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.
Frequent Or Loose Poo
Your bowel movements might be looser or more frequent than before your treatment.
You might need to take anti diarrhoea medicines, such as loperamide . Bulking agents, such as Fybogel might;also help. Your doctor or nurse can prescribe these for you,;talk to your doctor before taking these.
You might find that you need to avoid high fibre foods.;Although we normally think that a high fibre diet is the most healthy, it might make long term diarrhoea worse. Some people find it best to avoid high fibre vegetables, beans and pulses .
Let your doctor know if you have ongoing problems with frequent bowel movements or bleeding. They can refer you to a specialist team. The team includes cancer doctors, digestive system specialists, bowel surgeons, dietitians and specialist nurses.
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?
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Radioprotective Drugs For Reducing Side Effects
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.
Changes To Your Blood Cell Counts
Bone marrow is the substance inside your bones that makes blood cells. You have 3 kinds of blood cells. White blood cells fight off infection. Platelets help your blood to clot when you injure yourself. Red blood cells carry the oxygen you need for energy.
You may have lowered blood cell counts when large areas of bone marrow are in the area being treated. If youre also getting chemotherapy, it can also impact your blood cell count.
We may monitor you throughout your treatment with a blood test called a complete blood count . If your counts drop, we may stop your treatment until the level increases. We will discuss this with you.
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What Are The Side Effects Of Brachytherapy
- Frequent urination or urinary retention or burning with urination
- Erectile dysfunction
- Urethral stricture or narrowing of the urethra
- Diarrhea or blood in the stool
- Secondary cancers
For the short time that the seeds are giving off larger amounts of radiation, you should avoid close proximity to children or pregnant women. Make sure to talk with your radiation oncologist or oncology nurse for instruction about radiation safety and exposure for family members or pets.
If you are traveling through an airport following brachytherapy treatment, there is a chance that radiation detectors will be set off. Talk to your radiation oncologist and ask for a note to indicate youve just had radiation treatment.
Short Term Side Effects
Patients who receive any type of radiation therapy to treat their prostate cancer can have side effects. Short term side effects are ones that start during or shortly after your radiation treatment. Below is a list of possible short term side effects. Treatments can affect each patient differently, and you may not have these particular side effects. Talk with your care team about what you can expect from your treatment
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Proton Beam Radiation Therapy
Proton beam therapy focuses beams of protons instead of x-rays on the cancer. Unlike x-rays, which release energy both before and after they hit their target, protons cause little damage to tissues they pass through and release their energy only after traveling a certain distance. This means that proton beam radiation can, in theory, deliver more radiation to the prostate while doing less damage to nearby normal tissues. Proton beam radiation can be aimed with techniques similar to 3D-CRT and IMRT.
Although in theory proton beam therapy might be more effective than using x-rays, so far studies have not shown if this is true. Right now, proton beam therapy is not widely available. The machines needed to make protons are very expensive, and they arent available in many centers in the United States. Proton beam radiation might not be covered by all insurance companies at this time.
Why Does Radiation Therapy Cause Side Effects
High doses of radiation therapy are used to destroy cancer cells. Side effects come from damage to healthy cells and tissues near the treatment area. There have been major research advances in radiation therapy in recent years that have made it more precise. This has reduced this treatment’s side effects, compared to radiation therapy techniques used in the past.
Some people experience few side effects from radiation therapy. Or even none. Other people experience more severe side effects.
Reactions to the radiation therapy often start during the second or third week of treatment. Or, they may last for several weeks after the final treatment. Some side effects may be long term. Talk with your treatment team about what to expect.
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Your Role On Your Radiation Therapy Team
You will have a team of healthcare providers working together to provide the right care for you. Youre a part of that team, and your role includes:
- Arriving on time for all of your radiation therapy sessions.
- Asking questions and talking about your concerns. We have included a list of possible questions at the end of this resource.
- Telling someone on your radiation therapy team when you have side effects.
- Telling your doctor or nurse if you are in pain.
- Caring for yourself at home:
- Quitting smoking, if you smoke.
- Following your healthcare teams instructions to care for your skin.
- Drinking liquids as instructed by your healthcare team.
- Eating the foods suggested by your healthcare team.
- Maintaining your weight.
What Are The Side Effects
Urinary symptoms are the most common. These include frequent urination and a need to get to the bathroom quickly. Some men have a burning with urination and, in a few cases, an inability to empty the bladder completely.
These symptoms can usually be managed with medicine, and they improve over time. Temporary self-catheterization may be necessary to help drain the bladder.
Urinary incontinence from brachytherapy is rare. The risk may be somewhat increased in patients who have undergone a previous surgical procedure to remove a part of the prostate called a TURP . A doctor can minimize this risk by doing a careful prostate ultrasound before the procedure to determine how much prostate tissue is still present to implant the seeds.
The impotence rate at five years after the procedure is about 25% using brachytherapy alone. If hormone therapy is added, the impotence rate rises depending on the duration of the hormonal treatment.
Bowel problems can sometimes happen and include rectal pain, burning pain and diarrhea.
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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.
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.
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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.
