Monday, September 26, 2022

Complications Of Radiation For Prostate Cancer

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When Is Radiation Therapy Given

Side effects of radiation therapy for prostate cancer video

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 .

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.

What Is Stereotactic Body Radiation Therapy And What Advantages Does It Offer

Stereotactic body radiation therapy, or SBRT, involves the use of sophisticated image guidance that pinpoints the exact three-dimensional location of a tumor so the radiation can be more precisely delivered to cancer cells. Traditionally, external beam radiation has been delivered in anywhere from 45-48 sessions over multiple weeks. But large, randomized studies have shown that shorter courses of radiation are just as safe and effective. Therefore, at MSK, we have shortened all our radiation courses.

There is increasing interest in giving this radiation in very short courses of treatment using intense radiation doses, called hypofractionated radiation therapy. Many of the people we care for have a type of radiation therapy called MSK PreciseTM. This is a hypofractionated form of SBRT that can be given in five sessions. MSK has been doing this for the past 20 years, and the results in the several hundred people whove been treated have been excellent so far. The treatment is very well tolerated and quite effective

Because of its superior precision, MSK Precise can have fewer side effects than more conventional radiation techniques, with extremely low rates of incontinence and rectal problems. The sexual side effects are low, similar to what is experienced with more extended external radiation techniques. And of course, its much more convenient for patients.

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Urinary And Sexual Function

Perhaps the 2 most feared complications of RP from a patient’s perspective are urinary complications and impotence. One difficulty in assessing these complications is that there are no precise definitions of incontinence or impotence in the literature. Furthermore, centers have obtained their outcomes data by widely divergent methods, including questionnaires, telephone interviews, or surgeon assessment. Lastly, continence and potency rates are improved when the patient population is highly selected .

Urinary incontinence can be a devastating complication following prostatectomy. Given the difficulty in measuring this clinical outcome, however, continence results in the literature vary widely. Most centers with a high-volume experience in this procedure report continence rates between 80% and 95% .

Radiation Therapy In Advanced Disease:

Prostate Cancer Death Risk Higher After External Beam Radiation Therapy ...

Some forms of radiation therapy, like external radiation therapy and radiopharmaceuticals, can help with advanced prostate cancer. One type of external radiation therapy is used along with hormone therapy to treat cancer that has spread outside the prostate to nearby tissue. In addition, radiopharmaceuticals are used to manage pain and symptoms of bone metastases. Scroll down to learn more about radiopharmaceuticals.

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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.

Who Should Consider Taking Radiopharmaceuticals

Radiopharmaceuticals are given through a vein to men with metastatic prostate cancer that has spread widely to the bone. Strontium89 and Samarium-153 are radiopharmaceuticals given to reduce the pain caused by the bone cancer. Radium-223, or Xofigo®, is a radiopharmaceutical given to prolong life.

The side effects associated with radiopharmaceuticals are mainly the suppression, or lowering, of white blood cell and platelet levels in the blood. Your doctor will be able to assess whether your body can handle this side effect before you are given the treatment and will monitor your levels after you receive it. Your doctor, specialist nurse, or nuclear medicine practitioner will be able to give you more information about the treatment and possible side effects.

If your doctor has told you that your bone metastases have spread, you may be a candidate for a radiopharmaceutical. Speak with your oncology team to see if one of these treatments may be right for you.

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Which Treatment Is Best For You

The exact type of treatment that is best for you can depend upon many factors, such as the stage of the cancer, where in the prostate the cancer is located, and individual factors. These are all taken into account by the treating healthcare team when creating a personalized treatment plan.

When you meet with your healthcare provider, they will give you the options that will be the most effective in treating your case of prostate cancer.

For stage 1 prostate cancer, treatment may include:

  • Watchful waiting or active surveillance
  • Hormone therapy
  • Radical prostatectomy with pelvic lymphadenectomy
  • Radiation after surgery
  • Transurethral resection of the prostate

What Are The Advantages And Disadvantages Of External Beam Radiotherapy

Radiation Therapy Side Effects for Prostate Cancer Patients

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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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.

Prices And Where To Get It

The cost of a radical prostatectomy varies depending on insurance status and location of surgery.

Costs may include hospital fees, anesthesia fees, and surgeon fees. The average cost of hospital fees for prostatectomy in the United States is about $34,000. Anesthesiologist and surgeon fees average about $8,000. What out-of-pocket expenses the person being treated incurs will depend on their insurance.

The location of the procedure can be with a local surgeon, or the person being treated may travel to see a regional or national expert.

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Talk With Your Doctor About Side Effects And What To Expect

Your doctor can help you determine whether radiation therapy is right for you.

In addition, an oncologist a doctor specializing in cancer treatment can help you learn how to minimize your chance of developing side effects.

They can also refer you to local support groups where you can get in touch with other people who have undergone or are undergoing the same treatment.

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Complications of Prostate Cancer Treatment: Spectrum of Imaging ...

Surgical procedures to remove the diseased prostate are usually necessary. Surgical procedures are not always necessary. If the disease is caused by bacterial infections, a doctor can treat the symptoms using alpha-blockers or surgery. Physical therapy, relaxation exercises, and warm baths are all recommended. A physician may also prescribe antibiotics to cure the infection. A bacterial infection can also cause a recurrence of the condition.

An enlarged prostate can be uncomfortable for both men and women. Some of the symptoms of an enlarged male reproductive organ include a weakened urine stream, urgent need to urinate, and urinary tract infections. BPH can also cause damage to the kidneys. A sudden inability to urinate can be life-threatening, as it can lead to bladder and kidney damage. Unfortunately, most men with enlarged prostrates put up with the symptoms for years before they seek treatment. However, many of the men with symptoms finally decide to go to a doctor for proper gynecological evaluation and to begin enlarged prostatic therapy.

