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Hip Pain After Radiation For Prostate Cancer

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Who Might Benefit From Radiation Therapy

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Your doctor might recommend radiation therapy in several situations.

It can be the first treatment for cancer that hasnât spread outside your prostate gland and is âlow grade.â The grade is a number that tells you how abnormal your cancer cells look under a microscope. The lower the grade, the more normal-looking your cancer cells are â and, in general, the more likely your cancer is slow-growing.

Radiation, along with hormone therapy, might also be part of your first cancer treatment if the disease has spread beyond your prostate into nearby tissues.

If you get surgery for prostate cancer, your doctor might recommend you get radiation therapy afterward, too. It can be helpful if the surgeon couldnât remove all of the cancer or if the cancer comes back in the area of your prostate.

If you have advanced prostate cancer, radiation could help keep the disease under control for as long as possible. It can also help prevent or ease symptoms that the cancer might cause.

How Fertility Might Be Affected

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.

How Sex Might Be Affected

With some types of radiation therapy involving the pelvis and/or sex organs, men and women may notice changes in their ability to enjoy sex or a decrease in their level of desire.

For women: During radiation treatment to the pelvis, some women are told not to have sex. Some women may find sex painful. Treatment can also cause vaginal itching, burning, and dryness. You most likely will be able to have sex within a few weeks after treatment ends, but check with your doctor first. Some types of treatment can have long-term effects, such as scar tissue that could affect the ability of the vagina to stretch during sex. Again, your cancer care team can offer ways to help if this happens to you. You can also get more information in Sex and Women With Cancer.

For men: Radiation may affect the nerves that allow a man to have erections. If erection problems do occur, they are usually gradual, over the course of many months or years. Talk with your doctor about treatment options if this is a concern for you. You can get more information in Sex and Men With Cancer.

If you get internal radiation therapy with seed implants, check with your cancer care team about safety precautions during sex

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Will Radiation Therapy Make Me Tired

Everyone has their own energy level, so radiation treatment will affect each person differently.

People often feel fatigue after several weeks of treatment. For most, this fatigue is mild. But some people lose a lot of energy and need to change their daily routine.

If your doctor thinks you should limit how active you are, theyâll discuss it with you.

To minimize fatigue while youâre receiving radiation treatment:

  • Get enough rest.
  • Pace yourself, and plan rest breaks throughout your day.

What Causes The Pain

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We feel pain when our bones, muscles, organs, nerves or other parts of our bodies are damaged or irritated. Cancer which has spread into these areas might cause pain.

Sometimes pain can be due to cancer treatments. For example, radiotherapy to treat bone pain can sometimes cause your pain to get worse during treatment and for a few days afterwards. But this isnt very common.

Pain can also be caused by problems not linked to the cancer, such as an infection.

Your doctors and nurses will work with you to find out what is causing your pain and will talk to you about suitable treatments. There are effective ways to treat different types of pain.

Bone pain

If prostate cancer spreads to the bone, it can damage or weaken the bone and may cause pain. But not all men with cancer in their bones will get bone pain. Prostate cancer can spread to any area of bone around the body. It most commonly spreads to the spine. Pain in these areas can sometimes make it painful to walk and move around. The pain might remain in only one area, but over time it can spread to several parts of your body.

Bone pain is a very specific feeling. Some men describe it as feeling similar to a toothache but in the bones, or like a dull aching or stabbing. It can get worse when you move and can make the area tender to touch. Each mans experience of bone pain will be different. The pain may be constant or it might come and go. How bad it is can also vary and may depend on where the affected bone is.

Nerve pain

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External Beam Radiation Therapy

In this type of therapy, a machine outside the body is used to focus the beams of radiation on the prostate gland. It is used to treat early stages of cancer and helps to relieve you from symptoms such as pain.

Before the procedure, you will undergo simulation, which is a planning session. During this session, the radiation team takes measurements to find the correct angles for aiming the beams and the proper dosage.There are various types of EBRT namely:

  • Intensity-modulated radiation therapy
  • Three-dimensional conformal radiation therapy
  • Stereotactic body radiation therapy
  • Proton beam radiation therapy

Weekly Visits During Your Treatment

Your radiation oncologist and radiation nurse will see you each week to talk with you about any concerns, ask about any side effects you may be having, and answer your questions. This visit will be before or after your treatments each ________________. You should plan to be at your appointment for about 1 extra hour on those days.

If you need to speak with your radiation oncologist or radiation nurse any time between your weekly visits, call your radiation oncologists office or ask the support staff or your radiation therapists to contact them when you come in for treatment.