What Are The Different Types Of Internal Radiation Therapy
Brachytherapy and radiopharmaceuticals are both considered internal radiation therapies because they both work after being inserted inside the body, rather than being directed from outside. However, the similarities mostly end there. Brachytherapy works by implanting radioactive material into the prostate and is used for localized prostate cancer. Radiopharmaceuticals are injected into the bloodstream and are used for advanced, metastatic prostate cancer. Read on to find the details of each.
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What Are The Long
A new five-year study identifies how different treatment options affect long-term bowel, bladder and sexual function.
Any man who is diagnosed with prostate cancer and faces treatment choices must grapple with the risk of side effects. Urinary incontinence and erectile dysfunction are the most common. Sometimes, these side effects are temporary and get better with time.
Until now, however, there havent been good long-term data to help oncologists help men with prostate cancer make informed choices about treatment that take these side-effect risks into account.
The new study included more than 2,000 men who were followed for five years after receiving various types of prostate cancer treatment. The resulting paper quantifies key differences in those treatments associations with long-term bowel, bladder and sexual function. The study, called CEASAR, for the Comprehensive Effectiveness Analysis of Surgery and Radiation for Localized Prostate Cancer, is coordinated by the Vanderbilt University Medical Cancer and follows men who were diagnosed with localized prostate cancer between 2011 and 2012.
The 1,386 men with favorable-risk prostate cancer received one of these treatments:
The 619 men with unfavorable-risk prostate cancer received one of two treatments:
There were no clinically significant differences in bowel function after five years across the treatment types.
To read a press release about the study, .
To read the study abstract, .
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Stereotactic Body Radiation Therapy
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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Advantages And Disadvantages Of External Beam Radiotherapy For Early Prostate Cancer
You may want to think about the advantages and disadvantages of external beam radiotherapy when deciding about treatment.
Radiotherapy and radical prostatectomy;are both treatments that may cure early prostate cancer. They are equally effective in treating the cancer.
To choose the treatment that is best for you, it can help to look at the different advantages and disadvantages of each one. You can then make your decision;in partnership with your doctor.
Long Term Side Effects
Once the inflammation is all healed, there can be some scarring that occurs. ;This is one way in which the body heals inflammation. ;Scarring can cause long term side effects. ;An example would be some scarring of the blood vessels and nerves that control the erections, which would result in erectile dysfunction .
Long term side effects are harder to treat, because it is not easy to treat scar tissue. ;Treatments like hyperbaric oxygen therapy and laser therapy may be required. ;As well, long term side effects can be long lasting or permanent.
Fortunately, the most common urinary and rectal side effects with prostate radiation are short term side effects. ;The only common long term side effect is weakening of the erections. ;Less common long term side effects are bleeding from the rectum and incontinence .
Q) Will I feel sick while Im on radiation?
A) No. ;The side effects are mostly in the prostate, rectum, and bladder area.
Q) I have heard that radiation can burn you up. ;Will I get burns on my skin?
A) No. ;There is usually no skin reaction from prostate radiation. ;Occasionally there can be a few pinkish patches that go away in a few weeks.
Q) Will I be able to work? ;Will I be able to drive? ;Will I be able to play golf?
A) Yes, yes, yes!
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What Is Radiation Treatment For Prostate Cancer
More than half of people undergoing cancer treatment get radiation therapy.
The treatment uses concentrated waves of intense energy to destroy cancer cells. The radiation may be in the form of X-rays, gamma rays, electron beams, or protons. These high-energy waves break down the DNA inside cancer cells and prevent them from replicating.
Radiation therapy can also damage healthy cells, but treatment seeks to minimize damage to healthy tissue. Normal cells can often recover from damage once treatment stops.
- as the first treatment for low-grade cancer contained to the prostate gland
- as the first treatment in combination with hormone therapy for cancer thats growing outside the prostate and into nearby tissue
- after surgery if the surgery doesnt completely get rid of the cancer or if the cancer grows back
- to keep advanced cancer under control and to help prevent symptoms
Two types of radiation therapy are used to treat prostate cancer. These are external beam radiation therapy and brachytherapy.
If Youre Getting Radiation Therapy To The Brain
People with brain tumors often get stereotactic radiosurgery if the cancer is in only one or a few sites in the brain. Side effects depend on where the radiation is aimed. Some side effects might show up quickly, but others might not show up until 1 to 2 years after treatment. Talk with your radiation oncologist about what to watch for and when to call your doctor.
If the cancer is in many areas, sometimes the whole brain is treated with radiation. The side effects of whole brain radiation therapy may not be noticeable until a few weeks after treatment begins.
Radiation to the brain can cause these short-term side effects:
- Trouble with memory and speech
Some of these side effects can happen because radiation has caused the brain to swell. Medicines are usually given to prevent brain swelling, but its important to let your cancer care team know about headaches or any other symptoms. Treatment can affect each person differently, and you may not have these particular side effects.
Radiation to the brain can also have side effects that show up later usually from 6 months to many years after treatment ends. These delayed effects can include serious problems such as memory loss, stroke-like symptoms, and poor brain function. You may also have an increased risk of having another tumor in the area, although this is not common.
Talk with your cancer care team about what to expect from your specific treatment plan.
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