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When Is Brachytherapy Alone The Right Choice

For some patients with disease that is confined to the prostate and not too aggressive , brachytherapy alone is a good option. It is also convenient for the patient as it is done in an outpatient setting and most people can get back to work within a few days.

But brachytherapy is not right for everyone. For some patients with less-aggressive disease, a watch-and-wait approach would be preferred. At MSK, our philosophy is that when the disease is caught very early, it is very appropriate to do active surveillance and hold off on treatment.

This philosophy applies to patients with a low PSA level, or nonaggressive disease as reflected by a Gleason score of 6 with evidence of cancer in only a few of the biopsy samples and no evidence from the MRI of a significant amount of disease. There are also very select patients with Gleason 7 disease who may be candidates for active surveillance.

What Are The Dangers Of Radiotherapy Prostate Cancer Treatment

Radiotherapy is considered effective for treatment of cancer with a success rate of above 90%. But is it safe for prostate cancer treatment? Does it cause any side effects? And if yes, are radiation therapy side effects reversible?

Well, radio frequency is pain-free and considered safe for prostate cancer treatment. To help you understand the safety of this procedure we shall look at both the short and long-term side effects resulting from this treatment.

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Radiation Therapy Side Effects

Radiation not only kills or slows the growth of cancer cells, it can also affect nearby healthy cells. Damage to healthy cells can cause side effects.

Many people who get radiation therapy have fatigue. Fatigue is feeling exhausted and worn out. It can happen all at once or come on slowly. People feel fatigue in different ways and you may feel more or less fatigue than someone else who is getting the same amount of radiation therapy to the same part of the body. See Fatigue and Cancer Treatment to learn more.

Other radiation therapy side effects you may have depend on the part of the body that is treated. To see which side effects you might expect, find the part of your body being treated in the following chart. Many of the side effects in the list link to more information in the Side Effects section. Discuss this chart with your doctor or nurse. Ask them about the side effects that you might expect.

Cardiovascular Disease And Diabetes

Local Therapy – Managing Locoregional Complications in Metastatic Prostate Cancer

Diabetes and cardiovascular disease are leading causes of death in men. The adverse treatment-related changes in weight, body composition, lipids, and insulin sensitivity raise the possibility that ADT may increase the risk of these medical conditions. To evaluate the relationship between ADT and risk for incident diabetes and cardiovascular disease, Keating and colleagues conducted a large population-based study using the SEER-Medicare database.107

This landmark study included 73,196 men diagnosed with local or locoregional prostate cancer between 1992 and 1999 with follow up through 2001. Of the total population, one-third of men were treated with ADT during the study period. The analysis was adjusted for both patient and tumor characteristics. After adjusting for a variety of covariates, ADT with a GnRH agonist was associated with a significantly greater risk of incident diabetes , coronary heart disease , and admission for myocardial infarction . A subsequent study using SEER-Medicare data confirmed the link between ADT and incident cardiovascular disease.150

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Faq: Radiation Therapy For Prostate Cancer

Why would I choose radiation therapy?

Radiation therapy, including external beam radiation therapy and brachytherapy, is an alternative form of treatment for prostate cancer. EBRT may be used after other treatments, such as surgery, to manage cancer that has recurred or is at high risk of recurrence. Radiation therapy has an excellent record of success, providing long-term disease control and survival rates equivalent to other treatments, including surgery.

How should I expect to feel during radiation therapy?

Undergoing external beam radiation therapy is similar to having a routine X-ray. Radiation cannot be seen, smelled or felt. Generally, side effects don’t appear until the second or third week of treatment. Because radiation therapy is a local treatment, only the areas of the body where it is directed will experience side effects. Most patients will experience some or all of the following:

  • Increase in the frequency of urination
  • Urinary urgency
  • Softer and smaller volume bowel movements
  • Increased frequency of bowel movements
  • Worsening of hemorrhoids or rectal irritation with occasional scant blood and fatigue

Many questions may arise during radiation therapy treatment. Your doctors will be available to answer questions throughout your treatment.

How should I expect to feel after radiation therapy?

Bladder Neck Contracture Urethral Stricture

Another possible complication is a narrowing of the urethra, and this is generally called urethral stricture disease. However, when the narrowing occurs where the bladder meets the prostate of the urethra , this narrowing and blockage is called a bladder neck contracture. The symptoms of obstruction from a bladder neck contracture or a urethral stricture include a diminished urine flow rate, an intermittent start-stop stream, straining to urinate and a sensation of incomplete emptying.

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Other Questions About Radiation Therapy

Who can I contact if I have 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 they can give you information about resources. They can also discuss housing or transportation needs if you need.

People dealing with certain medical issues find it helpful to share experiences with others in the same situation. Your doctor can give you a list of support groups if youâre interested. Your social worker can offer more information about finding support, and you can look online for support group resources.

What about follow-up care?

After your radiation therapy sessions are complete, youâll visit your doctor for regular follow-up exams and tests. Your doctor will tell you how often to schedule your follow-up appointments.

You can also ask your doctor for a survivorship care plan. This outlines things like:

  • The treatment you received
  • What side effects you may get in the short and long term
  • Who should be following you for testing and care

Show Sources

American Cancer Society: âRadiation Therapy for Prostate Cancer,â âRadiation Therapy Side Effects,â âCancer Therapy,â âEating Well During Treatment.â

OncoLink: âRadiation Therapy: Which type is right for me?â

Memorial Sloan Kettering: âWhat Is Brachytherapy?â

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