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Early Menopause After Pelvic Radiotherapy

Pelvic radiotherapy can affect the way the ovaries work and cause an early menopause. This means the ovaries gradually stop producing the hormones oestrogen and progesterone. Monthly periods will gradually stop and you will not be able to get pregnant. You may get symptoms of the menopause such as:

  • hot flushes and sweats
  • loss of interest in sex
  • difficulty sleeping
  • needing to pass urine more often
  • weight gain

Radioprotective Drugs For Reducing Side Effects

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One way to reduce side effects is by using radioprotective drugs, but these are only used for certain types of radiation given to certain parts of the body. These drugs are given before radiation treatment to protect certain normal tissues in the treatment area. The one most commonly used today is amifostine. This drug may be used in people with head and neck cancer to reduce the mouth problems caused by radiation therapy.

Not all doctors agree on how these drugs should be used in radiation therapy. These drugs have their own side effects, too, so be sure you understand what to look for.

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How Is Joint Pain Treated And Managed

When possible, your health care team will treat the condition that is causing the joint pain. Possible treatment options include the information below.

Often, joint pain can be relieved with medications. Some of the medications that your health care team may suggest or prescribe include:

  • Pain relievers including acetaminophen and nonsteroidal anti-inflammatory drugs , such as ibuprofen , naproxen and celecoxib

  • Corticosteroids, which reduce swelling and inflammation

  • Certain anticonvulsants and antidepressant medications that may block pain signals

  • Antibiotics, if it is a joint infection

Your health care team may also recommend self-care and support methods of treating joint pain. You may decide to do some of these methods in addition to medication or instead of medication for mild joint pain. Some of these practices you can do on your own. Others require you to work with a licensed or certified specialist. Talk with your health care team before trying these methods.

Some self-care and support methods you can use to treat joint pain are:

Physical therapy. A physical therapist can help restore function in a joint, as well as teach you how to relieve pain using simple exercises or assistive devices.

Acupuncture. Some studies show that acupuncture can help relieve joint pain related to aromatase inhibitor therapy. Acupuncture involves placing small needles in specific points of the body.

What Types Of Radiotherapy Are There

There are two common types of external beam radiotherapy:

  • intensity-modulated radiotherapy
  • 3-dimensional conformal radiotherapy .

You may also hear about image guided radiotherapy . This is part of all radiotherapy treatments. Taking images of the prostate before each treatment allows your radiographer to make small changes to the area that is going to be treated, in case the prostate has moved slightly since your last treatment session. This makes sure the surrounding healthy tissue gets as little radiation as possible. It also makes sure the whole prostate is treated.

Intensity-modulated radiotherapy

This is the most common type of external beam radiotherapy in the UK. A computer uses the scans from your radiotherapy planning session to map the location, size and shape of your prostate. The radiotherapy machine gives beams of radiation that match the shape of the prostate as closely as possible. This helps to avoid damaging the healthy tissue around it, reducing the risk of side effects.

The strength of the radiation can be controlled so that different areas get a different dose. This means a higher dose of radiation can be given to the prostate without causing too much damage to surrounding tissue.

3D conformal radiotherapy

As with IMRT, the radiation beams are mapped to the size, shape and position of the prostate. But the strength of the radiation cant be controlled in 3D-CRT, so all areas are treated with the same dose.

Other types of radiotherapy

Proton beam therapy

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What Is Proton Beam Radiation Therapy

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.

Prostate Cancer: Radiation Therapy

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Radiation therapy, also called X-ray therapy, uses high levels of radiation to kill prostate cancer cells or keep them from growing and dividing while minimizing damage to healthy cells.

Radiation can be given from a machine outside the body and directed at the prostate . Or a surgeon can place radioactive materials into the tumor . These radioactive materials can be temporary or permanent.

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Questions To Ask Your Doctor Nurse Or Radiographer

You may find it helpful to keep a note of any questions you have to take to your next appointment.

  • What type of radiotherapy will I have?
  • How many sessions will I need?
  • What other treatment options do I have?
  • What are the possible side effects and how long will they last?
  • What treatments are available to manage the possible side effects from radiotherapy?
  • Will I have hormone therapy and will this carry on after radiotherapy?
  • How and when will I know if radiotherapy has worked?
  • If the radiotherapy doesnt work, which other treatments can I have?
  • Who should I contact if I have any questions?
  • What support is there to help manage long-term side effects?

