organs, and may lower your blood cell counts. You will need frequent medical tests, and you may need an occasional liver biopsy or chest X-ray. Your cancer treatments may be delayed based on the results.

If you need to be sedated for dental work, tell your dentist you currently use methotrexate.

Store methotrexate at room temperature away from moisture, heat, and light.

You may store Xatmep in a refrigerator or at room temperature. Avoid freezing or high heat. Throw away any unused Xatmep after 60 days if kept at room temperature.

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.

Also Check: Can Prostate Problems Affect Bowel Movements

Is Prostate Cancer Curable

Prostate cancer is the most common type of cancer among men, second only to skin cancer. Learning that one has any type of cancer isnt easy, but the first question on most patients minds after diagnosis is, is prostate cancer curable?

The short answer is yes, prostate cancer can be cured, when detected and treated early. The vast majority of prostate cancer cases are discovered in the early stages, making the tumors more likely to respond to treatment. Treatment doesnt always have to mean surgery or chemotherapy, either. Non-invasive radiation therapy can effectively treat prostate cancer in the case of Pasadena CyberKnife, radiosurgery treatment generally takes less than a week, and you can typically resume your normal activities the same day you receive treatment.

Cancer That Clearly Has Spread

Prostate cancer: Whether to treat or monitor

If the cancer has spread outside the prostate, it will most likely go to nearby lymph nodes first, and then to bones. Much less often the cancer will spread to the liver or other organs.

When prostate cancer has spread to other parts of the body , hormone therapy is probably the most effective treatment. But it isnt likely to cure the cancer, and at some point it might stop working. Usually the first treatment is a luteinizing hormone-releasing hormone agonist, LHRH antagonist, or orchiectomy, sometimes along with an anti-androgen drug or abiraterone. Another option might be to get chemotherapy along with the hormone therapy. Other treatments aimed at bone metastases might be used as well.

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Detecting Prostate Cancer Recurrence

If you have recurrent prostate cancer, its usually detected during follow up appointments. Once you undergo initial prostate cancer treatment, youll need to see your urologist once every few months to monitor your PSA levels and discuss any new symptoms. If your PSA levels begin to rise, it can be an indication that the cancer has returned. Your doctor will use imaging tests to try and locate the cancer and determine the best course of action for a second round of treatment. Tools for detection are continually improving, so be open to suggestions from your doctor.

Prostatectomy Twice As Likely As Radiotherapy For Prostate Cancer

HEALTH policies regarding the treatment of prostate cancer should be re-examined to provide greater patient choice after a study found men in New South Wales aged 45 years or more with prostate cancer were twice as likely to undergo radical prostatectomy as external beam radiotherapy, and few had consulted radiation oncologists prior to surgery.

Published in the Medical Journal of Australia, the study analysed data from 4003 NSW men aged 45 years or more enrolled in the population-based 45 and Up Study and in whom prostate cancer was first diagnosed during 20062013.

Surgery and radiation therapy are treatment options for low risk prostate cancer and both result in excellent survival rates but different side effects.

In total, 1619 of 4003 patients underwent radical prostatectomy as their first treatment, 893 external beam radiotherapy , 183 brachytherapy , 87 chemotherapy , 373 androgen deprivation therapy alone , and 848 no active treatment , wrote the researchers, led by Dr Mei Ling Yap, a radiation oncologist from the Collaboration for Cancer Outcomes Research and Evaluation at the Ingham Institute, University of NSW.

Only 205 of 1628 patients who had radical prostatectomies had radiation oncology consultations prior to surgery yet both treatments are acceptable options.

  • Cate Swannell

Correspondence:

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Physical Emotional And Social Effects Of Cancer

Cancer and its treatment cause physical symptoms and side effects, as well as emotional, social, and financial effects. Managing all of these effects is called palliative care or supportive care. It is an important part of your care that is included along with treatments intended to slow, stop, or eliminate the cancer.

Palliative care focuses on improving how you feel during treatment by managing symptoms and supporting patients and their families with other, non-medical needs. Any person, regardless of age or type and stage of cancer, may receive this type of care. And it often works best when it is started right after a cancer diagnosis. People who receive palliative care along with treatment for the cancer often have less severe symptoms, better quality of life, and report that they are more satisfied with treatment.

Palliative treatments vary widely and often include medication, nutritional changes, relaxation techniques, emotional and spiritual support, and other therapies. You may also receive palliative treatments similar to those meant to get rid of the cancer, such as chemotherapy, surgery, or radiation therapy.

Learn more about the importance of tracking side effects in another part of this guide. Learn more about palliative care in a separate section of this website.

How Chemotherapy Affects Your Body After Treatment

Side Effects of Surgery Vs Radiation for Prostate Cancer

Some side effects of chemotherapy only happen while you’re having treatment and disappear quickly after it’s over. But others can linger for months or years or may never completely go away.

Watch out for signs of chemo’s long-term changes, and let your doctor know how you feel. Your doctor can suggest ways to manage your symptoms.

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Before Taking This Medicine

You should not use methotrexate if you are allergic to it. You may not be able to take this medicine if you have:

  • alcoholism, cirrhosis, or chronic liver disease

  • low blood cell counts

  • a weak immune system or bone marrow disorder or

  • if you are pregnant or breastfeeding.

Methotrexate is sometimes used to treat cancer in people who have a condition listed above. Your doctor will decide if this treatment is right for you.

To make sure this medicine is safe for you, tell your doctor if you have ever had:

Tell your doctor if you are pregnant or plan to become pregnant. Methotrexate may cause injury or death to an unborn baby and should not be used during pregnancy to treat arthritis or psoriasis. However, methotrexate is sometimes used to treat cancer during pregnancy.

Methotrexate can harm an unborn baby if the mother or the father is using this medicine.

  • If you are a woman, you may need to have a negative pregnancy test before starting this treatment. Use effective birth control to prevent pregnancy while you are using methotrexate and for at least 6 months after your last dose.

  • If you are a man, use effective birth control if your sex partner is able to get pregnant. Keep using birth control for at least 3 months after your last dose.

  • Tell your doctor right away if a pregnancy occurs while either the mother or the father is using methotrexate.

It Is Possible To Get Radiation Treatment More Than Once

Asked by Charlotte, Southport, Connecticut

Is it possible — in some cases — to get a second round of radiation? When I had it 25 years ago I was told that this is once-in-a-lifetime treatment, yet a friend of mine is scheduled for a second round.

Conditions ExpertDr. Otis BrawleyChief Medical Officer,American Cancer Society

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