Osteoradionecrosis Of The Hip A Troublesome Complication Of Radiation Therapy: Case Series And Systematic Review

  • 1Department of Orthopedics, China-Japan Union Hospital of Jilin University, Changchun, China
  • 2Department of Orthopedics, The Second Hospital of Jilin University, Changchun, China

Background: Osteoradionecrosis of the hip is a serious complication of radiotherapy that is easily overlooked by physicians and patients in the early stages. There are relatively few reports on this subject, so there is no clear scientific consensus for the pathogenesis, early diagnosis, and clinical treatment of hip osteoradionecrosis. In this paper, we report two cases of hip osteoradionecrosis and systematically review the related literature.

Case Presentation: We report two cases of hip osteoradionecrosis. One patient successfully underwent total hip arthroplasty in our hospital and recovered well postoperatively. Another patient although we offered a variety of surgical options for this patient, the patient was worried that the bone loss would lead to poor prosthesis fixation, resulting in prosthesis loosening and infection, and therefore ultimately refused surgical treatment.

With the development of radiological techniques, the incidence of hip osteoradionecrosis is decreasing year by year, but early diagnosis and rational treatment remain challenging. The effects of non-surgical treatment are limited. Early prevention, early detection, and early intervention are crucial to delay or prevent the emergence of more serious complications.

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Radiation Therapy And Fertility

You must use contraception during your treatment if youre sexually active and you or your partner could get pregnant. You should not conceive a child while youre getting radiation therapy to your pelvis and for 1 to 2 years after your treatment is finished. For more information, read the section Sexual health in this resource.

If you would like to have children after your radiation therapy, speak with your doctor before you begin your treatment.

Questions To Ask Your Radiation Oncologist

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Before your appointment, its helpful to write down the questions you want to ask your radiation therapy care team. Examples of questions you can ask are listed below. Write down the answers during your appointment so you can review them later.

What kind of radiation therapy will I get?

How many radiation treatments will I get?

What side effects should I expect during my radiation therapy?

Will these side effects go away after I finish my radiation therapy?

What kind of late side effects should I expect after my radiation therapy?

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Early And Late Effects Of Radiation Therapy

  • Early side effects happen during or shortly after treatment. These side effects tend to be short-term, mild, and treatable. Theyre usually gone within a few weeks after treatment ends. The most common early side effects are fatigue and skin changes. Other early side effects usually are related to the area being treated, such as hair loss and mouth problems when radiation treatment is given to this area.
  • Late side effects can take months or even years to develop. They can occur in any normal tissue in the body that has received radiation. The risk of late side effects depends on the area treated as well as the radiation dose that was used. Careful treatment planning can help avoid serious long-term side effects. Its always best to talk to your radiation oncologist about the risk of long-term side effects.

Speaking With Your Healthcare Professional

It is important that your healthcare professional tries to diagnose the underlying cause of the bone changes, rather than simply treating the symptom itself.

You can speak with:

  • your clinical nurse specialist
  • your cancer doctor .

It can help to speak to a healthcare professional you already know, trust and who has an understanding of your medical history.

You might be having this conversation years after you have finished your treatment, so it is a good idea to be clear about what is happening. You could:

  • tell them that these bone changes happened after pelvic radiotherapy treatment
  • tell them when the symptoms started
  • tell them how long the symptoms have lasted for
  • explain the impact the symptoms are having on your life be prepared to give all the details.

It may be helpful to write down what you experience day-to-day.

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Symptoms Of Bowel Changes

Possible symptoms of late effects to the bowel include:

  • bleeding from the back passage
  • passing mucus
  • cramps or spasms in the bowel, which may be painful
  • feeling that you need to pass stools even when your bowel is empty this is called tenesmus
  • not being able to empty the bowel completely
  • diarrhoea or constipation
  • needing to rush to empty your bowels
  • problems controlling your bowel, causing leakage or soiling
  • passing a lot of wind, or losing control of passing wind.

Some people have mild symptoms that do not cause too many problems. They may only notice small changes, such as having to go to the toilet twice a day instead of once. For other people, bowel changes have a much bigger impact and can affect daily life. Bowel symptoms can affect your appetite or weight. Talk to your doctor if you notice that you are losing weight.

It is important that you get ongoing bowel symptoms checked by your doctor.

These symptoms might not be caused your radiotherapy treatment. They can be a sign of a more serious problem. It is important to find out the cause as soon as possible.

There are 4 symptoms you must always talk to your doctor about:

  • passing blood from your back passage
  • waking up from sleep to open your bowels
  • needing to rush to open your bowels
  • bowel incontinence.

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